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  Mouth diseases

The mouth also known as the oral cavity is the facial opening which serves for the following functions: breathing, eating and speech. Oral cavity diseases encompasses any medical and surgical disorders and may range from a localized mouth infection to a systemic disease that manifest as a combination of both mouth and other systemic symptoms.

Mouth diseases
Mouth diseases


The following are the list of some mouth diseases encountered in clinical practice: The candidiasis also known as the oral thrush or moniliasis is caused by growth of yeast cells. The causative agent is candida albicans. It is characterized as whitish plaques in the oral cavity seen most commonly in immunocompromised patients (e.g. acquired immunodeficiency syndrome or AIDS; severe combined immunodeficiency (SCID); diGeorge syndrome, a thymic hypoplasia) and also seen in those patients on prolonged inhalational steroids like in asthmatic patients who failed to wash their mouth every after steroid use.

Isolated inflammatory mouth diseases include: cheilitis or cheilosis; gingivostomatitis; aphthous stomatitis; laryngitis; tonsillopharyngitis and diphtheria. Cheilitis or cheilosis means inflammation of the lips such as in vitamin deficiency. Gingivostomatitis is an inflammatory condition of the gums and mouth which is most likely due to poor oral hygiene. Aphthous stomatitis is mouth ulcers, caused either by mechanical injury to the oral mucosa or due to some vitamin deficiency.

Throat infections like tonsillopharyngitis is commonly due to streptococcus termed as “strep throat”; common during cold or winter months and may spread to the entire members of the household. Although between a bacterium and a virus, the most common cause of sore throat is still viral in origin. However, recurrent bouts of strep throat may lead to serious complications such as acute rheumatic fever, rheumatic heart disease, subacute bacterial endocarditis (leading to a valvular heart problem). Furthermore, a hypertrophic tonsil also known as “kissing tonsils” due to recurrent tonsillitis may cause loud snoring and decrease air inflow during sleep leading to a condition known as obstructive sleep apnea. In this case, tonsillectomy is advisable to prevent nocturnal hypoxemia. Vocal cord infections also called laryngitis may also be due to viruses or bacteria. Laryngitis may be preceded by a tonsillopharyngeal infection which is left untreated hence, descending towards the voice box resulting to hoarseness or even loss of voice. A more serious throat infection is the highly contagious, diphtheria. This is a severe throat infection characterized with markedly swollen tonsils or adenoids, pharynx with exudates formation and cervical lymphadenopathy more common in infants and children. This is caused by corynebacterium diphtheriae but can be treated successfully with antibiotics. Immunization with DPT vaccine may give protection to a child because of antibody formation against the bacteria.

A surgical mouth disease is the congenital problem of incomplete fusion of the hard and soft palate or the mouth’s roof either with or without involving the lips is known as cleft palate or cleft lip. This condition is surgically corrected ideally before the child learns how to speak to avoid speech defects. In surgical repair, the “rule of 10s” ideally is followed which means surgery can be performed if the pediatric patient is around 10 pounds in weight, as early as 10 months’ old and with a hemoglobin of at least 10 mg/dl.

Malignant conditions of the mouth include the following: gum cancer; oral cancer; salivary gland cancer and tonsil cancer. Gum cancer is a malignant condition derived from the lining epithelium which consists of the rapidly dividing epithelial cells. Mouth or oral cancer may involve the lips such as the vermilion border (the junction between the upper or lower lip and the pinkish oral mucosa) or any part of the oral cavity. Mouth cancer is also epithelial cell in origin. Salivary gland cancer (e.g. parotid gland cancer) is named properly as an adenocarcinoma (malignancy of the glands) due to its glandular epithelium type of tumor in origin. The same term is used for malignancy of the tonsils, called adenocarcinoma which is derived from the adenoids or lymph glands.

An extremely painful condition along the face and the mouth while chewing or during mastication is trigeminal neuralgia. Any mouth opening and even facial muscle movement is painful secondary to involvement of cranial nerve V, the trigeminal nerve which is a mixed type of nerve with three branches namely: ophthalmic, maxillary and mandibular. The trigeminal nerve receives sensations to the entire face. A probable precipitating event is a previous viral infection. Another stinging and burning sensation around vesicular lesions with erythematous bases are known as cold sores caused by the virus, Herpes simplex type I (orofacial infections).

Mouth disease may be a manifestation of a systemic disorder such as the following: Raynaud syndrome; Sjogren’s syndrome and Crohn’s disease. Raynaud phenomenon is a vasomotor disorder that may involve the lips but also a part of the CREST (calcinosis, Raynaud, esophageal dysmotility, sclerodactyly and telangiectasia) syndrome. Sjogren’s syndrome is also known as keratoconjunctivitis sicca, a syndrome characterized by dry eyes, mouth and lips due to decrease lacrimal fluid and saliva production respectively. Recurrent infections such oral candidiasis occurs due to the fact that the oral cavity has been depleted with the natural antibodies and enzymes provided by the saliva as part of the body’s non-specific defense mechanism. Lastly, the Crohn’s disease which is an inflammatory bowel disease involving the terminal ileum (part of the small intestine). This is a chronic condition that leads to many gastrointestinal complications like fistula and abscess formation; viscus perforation and may include mouth inflammation (stomatitis).

Other mouth diseases include halitosis and dental disorders. Halitosis means “bad breath” in layman’s term which is strongly related to poor oral hygiene although some cases are due to a gastrointestinal problem or poor dietary habits. Dental disorders may include tooth loss, periodontitis and dental plaques formation.

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