PATHOLOGY OF THE ORAL MUCOSA

PATHOLOGY OF THE ORAL MUCOSA

Oral mucosal pathologies

The oral mucosa includes the tongue, the floor of the tongue, the gums, the inner surface of the cheeks and lips, the palate and the soft palate. Just like the skin, to which it is very similar in terms of constitution, it is exposed to all kinds of aggressions, whether bacterial, viral, mycotic (fungi), physical, chemical or thermal and can be the site of an extremely varied pathology, the main forms of which are discussed in the following lines.

Most of the lesions encountered are benign, but they can be the beginnings of much more serious lesions, which is why the slightest anomaly detected in the mouth should prompt you to consult a specialist. In this sense, the Dental Surgeon is often on the front line in the screening and prevention of certain oral pathologies. By examining a lesion, he may be led to trigger diagnostic procedures and initiate therapeutic action. He therefore often represents the first link in the therapeutic chain.

Canker sores

These are benign lesions that represent a frequent reason for consultation. They are painful ulcers of the oral mucosa. They are superficial, of variable size and location and are often perceived as burns. The known factors promoting their appearance are stress, certain foods such as nuts, Gruyere cheese, spices, kiwis, certain medications (e.g. aspirin, antibiotics), trauma (irritating dental prosthesis or filling, bite, slipping toothbrush), certain infections. In the absence of treatment, a canker sore generally takes 10 to 15 days to heal. Treatment consists first of eliminating the obvious causes (e.g. removal of a crown that has become sharp, monitoring diet, stopping taking the medications responsible). Locally, laser therapy provides the best results, thanks to its anti-inflammatory, analgesic and biostimulant effects (accelerates tissue regeneration). Additional treatment with local antiseptics (mouthwashes or gels) will further improve healing.

Typical appearance of a canker sore

Candidiasis

Also called “thrush”, they are the result of the massive colonization of the oral mucosa by a fungus: Candida Albicans. Normally, Candida Albicans is not an enemy; it is its proliferation that makes it pathogenic. Candidiasis occurs following the alteration of the body’s defenses, such as diabetes, prolonged use of antibiotics, dry mouth, malnutrition, decreased immunity. They can appear either as white plaques or as bright red and smooth. They generally cause a loss of appetite (discomfort and discomfort when eating), pain and sometimes bleeding. Treatment consists first of eliminating the supposed causes responsible (e.g. stopping antibiotics); it is also advisable to adopt a specific diet (reduction of sugars and alcohol which promote the multiplication of yeasts, consumption of yogurts to prevent the growth of yeasts); drug treatments based on antifungals may be indicated; Finally, the use of laser for its healing action can prove very interesting, in addition to mouthwashes.

One aspect of oral candidiasis

White, red and pigmented lesions

These oral lesions are very varied and range from the most benign to cancerous lesions. Any change in the appearance of the oral mucosa, whether painful or not, is a reason for consultation, because behind this change may be hidden a potentially risky lesion. The origins of these lesions can be diverse: tobacco, trauma (teeth or dental prostheses), thermal or chemical accident, candidiasis (fungus), viral or bacterial attack, certain diseases. The therapies implemented depend on the diagnosis of these lesions, itself often made after additional examinations.

Appearance of lichen planus on the inner side of the cheek

The epulis

These are benign growths of the gum, which bleed easily and can have multiple causes. Their treatment consists of their excision.

PATHOLOGY OF THE ORAL MUCOSA

Appearance of an epulis

Herpes

These are lesions that frequently affect the lips (these are the classic “cold sores”), but they can be located in other places. They are due to a virus that regularly passes from the passive phase to the active phase. Different stimuli such as solar irradiation, psychological stress, other conditions, hormonal factors or local stimuli such as a slight burn can cause the virus to become active again and develop. There is first a feeling of tension and tingling. After a few hours, painful vesicles appear, arranged in groups and filled with a very infectious clear liquid. Then, these vesicles rupture and dry up. The duration of symptoms does not generally exceed 10 days. To limit the appearance of these lesions, it is necessary to avoid the contributing factors mentioned above. Once the lesion has set in, the treatment consists of applying an Aciclovir-based cream as early as possible. The Laser allows, for its part, a clear improvement in healing, by reducing its time. Finally, during the active phase, these lesions being highly contagious, it is necessary to avoid contact with other people and to systematically wash your hands so as not to cause dissemination to other regions (e.g. eyes).

