Disease of the oral cavity in adults treatment. Inflammatory diseases of the oral cavity and pharynx

The state of the oral cavity (teeth, mucosa, gums, tongue) is an indicator of the work of many internal organs. It is affected by:

long-term use of various medications (primarily antibiotics);
immune failure (and in the case of HIV, AIDS);
inflammatory processes of teeth and gums, gastrointestinal tract, other internal organs;
unbalanced diet;
bad habits;
avitaminosis;
dehydration of the body;
hormonal disorders and a host of other factors.

So, in the list of diseases of the oral cavity in adults and children, dentists include pathologies of the oral mucosa, dental diseases and gum disease.

infections

The classification of diseases of the oral cavity involves the allocation of a separate group of inflammatory processes of an infectious and viral nature.

So, the main "representative" of this class of mucosal diseases is stomatitis. As a rule, the appearance of painful rashes, ulcerative lesions, plaque on the tongue, the inside of the cheeks is a consequence of poor home oral hygiene. In some cases, angina leads to stomatitis, malfunctions of the organs of the digestive tract.

Pathological changes in the oral mucosa are alarming signals of the body, announcing both the dysfunction of internal organs and local dental diseases

Types of stomatitis:

catarrhal (swelling of the entire oral mucosa and tongue, pain during meals, a characteristic yellow coating on the palate of the gums, tongue);
ulcerative (erosive lesions of the oral mucosa in combination with systemic symptoms - an increase in regional lymph nodes, aching bones and joints, weakness, malaise, dizziness). Patients with signs of ulcerative stomatitis undergo additional diagnostics of diseases of the intestines and stomach (enteritis, ulcers);
aphthous. The mucous membrane of the mouth and lips is covered with multiple ulcerations (aphthae). The causes of this form of viral disease of the oral mucosa are poor hygiene, rheumatism, pathological disorders of the intestines, stomach, and allergies. The course of aphthous stomatitis is accompanied by such changes in the mucosa as redness, swelling, and only then ulceration.

Important! The list of oral diseases of a viral nature includes ulcerative necrotic stomatitis and secondary manifestations of sexually transmitted infections. But first of all, herpes must be “sent” to this group of pathologies. In this case, there is a lesion of the oral mucosa with multiple bubbles filled with transparent exudate (liquid), which can also spread to the lips and skin of the face.

candidiasis

Fungal diseases of the oral cavity are represented by candidiasis. The causative agent is a yeast fungus of the Candida group. This "harmful agent" is activated against the background of an immune failure, hypothermia, and disorders of the gastrointestinal tract. There are several types of candidiasis of the oral mucosa:

Acute pseudomembranous. Classic manifestations: increased dryness of the lips, cheeks, tongue, palate, burning and itching on the mucosa. Patients experience discomfort during eating, diction, curdled plaque on the mucosa. This form of candidiasis can develop against the background of diabetes mellitus, blood diseases, beriberi.
Atrophic (acute form). Symptoms: redness, dryness of the mucosa, whitish coating on the gums, cheeks, tongue.
Atrophic (chronic form). The reason is the long wear of poorly fitting prostheses. Signs: inflamed hyperemic mucosa, seizures in the corners of the mouth.
Hyperplastic. "Identification mark" - knots, plaques, covering the palate, cheeks, tongue with a dense layer. When trying to clean off the plaque, bleeding ulcers form.

Stomatitis (ulcerative, catarrhal, atrophic) is the most common infectious and inflammatory disease of the oral mucosa.

red lichen

This is another common infection in the mouth. "Trigger" - weakened immunity, chronic diseases of the digestive system, diabetes. Manifestations: mucosal hyperemia, plaques, vesicles, erosion, localized not only on the oral mucosa, but also on the skin of the face (body).

Dysbacteriosis of the oral cavity

The list of diseases of the oral mucosa also includes local dysbacteriosis. The deficiency of beneficial and the predominance of pathogenic bacteria is the result of improper antibacterial treatment and (or) the abuse of antiseptic solutions for the treatment of the oral cavity. Symptoms of dysbacteriosis: bad breath, dryness, cracks in the lips and tongue, decreased salivation, exacerbation of other dental pathologies.

Glossitis

Infectious diseases of the oral cavity in children, adults, elderly patients are also represented by glossitis. This is an inflammation of the tongue, which is usually caused by streptococcus. The clinical picture of glossitis ("geographic tongue") is very bright: the mucous membrane is covered with multiple ulcers, reddens, swells, becomes painful during meals and outside the functional load.

