-
How many URI's are common for kids per year?
6-10
-
Caries usually begin in the ______ and ________.
-
If left untreated, caries usually destroy the tooth and invade the _______.
dental pulp
-
What can occur when dental pulp is invaded?
dental abscess
-
Pulpitis progresses to __________.
necrosis
-
Bacterial invasion of alveolar bone.
dental abscess
-
10% of normal infants are colonized with Thrush in the GI & Resp tract at how old?
5 days
-
The skin is usually colonized with Thrush at what age?
2 weeks
-
Oral candidiasis may be associated with _________ candidiasis.
diaper
-
Tx for Thrush.
- Generally self-limiting (3-8 wks)
- PO Nystatin painted on
- Gentian Violet
- should be better by 14 wks
- *Diflucan for breasts
-
Pharyngitis is uncommon in kids less than _______.
one yoa
-
Pharyngitis peaks at what age?
4-7
-
What causes most acute pharyngitis?
- Rhinovirus, coronavirus, adenovirus (30%)
- Influenza & parainfluenza (4%)
- Epstein Barr (1%)
-
GABHS accounts for 37% of acute pharyngitis in kids what age?
older than 5 yrs
-
Gradual onset of fever, malaise, anorexia, moderate throat pain, conjunctivitis, rhinitis, cough, hoarseness, ulcerative lesions; possible diarrhea.
Viral pharyngitis
-
Sudden onset of fever, h/a, n/v, abdominal pain, tonsillopharyngeal inflammation, palatal petechiae, tender cervical nodes.
GABHS
-
Common age for GABHS
5-15 yoa
-
h/a & abdominal pain w/ vomiting; fever as high as 104, sore throat, anterior cervical lymphadenopathy; petechial mottling of soft palate.
Acute bacterial pharyngitis
-
Strep should be treated when?
within first 9 days of s/s
-
Which three abx are used to tx bacterial pharyngitis?
- PCN
- cephalosporins
- macrolides
-
Recurrent or persistent sore throat; pain w/ swallowing; obstruction to swallowing or breathing; enlarged cervical lymph nodes; mouth breathing; sleep apnea.
chronic tonsilitis
-
What is ptyalism?
- excess saliva
- can be from meds
-
What is sialosis?
bilaterally recurring salivary gland edema
-
s/s of sialolithiasis.
painful edema that increases w/ eating
-
Tx for sialolithiasis.
- warm compresses
- analgesics
- sialagogues (stim production and flow of saliva) - lemon galls, gum, etc
- sometimes sx
-
Most common infection of parotitis.
viral mumps
-
RF for parotitis.
- poor oral hygiene
- chronic illness
- recent surgery
- immunocompromised
- hypovolemia
-
Rapid onset of pain, edema, induration in mouth; fever, chills, malaise, pain with opening mouth, foul taste.
Parotitis
-
Tx for parotitis.
- abx
- replace IVF if dehydrated
- oral hygiene (sialogogues)
- analgesics
- local heat
- massage
-
Surgical drainage for parotitis may be needed when?
- if no improvement in 3-4 days
- (CT first)
-
Shallow, painful, often recurrent lesions of mouth.
aphthous ulcers (canker sores)
-
aphthous ulcers (canker sores) can be related to?
- Crohn's
- ulceratice colitis
- gluten sensitive enteropathy
-
Gray-yellow pseudomembranous base surrounded by erythema; not typically on anterior hard palate or gingiva; NO fever or lymphadenopathy.
aphthous ulcers (canker sores)
-
Tx for aphthous ulcers (canker sores).
- symptom relief: triamcinolone in Oralbase, steroid mouth rinse w/ betamethasone
- liquid Benadryl & Kaopectate/Mylanta (1:1) swish & spit 6xday
-
Causes of stomatitis.
- chemical or heat injuries
- poorly fitting dentures
- nicotine abuse
- poor oral hygiene
-
Tx for thrush should be continued how long?
48 hours after symptoms resolve
-
Inflammation of the tongue
glossitis
-
Causes of glossitis
- allergic rxn toothpaste, mouthwash
- dry mouth
- infection
- burn injuries
- low iron levels or B12
- tobacco use
-
Irregular patches on the surface of the tongue; can move daily; some have burning and pain. Cause?
- Geographic tongue
- May be r/t B-vitamin deficiency
-
Inflammatory condition of the mucus membranes of the mouth (inside of cheeks, tongue, throat, esophagus, inside of lips); may appear as white lacy patches, red swollen tissue, or open sores.
Oral Lichen Planus
-
_____________ is usually chronic and may appear as white lacy patches, red swollen tissue, or open sores in mouth; may have metallic taste.
Oral Lichen Planus
-
Oral Lichen Planus is thought to be what?
- an abnormal immunce response
- from HepB or HepC
- can be triggered by NSAID use
-
Tx for Oral Lichen Planus.
- steroids
- retinoids
- nonsteroidal ointments
- *Treat cause*
-
Which symptoms, if present with hoarseness, warrants r/o of neoplasm, systemic disease, or neuro causes?
- cough
- SOB
- wt loss
- dysphagia
- ear or throat pain
-
Tx for laryngitis
vocal rest, NSAIDs
-
If s/s of laryngitis last longer than ________ weeks, it may indicate other causes.
3 weeks
-
Hoarseness that is altered by ________ suggests a mobile lesion such as a polyp.
position
-
Oral CA is only discovered when?
when it has metastasized, usually lymph nodes of neck.
-
HPV ___ can be a cause of oral cancer.
16
-
What type of mouth patches are most likely to become malignant? Least likely?
- Red patches (erythroplakia)
- White patches least likely (leukoplakia)
- Mixed more likely than white (erythroleukoplakia)
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