Viral, bacterial, and fungal infections of the oral mucosa: Types, incidence, predisposing factors, diagnostic algorithms, and management

Chen

et al. 2020

Preprint

Background: Stroke-associated pneumonia (SAP) is a major complication after stroke, oral microorganisms are important contributors to SAP. Here, we aimed to investigate whether the oral hygiene was associated with SAP and related risk factors of them in patients with acute ischemic stroke. Methods: We performed a cross-sectional study that recruited 331 patients with acute ischemic stroke from two medical centers. A series of assessments were performed to evaluate the neurological status and habits of oral hygiene. According to whether the oral hygiene was abnormal and SAP occurred, univariate analyses were performed in cohort 1 (normal / abnormal oral hygiene groups) and cohort 2 (SAP / non-SAP groups). Multiple logistic regression analyses were conducted to confirm risk factors of oral cleanliness and SAP in stroke patients. Results: A total of 12 and 8 independent variables were included in the model 1 and 2 analysis. After adjusting for confounders, multivariable logistic regression analysis showed that oral cleanliness was not only closely related to SAP (OR=2.219, P=0.026), dental caries (OR=1.292, P=0.005) and age (OR=1.030, P=0.006) in model 1, but also an independent risk factor for predicting SAP (OR=1.678, P=0.001) in model 2. Barthel index was a protective factor for oral cleanliness (OR=0.986, P=0.019) and SAP (OR=0.977, P=0.002) in ischemic stroke patients. Conclusions: Mutually primary risk roles of abnormal oral cleanliness and SAP exist in patients with acute ischemic stroke. Dental caries and aging are important risk factors for oral health disorders. Improving the activities of daily living would have protective effects on both oral hygiene and SAP prevention in stroke patients.

Section: Discussionmentioning

confidence: 99%

Mutually Risk Roles of Oral Cleanliness and Stroke-associated Pneumonia in Patients with Acute Ischemic Stroke: A Cross-Sectional Study

Chen

et al. 2020

Preprint

“…History; clinical presentation; chest X-ray; cultures 36 Deep, irregular single painless ulcer with inverted margins and granulations on the floor with sloughing tissue associated with enlarged regional lymph node, tuberculomas, and nodules, commonly affecting the tongue 29,36 Indicated May manifests sore throat and development of palatal petechiae exudative pharyngitis, tonsillitis, and posterior cervical lymphadenopathy are common 35,36 Not indicated Supportive treatment, rest, and analgesics; Antiviral or corticosteroids treatment 36 Cytomegalovirus infection Serological test of CMVspecific antibodies or IgG; CMV-specific IgM antibodies 36 Persistent, solitary or numerous, painful or painless, shallow ulcerations, with a base covered by a yellow slough or pseudomembrane, and the margins can be rolled, elevated, with or without induration 36,37 Not indicated Antiviral drugs 36 Herpes simplex virus Clinical presentation; Virologic tests; Cytology smears stained with Giemsa or Papanicolaou stain; PCR; Serological tests 36 Blisters or vesicles with eruptions extremely painful and break in tiny, shallow-grey ulcers on a red base 29,36 Indicated Analgesics and antipyretics, topical anesthetics, and antiviral therapy 36 osteoblasts. [7][8][9][10] Based on Wilden and Karthein's research, 43 a relevant subject arises from the wavelength (energy range) between 600-700 nm; it is effective in triggering cell proliferation and differentiation.…”

Section: Tuberculosismentioning

confidence: 99%

Low-Level Laser Therapy Approach of Bilateral Necrotizing Sialometaplasia of the Hard and Soft Palates

et al. 2020

Introduction: Necrotizing sialometaplasia (NS) is a rare locally destructive inflammatory benign disease that commonly affects the minor salivary glands. It is frequently associated with the glands located in the posterior portion of the hard and soft palates. Low-level laser therapy (LLLT), also called photobiomodulation therapy (PBMT), has been deemed a substantial method for the regenerative wound process. Case Presentation: A 32-year-old male patient was referred with a chief complaint of two asymptomatic crater-like ulcers measuring approximately 1.5 cm wide on the right side of the hard and soft palates, and another measuring 0.3 cm wide on the left side of the hard palate. The lesion had two weeks of evolution followed by a previous infectious "sore throat" event that kept the patient hospitalized for 4 days. A clinical diagnosis of NS was made. LLLT was applied during 2 sessions per week, favoring the total wound healing within 2 weeks. At 3 months of clinical followup, the patient did not present any complication or relapse and was thus released. Conclusion: This is, to our knowledge, the first clinical report of LLLT applied for the management of NS. Large palatal ulcers caused by NS usually have long healing periods. The shortened healing period observed in this case encourages the inclusion of LLLT in any treatment protocol for similar lesions.

“…Some may evade the natural defense barriers and both local and systemic nonimmune and immunological mechanisms and can be life threatening. Bandara and Samaranayake provide a comprehensive review of fungal, bacterial, and viral infections affecting the soft tissues of the mouth. This chapter provides epidemiology, risk factors, clinical presentation, diagnosis and treatment of common as well as relatively rare infections.…”

Section: Infections Of the Oral Mucosamentioning

confidence: 99%

Nonneoplastic diseases and disorders of the oral mucosa: A contemporary overview

Ariyawardana

Johnson

2019

Periodontology 2000

Oral mucosal diseases encompass a diverse array of conditions and disorders arising from malignant, potentially malignant, and nonneoplastic processes. Considerable attention has been paid to the former in recent years, much less to the wide range of nonneoplastic disease processes, which constitute a sizeable proportion of the oral disease burden globally. Many nonneoplastic disease processes of the oral mucosa significantly affect the patient's quality of life. Fortunately, timely identification and intervention can reduce the associated morbidity and, sometimes, mortality. As such, it is of utmost importance that dentists are familiar with early identification and management of this wide range of oral mucosal diseases. This volume of Periodontology 2000 provides a comprehensive contemporary review of such diseases and disorders through 15 chapters. We cover all relevant disease categories: developmental anomalies, infections, white and red lesions, vesiculo‐bullous diseases, oral dermatoses, oral ulcerative conditions, dysplastic lesions, and mucosal diseases as manifestations of systemic disease or oral lesions as a part of systemic diseases. Each chapter discusses epidemiology, etiopathogenesis, clinical features, diagnosis, and management. Controversies and many significant gaps in knowledge are exposed, with suggestions for research to address limitations in current understandings. We take a look at the 2017 classification of the periodontal diseases and discuss the importance of close liaison between the specialties of oral medicine and of periodontology in the management of the many oral diseases, apart from the common forms primarily related to oral biofilm, affecting the gingivae and other parts of the periodontium.