Important! Glossitis is primary (caused by injuries of the tongue with fillings, crowns, local dental problems), secondary (inflammation is provoked by diseases of the digestive tract, hormonal disorders).

salivary gland dysfunction

Xerotomia (dry mouth) is another common dental problem. May be the result of diabetes mellitus, dysfunction of the salivary glands, endocrine failure, systemic and local allergic reactions. "Identification marks" of xerotomy are overdrying of the mucosa, local inflammation, itching, burning on the cheeks, gums, tongue. The salivary glands and/or submandibular lymph nodes may become inflamed.

Gastritis, peptic ulcer of the stomach and duodenum, enteritis and other diseases of the digestive system "leave their mark" on the oral mucosa. Cheilitis is an inflammation of the mucous membrane of the lips. Occurs against the background of hormonal disorders, its “culprits” are often infections of the oral cavity, allergies, deficiency of B vitamins in the body, prolonged exposure to ultraviolet radiation, and neurological factors. Cheilitis "declares itself" with painful ulcers in the corners of the lips, swelling and redness of the mucosa.

Diseases of the teeth and gums

Infectious diseases of the oral mucosa are far from all the troubles that patients have to face. Factors such as immune failure, malnutrition, bad habits, injuries and inflammation of the mucosa, allergies, poor oral care lead to a lot of “local” problems that only a dentist can handle.

The first representative of this group of diseases is periodontal disease (destructive changes in periodontal tissue). It can be asymptomatic, eventually flows into periodontitis (inflammatory process). This is facilitated by metabolic disorders, concomitant neuro-somatic diseases, insufficient amount of fibrous roughage in the diet.

Poor home and neglect of professional oral hygiene lead to diseases of the teeth, gums, infectious lesions of the mucosa

Important! Periodontitis is a common complication of gingivitis (inflammation of the gums). The latter "declares itself" by bleeding gums during hygiene procedures or eating, bad breath, a powerful layer of bacterial plaque on the enamel. Advanced stages of gingivitis are fraught with abscesses, severe swelling of the soft tissues of the oral cavity, pain and loosening of the teeth.

The list of the most common dental diseases includes caries and pulpitis. These pathologies cause the destruction of enamel, after - dentin and soft tissue formation of the tooth (pulp). As a rule, poor oral hygiene, the accumulation of powerful bacterial plaque, and “stagnant” tartar lead to caries.

Cancer

Oncological diseases can also develop in the oral cavity. So, there is cancer of the cheeks, the bottom of the mouth, tongue, alveolar process, palate. Malignant pathologies in the mouth come in three forms:

Knotty (a seal appears on the mucosa with clear edges, its color does not change or is covered with whitish spots). The innovation is growing rapidly.
Ulcerative (one or more ulcers form on the soft tissues of the oral cavity, which hurt, bleed heavily, and heal poorly).
Papillary (dense homogeneous tumor, as a rule, hanging to the mouth floor) Color, structure of the mucosa remain unchanged.

Malignant neoplasms can affect various parts of the oral cavity, as a rule, develop in immunocompromised patients and smokers. Cancer of the oral cavity actively metastasizes, most often spreading to nearby submandibular nodes. Distant metastases (lung, liver, brain) are rare.

The risk zone for developing malignant tumors in the mouth includes:

smokers;
those who abuse alcoholic beverages;
people whose oral mucosa is constantly injured by poorly polished fillings or not very carefully fitted prostheses;
patients infected with human papillomavirus;
patients with weak immunity, as well as those suffering from beriberi.

Diagnosis and treatment

Chronic diseases of the oral mucosa are easily determined visually during a dental examination. If necessary, the doctor directs the patient to an x-ray, a number of laboratory tests (bacterial culture from the throat, tongue), general and biochemical blood tests, etc. If the doctor determines that dental diseases are of a secondary nature, he sends the patient to a gastroenterologist, otolaryngologist, neuropathologist and other narrow specialists.

Treatment of diseases of the oral cavity depends on the causes, form, severity of the course, the characteristics of the patient's body and other factors. It happens that in order to cope with unpleasant symptoms and avoid complications, a simple hygienic cleaning in the dentist's office is enough. Caries and pulpitis - indications for the removal of affected foci of enamel, dentin, antiseptic treatment of "affected" units, the installation of fillings (crowns).