Ministry of Higher Education and Research 

Faculty of Medicine of Algiers

Department of Dental Medicine

PATHOLOGY OF THE ORAL MUCOSA

HANDOUT

2023 / 2024

Pr AyedBelarbi

Oral mucosal pathologies

The oral mucosa includes the tongue, the floor of the tongue, the gums, the inner surface of the cheeks and lips, the palate and the soft palate. Just like the skin, to which it is very similar in terms of constitution, it is exposed to all kinds of aggressions, whether bacterial, viral, mycotic (fungi), physical, chemical or thermal and can be the site of an extremely varied pathology, the main forms of which are discussed in the following lines.

Most of the lesions encountered are benign, but they can be the beginnings of much more serious lesions, which is why the slightest anomaly detected in the mouth should prompt you to consult a specialist. In this sense, the Dental Surgeon is often on the front line in the screening and prevention of certain oral pathologies. By examining a lesion, he may be led to trigger diagnostic procedures and initiate therapeutic action. He therefore often represents the first link in the therapeutic chain.

Canker sores

These are benign lesions that represent a frequent reason for consultation. They are painful ulcers of the oral mucosa. They are superficial, of variable size and location and are often perceived as burns. The known factors promoting their appearance are stress, certain foods such as nuts, Gruyere cheese, spices, kiwis, certain medications (e.g. aspirin, antibiotics), trauma (irritating dental prosthesis or filling, bite, slipping toothbrush), certain infections. In the absence of treatment, a canker sore generally takes 10 to 15 days to heal. Treatment consists first of eliminating the obvious causes (e.g. removal of a crown that has become sharp, monitoring diet, stopping taking the medications responsible). Locally, laser therapy provides the best results, thanks to its anti-inflammatory, analgesic and biostimulant effects (accelerates tissue regeneration). Additional treatment with local antiseptics (mouthwashes or gels) will further improve healing.

PATHOLOGY OF THE ORAL MUCOSA

Typical appearance of a canker sore

Candidiasis

Also called “thrush”, they are the result of the massive colonization of the oral mucosa by a fungus: Candida Albicans. Normally, Candida Albicans is not an enemy; it is its proliferation that makes it pathogenic. Candidiasis occurs following the alteration of the body’s defenses, such as diabetes, prolonged use of antibiotics, dry mouth, malnutrition, decreased immunity. They can appear either as white plaques or as bright red and smooth. They generally cause a loss of appetite (discomfort and discomfort when eating), pain and sometimes bleeding. Treatment consists first of eliminating the supposed causes responsible (e.g. stopping antibiotics); it is also advisable to adopt a specific diet (reduction of sugars and alcohol which promote the multiplication of yeasts, consumption of yogurts to prevent the growth of yeasts); drug treatments based on antifungals may be indicated; Finally, the use of laser for its healing action can prove very interesting, in addition to mouthwashes.

One aspect of oral candidiasis

White, red and pigmented lesions

These oral lesions are very varied and range from the most benign to cancerous lesions. Any change in the appearance of the oral mucosa, whether painful or not, is a reason for consultation, because behind this change may be hidden a potentially risky lesion. The origins of these lesions can be diverse: tobacco, trauma (teeth or dental prostheses), thermal or chemical accident, candidiasis (fungus), viral or bacterial attack, certain diseases. The therapies implemented depend on the diagnosis of these lesions, itself often made after additional examinations.

PATHOLOGY OF THE ORAL MUCOSA

Appearance of lichen planus on the inner side of the cheek

The epulis

These are benign growths of the gum, which bleed easily and can have multiple causes. Their treatment consists of their excision.

Appearance of an epulis

Herpes

These are lesions that frequently affect the lips (these are the classic “cold sores”), but they can be located in other places. They are due to a virus that regularly passes from the passive phase to the active phase. Different stimuli such as solar irradiation, psychological stress, other conditions, hormonal factors or local stimuli such as a slight burn can cause the virus to become active again and develop. There is first a feeling of tension and tingling. After a few hours, painful vesicles appear , arranged in groups and filled with a very infectious clear liquid. Then, these vesicles rupture and dry up. The duration of symptoms does not generally exceed 10 days. To limit the appearance of these lesions, it is necessary to avoid the contributing factors mentioned above. Once the lesion has set in, the treatment consists of applying an Aciclovir-based cream as early as possible. The Laser allows, for its part, a clear improvement in healing, by reducing its time. Finally, during the active phase, these lesions being highly contagious, it is necessary to avoid contact with other people and to systematically wash your hands so as not to cause dissemination to other regions (e.g. eyes).

PATHOLOGY OF THE ORAL MUCOSA

PATHOLOGY OF THE ORAL MUCOSA