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Applied Oral Pathology
through Interactive
Learning
Infectious Diseases
Rachel S. Ennis
MDH707 Spring 2011
Infectious Diseases
Chapter 4 Objectives
Inflammatory and immune response
Causes of opportunistic infection
Organisms involved in specific infectious
diseases
Oral candidiasis; five forms
Herpes labialis; clinical features
Recurrent intraoral herpes simplex
infection; clinical features
Minor aphthous ulcers; clinical features
Objectives continued:
Herpes Zoster; clinical characteristics
Epstein-Barr Virus; four associated
diseases
Coxsackie virus and oral
manifestations
Oral manifestations of HIV infection;
clinical appearance
Any ideas?
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Acute Necrotizing
Ulcerative Gingivitis
Edematous and erythematous gingiva
Cratered or “punched out”
interdental papillae
Painful
Foul odor
Metallic Taste
Associated with decreased resistance
Caused by Fusiform bacilli,
and spirochetes
Inflammatory and Immune
Response
Inflammatory response: body’s first
line of defense against tissue injury
and disease-producing
microorganisms
Immune response: defends body
against injury, remembers past
instances of injury
Opportunistic Infection
Alteration in the oral micro flora
Organisms that are normally
nonpathogenic are able to cause
disease
Opportunistic infections of
the oral cavity
Dental caries
Periodontal disease
Infectious Diseases and the organisms
involved
Impetigo: Staph Aureus, Staph pyogenes.
Tonsillitis and Pharyngitis: Streptococci, Adenoviruses,
Influenza, and Epstein-Barr virus
Tuberculosis: Mycobacterium tuberculosis
Actinomycosis: Actinomyces israelii
Syphilis: Treponima pallidum
Veruca vulgaris: Human papilloma virus
Condyloma acuminatum: Human papilloma virus
Primary herpetic gingivostomatitis: Herpes simplex virus
Acute Necrotizing Ulcerative Gingivitis: Borrelia vincentii
fusiform bacillus, and spirochete
Impetigo
Adult male with impetigo
on chin
Child with impetigo on chin
Syphilis chancre
Dorsal surface of tongue
Actinomycosis
Left mandible
Condyloma acuminatum
Lower lip
Oral Candidiasis
(thrush)
Pseudomembranous
Erythematous
Denture stomatitis (chronic atrophic
candidiasis)
Chronic hyperplastic candidiasis
Angular cheilitis
Angular cheilitis
Commissure of lips
Pseudomembranous
candidiasis
Hard palate
Herpes Labialis
Caused by herpes simplex virus
Also called “cold sore or fever
blister”
Vermillion of lips
Herpes Labialis
Vesicles on lips and vermillion boarder
Herpes Labialis
Lower lip
Recurrent intraoral herpes
simplex infection
Herpes simplex virus
Keratinized mucosa (hard palate,
and gingiva
May be caused by sunlight,
menstruation,fatigue,fever,stress
Painful, focal crops of vesicles
Prodromal symptoms:
pain,burning,tingling
Primary Herpes Simplex
Infection
Dorsal surface of tongue
Minor aphthous ulcers
Nonkeratinized mucosa
One to several ulcers present
No vesicle preceding ulcer
Pain
<1cm
Round to oval
Can recur
Minor aphthous ulcer
Floor of mouth
Major Aphthous Ulcer
Soft palate
Herpes Zoster
Shingles
Unilateral, painful eruption of
vesicles along sensory nerve
May affect three branches of
trigeminal nerve
Prodromal symptoms: pain,
burning,paresthesia
May last several weeks
Herpes Zoster
Shingles
Varicella Zoster
Lips and palate
Epstein-Barr Virus
Infectious Mononucleosis
Palatal petichiae
kissing disease
Nasopharyngeal carcinoma
Burkitt lympoma
Hairy Leukoplakia
usually on lateral border of tongue
Hairy Leukoplakia
Lateral boarder of tongue
Coxsackievirus
Discovered in Coxsackie, NY
Transmission by fecal-oral contamination,
saliva, respiratory droplets
May cause:
Herpangina
Hand-Foot-and Mouth Disease
Acute Lymphonodular Pharyngitis
Coxsackie virus
Sores on dorsal surface of tongue and palate
HIV and Oral Lesions
Candidiasis
Herpes simplex infection
Herpes Zoster
Hairy Leukoplakia
Human papilloma virus lesions
Atypical gingivitis and periodontitis
Kaposi sarcoma
Non-Hodgkin lymphoma
Aphthous ulcers
Mucosal pigmentation
Bacterial salivary gland enlargement and xerostomia
Spontaneous gingival bleeding resulting from
thrombocytopenia
HIV associated thrush
Soft palate
Papilloma
Papilloma on soft palate
Papilloma
Lateral boarder of tongue
Papilloma
Buccal Mucosa
Kaposi sarcoma
HIV infection
!
References
Ibsen, O., Phelan, J.A. (2009). Oral pathology for the dental hygienist, 5thed.
St. Louis, MO: Saunders Elsevier.
Langlais, R. P. , Miller, C.S. , Nield-Gehrig, J. S. (2009) Color atlas of common
oral diseases, 4thed. Philadelphia, PA: Lippincott Williams and Wilkins.