Diseases of an infectious-inflammatory nature require local, systemic anti-inflammatory, antiseptic, and sometimes antibiotic therapy. With glossitis, cheilitis, xerotomia, a thorough diagnosis of the state of the digestive tract is always carried out, endocrine disorders are excluded. Such diseases are usually secondary, so the main treatment is aimed at eliminating the root cause of abnormal changes in the state of the mucosa.

It is necessary to fight herpes in the mouth (and other diseases of a viral nature) with systemic and local antiviral agents, treatment of candidiasis, stomatitis is carried out with antifungal, anti-inflammatory drugs in combination with symptomatic agents (antiseptics, painkillers, natural mouthwash solutions with soothing, astringent properties) .

Important! Cancer lesions of the oral mucosa are subject to surgical treatment followed by chemotherapy, radiation therapy.

Bad habits, unbalanced diet, weak immunity - "provocateurs" of dental diseases

Complications and prevention

With untimely treatment (or lack thereof), diseases of the oral cavity lead to partial or complete adentia, the spread of inflammation (infection) in the gastrointestinal tract, upper respiratory tract, and a host of other problems. To avoid problems with teeth, gums, oral mucosa, you must:

strengthen immunity;
carefully monitor the condition of the oral cavity, observe the rules of hygiene;
visit the dentist regularly;
rational and balanced diet;
avoid stress;
monitor the hormonal background, the work of the digestive tract, treat all chronic diseases in a timely manner.

If the first abnormal changes in the condition of the oral mucosa (hyperemia, swelling, plaque, rash), toothache, bleeding and sensitivity of the gums are detected, it is necessary to seek medical help from a dentist.

Food begins to break down in the mouth. If a person develops a disease of the oral mucosa (OMD), then the enzymes contained in saliva will not work at full strength. This can provoke disturbances in the functioning of the organs of the digestive system, causing unpleasant. Even brushing your teeth does not allow you to freshen your breath for a long time, as purulent defects form in the oral cavity. They give a person pain, itching and burning. Therefore, soft tissue inflammation should be treated as soon as possible.

There are the following reasons leading to the development of diseases of the oral cavity:

Poor hygiene. Sometimes a person simply rarely brushes his teeth, sometimes he does it wrong, and sometimes he even uses poor-quality products to treat the oral cavity.

Alcohol abuse. Alcoholism leads to failures in metabolic processes in the mucous membranes of the oral cavity.

Eating too hot foods and drinks. Microburns violate the integrity of the mucous membrane and reduce its protective functions.

Alternating hot and cold foods or drinks. This contributes to the destruction of tooth enamel.

Excessive consumption of sugary foods. Violation of the acid-base balance in the oral cavity leads to the reproduction of harmful flora and irritation of the mucous membranes.

Diseases that increase the likelihood of damage to the oral mucosa:

Chronic and acute inflammatory processes.

Violations in the functioning of the immune system, which may be due to rheumatoid diseases, STDs, etc.

Allergy.

It is impossible to ignore the unpleasant sensations that arise in the mouth. If they persist for several days, and the defects that have appeared do not disappear after treatment with antiseptic agents, you should contact your dentist.

Symptoms to watch out for!

Discomfort in the oral cavity is a reason to visit the dentist's office. The doctor will diagnose and prescribe the necessary treatment.

Symptoms that require medical advice:

Bad breath.

The appearance of rashes, ulcers and other defects in the mouth.

Pain and burning of the mucous membranes, which are aggravated during meals.

Increased salivation or dry mouth.

SOPR classification:

Depending on the form of the course of the pathological process, acute and chronic diseases are distinguished. In turn, chronic disorders can worsen and enter a phase of remission.

Depending on the stage of development of the disease, there are: initial, acute and neglected form.

Depending on the causative agent of the disease, viral, bacterial and fungal infections are isolated. Also, diseases of the oral mucosa can be autoimmune and traumatic in nature.

Depending on the method of transmission of the disease, infections are distinguished, sexually transmitted, domestic, airborne. Also, the pathology may be of an allergic nature or occur due to hypothermia of the body. Inflammation, accompanied by suppuration, is often the result of dirt getting into microscopic wounds on the oral mucosa.

Depending on the place of concentration of inflammation, diseases of the lips, gums, tongue, and palate are distinguished.

