="http://www.w3.org/2000/svg" viewBox="0 0 512 512">

42 Oro-facial


Mouth examination


Perioral Dermatitis



Angular cheilitis / stomatitis


Herpes simplex stomatitis

Herpes simplex stomatitis PUK


Apthous ulcers


Behcets syndrome


Oral thrush

C. albicans yeast infection of the oral mucous membrane and tongue

3 types
acute pseudomembranous – newborn and impaired immunity including inhaled steroids – use a spacer and gargle with water afterwards
chronic atrophic
chronic hyperplastic

DD – Consider leukoplakia oral lichen planus

1st line Rx Nystatin suspension 100,000 units/mL, 1mL 6 hourly for 7 days or 48 hours after lesions have resolved
Increase dose to 500,000 units if extensive in terminal illness and immuno-compromised adults.
Miconazole gel in babies and small children.
2nd line Fluconazole 50-100mg daily for 7-14 days or itraconazole 100mg daily for 15 days. (200mg daily in immuno-compromised).




Oral Lichen Planus


Geographic Tongue

Smooth patches due to loss of papillae.  Not clinically significant.
tauntonmaxfax.net geographic tongue



Pale smooth tongue

with atrophy of filiform papillae  – iron/B12 deficiency


Giant black hairy tongue

Benign condition due to overgrowth/elongation of dermal papillae.
?? May be due to candida secondary to smoking, antibiotics or steroids.




Enlarged tongue

Amyloidosis, acromegaly, myxoedema


Neurological Conditions

fasiculations and wasting  – LMN lesions eg progressive bulbar palsy
spastic tongue + dysarthria and increased jaw jerk  – pseudobulbar palsy




Xerostomia dry mouth



bad breath netdoctor

Halitosis PUK


Facial pain

Facial pain tauntonmaxfax.net


TMJ disorders

TMJ tauntonmaxfax.net


Salivary gland disease

Parotid  swelling
Mumps, DM, debilitated alkies, TB sarcoid, Sjorjens lymphoma and syphilis.
Unilateral swelling – mised parotid tumour
Intermittent swelling – salivary calculi

Submandibular swelling
Whartonns submandibular duct obstruction

tauntonmaxfax.net salivary glands




Dentition naming systems

Dental arch

Dental archVisual Dictionary ©2005-2011 – All rights reserved

Tooth numbering system Web dental office


Dentition Nomenclature Murtagh Check Permissions !!

Teeth are numbered from 1 to 8 from the midline.
Permanent teeth (n =32)
Deciduous teeth (n = 20)
World Dental Federation International 2 digit notation
Each of the four quadrants are numbered

Palmer’s notation
A cross is drawn to represent quadrants, but the numerals are used as above for permanent teeth. Deciduous teeth are represented by the letters A-E.

Wisdom teeth
Lower third molars.
upper (maxillary) right
upper (maxillary) left
Lower (mandibular) right
Lower (mandibular) left


Teething and tooth eruption

Teeth eruption charts medicinenet.com



Dental problems and toothache

emedicinehealth toothache

toothache medlineplus


Dental abcess


Dental caries

NHS choices dental decay



Periodontitis periodental disease

Dental Plaque and Gum Disease PUK




Gum disease


Dry dental socket

Tooth extraction 1-3 days earlier.
Very severe pain. unrelieved by analgesics.
Continuous pain on the side of the face.
Foetid odour.
Mainly in the lower molars. especially the third (wisdom teeth).
Examination shows a socket with few or no blood clots. and sensitive bone surfaces covered by a greyish-yellow layer of necrotic tissue.


Wisdom teeth (3rd Molars)

Dento-alveolar surgery for Third Molars tauntonmaxfax.net


Orofacial and dental trauma

Maxfax trauma Cork Emergency medicine



Knocked-out tooth

Paediatric Orofacial Trauma New York partners in oral health

If a permanent (second) tooth is knocked out (in an accident or fight) but is intact, it can be saved by the following, immediate procedure.
1. Replace the tooth in its original position,preferably immediately; if dirty, put it in milk, before replacement or place it under the tongue
Note: Do not use water, and do not wipe it or touch the root.

2. Fix the tooth by moulding strong silver foil (e.g.a milk bottle top or cooking foil) over it and the adjacent teeth.

3. Refer the patient to his/her dentist or dental hospital as soon as possible.

Note: Teeth replaced within half an hour have a 90% chance of successful re-implantation.
(source Murtagh)



Oral cancer


Oro-facial Copyright © 2012 by 250 Textbooks / Metacognitives / Gifted Amateurs. All Rights Reserved.


Comments are closed.