Transcript ORAL MUCOSA DISEASES Dr. Shahzadi Tayyaba Hashmi [email protected] VIRAL INFECTIONS Incubation period: • The time taken for the virus to infect the host, replicate and for cellular.

ORAL MUCOSA
DISEASES
Dr. Shahzadi Tayyaba
Hashmi
[email protected]
VIRAL INFECTIONS
Incubation period:
• The time taken for the virus to infect the host, replicate and for
cellular damage is known as incubation period
• Duration is from 3 to 21 days
• Most severe viral infections last between 10 and 14 days after
which time the host has mounted an effective immune
response and the infection resolves
Viral infections in oral cavity
The common viral infections affecting the oral
cavity are:
1. Herpes zoster: primary and secondary
2. Herpes simplex: primary and secondary
3. Hand, foot and mouth disease
4. Herpangina
Of these infections, herpes simplex is most
common and important
1)HERPES SIMPLEX
a) Primary herpes ( primary gingivoherpetic
stomatitis)
b) Secondary herpes ( cold sores)
A)PRIMARY HERPES
Etiology:
• Caused by herpes simplex virus type 1, which is transmitted
in saliva
Clinical Features:
• Fever and enlarged lymph nodes in the neck ( cervical
lymphadenopathy)
• Painful blisters known as vesicles develop on the gingiva,
palate, buccal mucosa and tongue. These bristles burst to form
superficial ulcers covered in grey-white slough
• Surrounding tissues are red and lips may appear swollen
• Difficulty in swallowing and eating
• Affects children and young adults
Vesicles on Lips, Fever and enlarged Lymph nodes
TREATMENT
• Isolation and bed rest advised because patients are highly
infectious
• Most treatment is symptomatic and the disease resolves about
10-14 days
• Soft diet and adequate fluid intake
• Antipyretics and analgesics for the symptoms
.
B) SECONDARY HERPES
Key features:
• After a person’s initial herpes simplex virus infection, the herpes
virus remains dormant in the ganglion of the trigeminal nerve and
is reactivated by a number of agents including sunlight, stress
and menstruation
• It travels down the trigeminal nerve to form characteristic
vesicles, which burst on the lips
• The lips may become swollen and the lesions are known as cold
sores
TREATMENT
• Treatment with antiviral agents at this stage may shorten the
course of the disease which otherwise lasts 10-14 days
• Patient is infectious during this time and dental treatment should
be avoided
2) Varicella zoster viral
infections
VARICELLA ZOSTER VIRAL
INFECTIONS
• The primary infection of Varicella zoster virus
( VZV) is known as Varicella or chicken pox
• The recurrent disease is known as herpes zoster or shingles
1) PRIMARY INFECTION OF VZV
( CHICKEN POX)
Clinical features:
• Initial infection of VZV which is common in children
• Primary infection includes fever, headache, sore throat and lung
congestion
• Incubation period lasts up to 21 days
• After an incubation period, patient develops a rash accompanied by
low-grade fever
• Lesions quickly progress to vesicles that rupture and become crusted
• Small number of vesicular lesions are found on oral mucosa including
the tongue, buccal mucosa, gingiva and palate
• If patients are immunocompromised, death can also occurs
Treatment:
• Symptomatic treatment
Stages of chicken pox
2) SECONDARY VZV INFECTION
(SHINGLES)
Key features:
• Is the recurrent form of Varicella infection
• Caused by reactivation of VSV latent in the dorsal ganglion
during the primary infection
• More common in adults who are immunocompromised
• Most common clinical feature is the linear vesicular rash on
the skin
• Factors that decrease immune function such as human
immunodeficiency virus infection, chemotherapy and
malignancies increase the risk of herpes zoster
TREATMENT
• Orally administered acyclovir
• The antiviral medications are most effective
when started within 72 hours after the onset of
the rash
3)HAND, FOOT AND MOUTH DISEASE
4)HERPANGINA
Hand, foot and mouth disease and
Herpangina
Key Features:
• These two infections are caused by the coxsackie A virus
• Relatively mild diseases usually affect children
• In both infections, the lesions are characterized by vesicles,
which break down to form shallow ulcers
• In hand, foot and mouth disease almost any part of the oral
mucosa may be affected together with the hands and the
plantar surfaces of the feet
• In herpangina, the lesions may affect the soft palate, tonsils
and pharynx and the patient usually complains of a sore throat
• In both conditions lesions resolve within a few days
HERPANGINA