Depending on the type of affected tissues, infections are distinguished that are concentrated on the mucous membranes, on soft tissues, and on the bone structures of the oral cavity.

The oral cavity suffers all the time due to exposure to various irritants. They can be mechanical, physical or chemical. If such factors are not too intense, then the mucous membranes cope with them on their own. When local immunity is not enough, irritation and inflammation appear in the mouth.

Mechanical damage to the oral cavity. Injury can be obtained due to a blow, when biting soft tissues with teeth, or when injured with sharp objects. A bruise, abrasion, erosion, or other deep defect occurs at the site of injury. If bacteria enter the wound, it will transform into an ulcer and take a very long time to heal.

Chronic injury. These are the most common lesions of the mucous membranes of the oral cavity. Sharp edges of teeth, chipped fillings, broken crowns, dentures and other orthodontic structures can lead to their occurrence. Swelling and redness occur at the site of injury. Then this area is transformed into erosion, and then into a decubital ulcer. The ulcer hurts a lot, has an even base, it is covered with a fibrinous coating on top. Along the edges of the ulcer is uneven, if it is present in the oral cavity for a long time, then its edges become dense. Chronic or acute inflammation leads to an increase in regional lymph nodes in size. When they are probed, a person experiences pain. If left untreated, such an ulcer can develop into a malignant tumor.

Infectious and inflammatory processes in the oral cavity develop due to the multiplication of viruses or bacteria. Most often, people are diagnosed with gingivitis, glossitis, pharyngitis, stomatitis. Errors in oral hygiene, poor-quality care for the gums, tongue or teeth lead to inflammation. Other risk factors include diseases of the digestive system, namely: gastritis, enterocolitis, stomach ulcers and duodenal ulcers.

Stomatitis

Stomatitis can be diagnosed at any age.

Doctors distinguish several varieties of stomatitis, including:

Aphthous stomatitis. The patient swells and reddens the mucous membrane of the oral cavity, then ulcers form on it, which will be covered with a white coating. These defects hurt a lot.

Ulcerative stomatitis. This disease is accompanied by the formation of erosions in the oral cavity. The patient's body temperature may rise, the lymph nodes become painful. General health is deteriorating. To find out the cause of inflammation, you need to check the condition of the organs of the digestive system. Often these patients are diagnosed with enteritis or stomach ulcers.

Catarrhal stomatitis. The main symptom of the disease is swelling and redness of the mucous membranes of the oral cavity. A white patch appears at the site of infection. It is difficult for the patient to talk and eat. From the mouth of a person, an unpleasant odor begins to emanate, salivation intensifies.

It will not be possible to independently diagnose the type of stomatitis, in order to understand what kind of disease a person develops, you need to visit the dentist's office.

Glossitis is an infectious and inflammatory disease of the tongue, which can be caused by viruses or bacteria. At risk are people who neglect oral hygiene.

Often inflammation is caused by streptococci. However, these are not the only microorganisms that can provoke the disease. Increases the likelihood of penetration of pathogenic flora into the thickness of the tongue resulting in burns and injuries. Glossitis often develops in people who use sprays to freshen their breath, as well as in people who abuse alcohol.

Symptoms of glossitis:

Burning tongue, the appearance of a sensation of a foreign body in the thickness of the organ.

Redness of the mucous membranes of the tongue, increased salivation.

Distortion of taste.

Glossitis can occur in such forms as:

Superficial glossitis. Symptoms of the disease resemble stomatitis. Only the mucous membrane of the oral cavity suffers. Inflammation has an uncomplicated course and responds well to correction.

Deep glossitis. The entire surface of the tongue suffers, along its entire thickness. Often, abscesses and areas of abscess appear on the organ. Treatment must be started immediately, otherwise the infection may spread to the neck. This is a direct threat to human life. Deep glossitis requires surgical intervention.

Separately, non-inflammatory forms of glossitis are distinguished:

Desquamative glossitis. Often it develops in women who are carrying a child, in people with diseases of the digestive system, with blood pathologies. Also, risk factors leading to its occurrence are: metabolic disorders, rheumatism, helminthic invasions. The patient on the back of the tongue and on its sides begins to collapse the epithelium. This leads to the formation of foci of bright red color. They alternate with the unchanged mucosa of the organ, therefore, when examining it, it seems that the tongue resembles a geographical map. Therefore, this type of gloss is called "geographical language".

