STUDY - Technical - New Dacian's Medicine
Mouth
lesions (Classical / Allopathic Medicine)
Mouth lesions
include ulcers (the most common type), cysts, firm nodules,
hemorrhagic lesions, papules, vesicles, bullae, and
erythematous lesions. They may occur anywhere on the lips,
cheeks, hard and soft palate, salivary glands, tongue,
gingivae, or mucous membranes. Many are painful and can be
readily detected. Some, however, are asymptomatic; when these
occur deep in the mouth, they may be discovered only through a
complete oral examination. (See Common mouth lesions.)
Mouth lesions can
result from trauma, infection, systemic disease, drugs, and
radiation therapy.
HISTORY:
Ask the patient when the lesions appeared and whether he has noticed pain, odor, or drainage.
Ask the patient about associated symptoms, particularly skin lesions.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Ask the patient about drug allergies. Also, ask him about his alcohol intake.
Review the patient's medical history, noting especially malignancies, sexually transmitted diseases, recent infections, and trauma.
Ask the patient about his dental history, including oral hygiene habits, frequency of dental examinations, and the date of his most recent dental visit.
Ask the patient when the lesions appeared and whether he has noticed pain, odor, or drainage.
Ask the patient about associated symptoms, particularly skin lesions.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Ask the patient about drug allergies. Also, ask him about his alcohol intake.
Review the patient's medical history, noting especially malignancies, sexually transmitted diseases, recent infections, and trauma.
Ask the patient about his dental history, including oral hygiene habits, frequency of dental examinations, and the date of his most recent dental visit.
Common mouth
lesions
Squamous cell carcinoma
Lichen planus
Ulceration from tongue biting
Gingival hyperplasia
Recurrent aphthous stomatitis
Syphilitic chancre (rare)
PHYSICAL ASSESSMENT:
Examine the lips for color and texture.
Inspect and palpate the buccal mucosa and tongue for color, texture, and contour; note especially any painless ulcers on the sides or base of the tongue. Hold the tongue with a piece of gauze, lift it, and examine its underside and the floor of the mouth. Depress the tongue with a tongue blade, and examine the oropharynx.
Inspect the teeth and gums, noting missing, broken, or discolored teeth; dental caries; excessive debris; and bleeding, inflamed, swollen, or discolored gums.
Palpate the neck for adenopathy, especially in a patient older than age 45 who smokes tobacco or uses alcohol excessively.
Squamous cell carcinoma
Lichen planus
Ulceration from tongue biting
Gingival hyperplasia
Recurrent aphthous stomatitis
Syphilitic chancre (rare)
PHYSICAL ASSESSMENT:
Examine the lips for color and texture.
Inspect and palpate the buccal mucosa and tongue for color, texture, and contour; note especially any painless ulcers on the sides or base of the tongue. Hold the tongue with a piece of gauze, lift it, and examine its underside and the floor of the mouth. Depress the tongue with a tongue blade, and examine the oropharynx.
Inspect the teeth and gums, noting missing, broken, or discolored teeth; dental caries; excessive debris; and bleeding, inflamed, swollen, or discolored gums.
Palpate the neck for adenopathy, especially in a patient older than age 45 who smokes tobacco or uses alcohol excessively.
SPECIAL
CONSIDERATIONS:
If the patient's mouth lesions are painful, a topical anesthetic may be given.
If the patient's mouth lesions are painful, a topical anesthetic may be given.
PEDIATRIC
POINTERS:
In neonates, mouth ulcers can result from candidiasis or congenital syphilis.
Causes of mouth ulcers in children include chickenpox, measles, scarlet fever, diphtheria, and hand-foot-and-mouth disease.
In neonates, mouth ulcers can result from candidiasis or congenital syphilis.
Causes of mouth ulcers in children include chickenpox, measles, scarlet fever, diphtheria, and hand-foot-and-mouth disease.
PATIENT
COUNSELING:
Instruct the patient to avoid irritants, such as highly seasoned foods, citrus fruits, alcohol, and tobacco. As appropriate, teach the patient proper oral hygiene. Tell him to report mouth lesions that don't heal within 2 weeks.
Instruct the patient to avoid irritants, such as highly seasoned foods, citrus fruits, alcohol, and tobacco. As appropriate, teach the patient proper oral hygiene. Tell him to report mouth lesions that don't heal within 2 weeks.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common symptoms,
Edition V, McGraw - Hill, 2002.