Introduction to Dentistry

Introduction to dentistry

Branches of dentistryOral Medicine and RadiologyConservative Dentistry and Endodontics.PeriodonticsOral and Maxillofacial SurgeryProsthodonticsPedodonticsOrthodontics Oral PathologyCommunity Dentistry

Oral cavity is the mirror of body

Angular cheilitis

Depapillated tongue

Candidiasis

Oral hairy leukoplakia

Desquamative gingivitis

Gingival bleeding

Tooth ChangesNormal teeth and gingiva (age 43)Tobacco staining (age 76)Worn, yellowing teeth (age 83)Yellow, worn teeth (age 90)

Dental erosion

Drug-Related Gingival Hyperplasia

Human Dentition

Notation 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8

Divided into four quadrants

Periodontium

Common diseases Dental cariesPeriodontitisOral mucosal diseases

Root caries and periodontitis

Periodontal ChangesGingival recessionPlaque, recession, and tooth lossGingivitis with poor oral hygiene

Mouth ulcers

Geographic tongue

Coated tongue

Leukoplakia

Herpes Labialis

Oral submucous fibrosis

Oral Cancer

Oral hygiene aids

Dental floss

Mouthwashes

Other Helpful ProductsMouth propsTongue scraperSpecial toothbrush for use by caregiversBuilt up handlesInterproximal cleaners

Take Home MessagesMouth is the mirror of the body- It reflects systemic diseasesExamine teeth and oral mucosa especially tongue and palate

***********This slide displays the spectrum of tooth changes in older adults.*************This slide presents the spectrum of periodontal changes that can occur with age and can lead to oral disease. Some are directly age-related, such as gingival recession, but many are worsened by poor oral hygiene. Periodontal disease is a major cause of tooth loss.*****Herpes labialis, also known as cold sores, produces burning, itching, or warmth during the 12-36 hours preceding eruption of the lesions. Vesicles rupture, ulcerate and crust within 24-48 hrs. Treatment is with topical or systemic antiviral agents, either prophylactically, abortively, or for a full course of treatment.

Upper photo shows early vesicles. Lower photo shows large crusted lesions.

Spruance SL, Jones TM, Blatter MM, Vargas-Cortes M, Barber J, Hill J, et al. High-dose, short-duration, early valacyclovir therapy for episodic treatment of cold sores: results of two randomized, placebo-controlled, multicenter studies. Antimicrobial Agents Chemother 2003;47:1072-80.***This slide shows a variety of large cancerous lesions. In the United States, cancers of the oral cavity and oropharynx are the ninth most common cancer, accounting for approximately 3 percent of malignancies among men and 2 percent of malignancies among women. The prevalence of these cancers increases with age. Ninety percent of oral cancers are squamous cell carcinomas. These cancers occur most commonly on the tongue, floor of mouth, and lower lip vermilion (top right photo). Sixty percent of oral carcinomas are advanced by the time they are detected, and about 15 percent of patients will have another cancer in a nearby area such as the larynx, esophagus, or lungs. Tobacco use and heavy alcohol consumption are the two principal risk factors and are responsible for 75 percent of oral carcinomas. Any red or white lesion persisting longer than two weeks warrants referral for biopsy. Treatment of oral squamous cell carcinoma is guided by clinical staging and may involve surgical resection, lymph node dissection, radiation therapy, or chemotherapy. The overall five-year survival rate for oral cancer is 50-55 percent. Long-term follow-up is advised because of the potential for recurrence or development of additional lesions. Smith RA, Cokkinides V, von Eschenbach AC, Levin B, Cohen C, Runowicz CD, et al. American Cancer Society guidelines for the early detection of cancer. Ca: a Cancer Journal for Clinicians. 2002;52(1):8-22.

****If a patient is unable to brush their own teeth, mouth props and special toothbrushes can assist caregivers. A tongue scraper can be very helpful in hairy tongue. Built up handles on toothbrushes and interproximal cleaners can assist patients with impaired manual dexterity. *These are the key messages to take away from this talk.