Rhomboid glossitis. This disease refers to congenital pathologies, it occurs due to anomalies in the development of the fetus. It is also called median glossitis.

Villous glossitis. In patients with this form of the disease, papillae grow on the tongue, which cover its entire surface.

Folded glossitis. This developmental anomaly is characterized by the appearance of folds on the back of the tongue. The deepest groove runs along the central part of the organ. The disorder is diagnosed in children immediately after birth. As a rule, it does not cause any discomfort to a person, so treatment is not carried out.

Gunther's glossit. A person's tongue acquires an unnatural smoothness, papillae disappear on it, so it looks polished. Gunter's glossitis is a symptom of a deficiency in the body of vitamin B12 and folic acid, that is, it is a sign of anemia.

Interstitial glossitis. This disease develops against the background of progressive syphilis. The tongue becomes dense, the patient cannot move it normally.

Gingivitis is characterized by inflammation of the gums. In this case, only their surface layer suffers. They talk about gingivostomatitis when ulcers form not only on the gums, but also on the surface of the cheeks. Most often, this form of the disease is diagnosed in children.

The main cause of gingivitis is called poor oral hygiene. Often men who lead an unhealthy lifestyle suffer from gum disease. If there is no treatment, then gingivitis will progress and turn into periodontitis, which is associated with the risk of tooth loss.

You need to take good care of your teeth. If you do not clean out the remnants of food, then bacteria begin to multiply in them. The more of them, the higher the likelihood of gum disease. Gingivitis can be acute or chronic. In some people, the inflammation is recurrent.

Dentists distinguish several types of gingivitis:

Ulcerative gingivitis. The disease develops acutely, the gums swell, become bright red. An unpleasant odor comes from the patient's mouth.

Catarrhal gingivitis. This inflammation is manifested by swelling, pain and bleeding of the gums. However, the lesion is superficial, gum pockets do not suffer.

Hypertrophic gingivitis. The disease is accompanied by swelling and hardening of the gingival papillae, the gum pocket hurts, becomes red. Hypertrophic gingivitis can be edematous and fibrous. The edematous form of inflammation leads to severe bleeding of the gums, they fill up and increase in size. With fibrous gingivitis, the gum tissue thickens, but the person does not complain of pain, there is no bleeding. It will not be possible to cope with hypertrophic gingivitis with drugs, the patient will need the help of a surgeon.

Pharyngitis

Immunity disorders become the basis for the development of pathology. Also, doctors are of the opinion that the tendency to red lichen can be inherited.

The acute stage of the disease is said in the case when the lichen appeared less than a month ago. Subacute illness lasts no more than six months. The chronic form of lichen lasts more than 6 months.

The oral cavity, like other parts of the body, is prone to cancerous tumors. The disease can affect the cheeks, tongue, palate, alveolar process and other areas.

There are three forms of oral cancer:

Knotty cancer. A seal appears on the tissues, which has clear boundaries. The color of the node may not differ from the surrounding mucosa, and may be white. Tumor growth is quite intense.

Ulcerative form. One or more ulcers form in the oral cavity, which cause pain to a person. They ooze blood. Defects exist for a long time and do not go away.

papillary form. The tumor will be dense, hanging down. Its color does not differ from the color of the mucous membranes of the oral cavity.

At risk for developing cancer are people with low immunity, as well as smokers. The neoplasm of the oral cavity is dangerous with early metastasis. First of all, the daughter cells of the tumor penetrate into the submandibular lymph nodes. In addition, they can be found in the liver, brain and lungs.

Oral cancer treatment requires surgery. The patient is then given radiation therapy and chemotherapy.

Occupational diseases of the oral cavity develop due to the fact that certain pathological factors influence the body. Moreover, they will be associated with the conditions of human labor activity.

Various harmful substances, such as salts of heavy metals, can negatively affect the oral cavity. Under their influence, a person develops stomatitis, which will have a certain set of symptoms. Doctors distinguish stomatitis mercury, bismuth, lead, etc.

It is most often possible to cope with occupational diseases only after a change of workplace. When the negative factor ceases to influence the body, the disease recedes. Sometimes a person needs an antidote.

The general principles of treatment are: sanitation of the oral cavity, relief of inflammation, elimination of pain. Any disease is easier to prevent than to treat it later. Therefore, you need to remember about preventive measures.

