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Most common one of the four types of oral candidiasis
Pseudomembranous, aka thrush
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Gingival diseases of fungal origin
- Common in immunocompromised patients caused by disease (HIV etc) or medication (steroids etc).
- Seen in patients where normal flora is disrupted (opportunistic).
- Most common oral fungal infection is Candidiasis.
- a. Common under prosthetic devices.
- b. White patches on gingiva, tongue, or oral mucous membranes. Can be easily wipe off.
- c. Diagnosis of candida infection can be made by culture, smear or biopsy.
- Histoplasmosis.
- Treat w/ common anti-fungi drugs.
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Herpetic gingivostomatitis
- HSV-1
- children
- vesicle formation,
- fever,
- gingival inflammation
- Acute onset (severe or not, depending on the patient and dose of virus exposed to)
- vesicles are contagious
- Latency in ganglia
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Herpetic gingivostomatitis - oral symptoms
- Generalized “soreness” of the oral cavity
- Ruptured vesicles are the focal sites of pain
- Eating, drinking, oral hygiene affected
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Secondary Herpetic gingivostomatitis
- Stimuli: sunlight, trauma, fever, stress
- Herpes labialis
- palate, gingiva , mucosa
- pain away from the site of stimuli 2 to 4 days later
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HIV-related periodontal disease
- Oral Signs & Symptoms
- Candidiasis
- Lymphadenopathy
- Viral Lesions
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Oral Hairy Leukoplakia (HL)
- White lesions
- Primarily found on lateral border of tongue.
- Surface of lesion can be smooth or corrugated & does
- not rub off.
- Most likely a viral induced lesion
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Oral Hairy Leukoplakia (HL)
- White lesions
- Primarily found on lateral border of tongue.
- Surface of lesion can be smooth or corrugated & does
- not rub off.
- Most likely a viral induced lesion. 99% HIV related
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HIV-related periodontal diseases
- Viral Lesions
- Oral Papillomas
- Condyloma acuminatum
- Focal eipthelial hyperplasia
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HIV-related neoplastic lesions
- Kaposi Sarcoma
- Malignant lesion arising from lymphatic or
- vascular endothelium.
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HIV associated gingivitis (HIV-G) or (LGE)
- Linear Gingival Erythema.
- 1. Persistent & easily bleeding.
- 2. Lesions can be localized or generalized.
- 3. May be limited to marginal tissues.
- 4. Can also extend into attached gingiva and into alveolar mucosa.
- 5. Oral candida identified with LGE.
- 6. Some LGE lesions may undergo spontaneous
- remission.
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HIV associated periodontitis (HIV-P) - Treatment
- 1. Mechanical debridement.
- 2. Chemotherapeutic agents.
- 3. Home care instructions.
- 4. Routine maintenance care.
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Oral lesions strongly associated with HIV-infection
- 1.Candidiasis
- 2.HL
- 3.Kaposi’s sarcoma
- 4.Non-Hodgkin’s Lymphoma
- 5.Periodontal Diseases
- a. LGE
- b. NUP
- c. NUG
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Muco-cutaneous disorders: desquamative gingivitis
- Tissue peeling off
- Lichen Planus - T cells involved
- BMMP - Benign mucus membrane pemphigoid. Targets B cells
- Pemphigus Vulgaris
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Most common additive in toothpaste is cinnamon flavoring and can cause
desquamative gingivitis
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must do immunofluorescence biopsy on intact tissue to diagnose or differentiate between
Lichen planus and BMMP
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desquamative gingivitis - Treatment:
- Eliminate etiology
- Steroids
- 1.Topical
- 2.Intra-lesional
- 3.Systemic
- Appropriate referral to medical specialist
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