The main preventive measure is regular visits to the dentist. An examination by a doctor should be done at least 2 times a year.

In addition, the following guidelines must be followed:

You need to brush your teeth every morning and evening. The procedure should last at least 3 minutes.

After eating, the mouth should be rinsed. The rinse aid should not be too cold or too hot.

You should not eat a lot of sweets. After using them, rinse your mouth with water.

Do not drink hot drinks and sweet foods at the same time.

The diet should contain foods that contain a sufficient amount of vitamins.

Diseases of the oral mucosa can be both mild and quite serious. The sooner a disease is detected, the sooner it can be dealt with. Alternative methods of treatment help to get rid of only the symptoms of the disorder. They can also be used prophylactically. However, professional medical assistance is required to eliminate the disease.

Education: Moscow Medical Institute. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".

Diseases of the oral cavity is an extensive group of diseases that affects all inflammatory and degenerative processes in the oral cavity. Some have pronounced symptoms, others do not bother the patient so much. But any pathological process must be treated. After all, in addition to unpleasant sensations, it is dangerous for its consequences: damage and loss of teeth, damage to the jaw, the spread of infection throughout the body.

Any pathological process is reflected in the mucous membrane. There are a lot of bacteria in the mouth. Normally, they coexist, providing the process of primary processing of food. But in the presence of adverse factors, the composition of the flora changes: the number of pathogens increases, which cause diseases of the oral cavity and, as a result, inflammation, suppuration, various formations, tissues are damaged.

The impetus for the disease can be:

The presence of a source of infection in the body;
Weakened immunity;
Avitaminosis;
Hormonal imbalance;
The focus of caries;
Damage to the mucosa - mechanical, thermal, chemical.

Symptoms to watch out for

Any discomfort is a reason to visit a doctor. It will help to diagnose and cure the disease in time and prevent damage to the teeth.

Signs that are the reason for a medical consultation:

Sharp bad breath;
Swelling and bleeding of the gums;
Formations (sores, rash, abscesses) on the tongue, gums, mucosa;
Pain, burning, which increase during meals;
Increased salivation or severe dry mouth.

After the examination, the doctor will prescribe treatment. Perhaps, there will be enough rinses and medicinal ointments. In severe and advanced cases, a course of antibiotics will be needed.

Cause oral diseases are:

bacteria,
fungi,
viruses.

Classification of infectious and inflammatory diseases

This group of oral diseases traditionally includes stomatitis. All of them appear as a result of improper care of the oral cavity, and also accompany some diseases of the intestines or stomach.

Catarrhal stomatitis

manifested by painful swelling of the mucous membrane, the surface of which may be covered with white or yellowish plaque.

Ulcerative stomatitis

affects the mucous membrane to its full depth. Ulceration is accompanied by an increase in lymph nodes, weakness, headaches. Occurs in people with stomach ulcers or chronic enteritis.

Aphthous stomatitis

characterized by multiple aphthae (erosion) on the mucosa. It can be provoked by oral infections, allergic reactions, imbalances in the gastrointestinal tract, and even rheumatism. This type of disease begins with malaise, a possible increase in temperature, and only then aphthae appear.

Viral oral diseases

Most often, the mucous membrane is infected with the herpes virus. Usually it captures the space around the mouth, but in some situations the oral cavity is also affected. In these cases, a specialist should be consulted for treatment.

Herpes of the oral cavity is localized by aphthae on the palate, cheeks, tongue, and on the inner surface of the lips. Clinically, the disease manifests itself sequentially in the form of primary herpes infection and chronic recurrent herpes. The gums are also affected - in the form of acute catarrhal gingivitis.

Fungal diseases of the oral cavity

They arise due to the appearance in the human body, and in particular in the oral cavity, yeast-like fungi. However, more than half of the population is a carrier of the fungus in an inactive state. The signal for activation is various pathologies of the body, which sharply reduce the immune defense. As a result, canididomycosis of the oral cavity is diagnosed, since the fungi belong to the Candida group.

According to the clinical course, several types of candidiasis are distinguished.

Acute pseudomembranous candidiasis

the so-called thrush, is diagnosed most often. The surface of the cheeks, palate, lips, back of the tongue becomes dry, they are covered with a whitish coating. Patients suffer from a burning sensation in the mouth, discomfort when eating. Children tolerate it easily, while the appearance of the disease in adults may be due to diabetes, hypovitaminosis, blood diseases, so treatment can be difficult.

Acute atrophic candidiasis

very painful for a person. The mucosa acquires an intensely red color, its surface is extremely dry, there is almost no plaque. If present, then in the folds, and it includes not only the fungus of the oral cavity, but also the desquamated epithelium.

Chronic hyperplastic candidiasis

With a slightly affected surface, an unusually thick layer of inseparable plaque in the form of plaques or nodules is present. When you try to remove plaque, the cleaned inflamed surface bleeds.

Chronic atrophic candidiasis

occurs when wearing removable lamellar dentures for a long time. The mucous membrane dries up and becomes inflamed. The classic symptoms of this type of disease are characteristic inflammation of the tongue, palate, corners of the mouth.

Since effective treatment depends on the correct identification of the causative agent of the disease, only a qualified doctor has the right to prescribe it after a series of tests.

Glossitis

Glossitis is an inflammation of the mucous membranes of the tongue.

With this disease, inflammation can occur:

taste buds on the surface of the tongue
mucous membranes of the sublingual region.

Symptoms of glossitis

Pain. Characteristic are pain when eating, drinking, and talking. Sometimes burning, soreness, or even numbness in the area of \u200b\u200bthe tongue worries. If the infection has penetrated the region of the taste buds of the tongue, there is a violation of taste sensations.

Edema. This symptom is a common manifestation of inflammation. With swelling, the tongue increases in size. With severe inflammation, speech may be impaired due to edema.

Glossitis can be manifested by redness of the mucous membranes of the tongue, as well as the formation of ulcers, wounds, pustules and vesicles filled with a clear liquid.

Stomatitis

Stomatitis is an inflammatory disease of the oral mucosa.

Stomatitis is a common infectious inflammation of the oral mucosa. It is characterized by swelling, redness, ulcers form on the surface. There are several types:

Catarrhal manifests itself in the form of redness and white bloom;
Ulcerative is accompanied by wounds, fever, headache and fever. Often develops against the background of diseases of the gastrointestinal tract, dysbacteriosis;
Aphthous - begins with a high temperature, then ulcers appear on the mucous membrane. Infections and allergic reactions can be the cause.

The cause of stomatitis can be damage - a scratch, cut, biting, into which the infection enters. Damage can occur with an improperly selected denture that scratches the gums or mucous membranes.

Also, this painful condition can occur as a result of trauma to the mucous membranes with sharp particles of food, foreign objects. Damage to the mucous membranes is accompanied by an increase in the activity of pathogenic microbes and the development of inflammation. Stomatitis can develop on:

a limited area of the mucosa,
throughout the mucosa.

The spread of infection is determined by the type of pathogen, as well as the state of human immunity.

Symptoms of stomatitis

Pain. Pain with stomatitis is often intense. It interferes with eating and normal articulation. Often, the severity of pain becomes the cause of the patient's insomnia.

Edema. Thickening of the mucous membranes with stomatitis is also a consequence of inflammation. The edematous mucosa becomes loose, it is easily injured by the teeth when talking, which creates additional "gates" for the infection to penetrate.

Mucosal changes. The appearance of spots and sores is a non-specific symptom that occurs with stomatitis of both a viral and bacterial nature. The formation of grayish films is characteristic of diphtheria. Convex whitish spots on the inner surface of the cheeks (Filatov-Koplik spots) are the first sign of incipient measles.

With stomatitis, antibacterial rinses, ointments, applications are prescribed. You may need to take antimicrobial or antiallergic drugs.

Gingivitis

Gingivitis is an inflammation of the gums.

Gingivitis is a frequent companion of dental diseases. It also sometimes occurs in the background:

lack of vitamins in the diet (typical for children),
immune disorders,
hormonal disruptions, etc.

Symptoms of gingivitis

Pain. With gingivitis, pain bothers the patient when brushing his teeth, eating, using toothpicks or dental floss.

Edema. The gum increases in size, becomes looser.

Mucosal changes. Depending on the type of infection, sores or erosions of various shapes can form on the gums. The gums may bleed.

Timely treatment is the key to a quick recovery

When the first symptoms appear, it is important to start the right treatment aimed at the cause of oral diseases - pathogens. This will help stop the development of inflammation, get rid of discomfort and avoid complications.

Leukoplakia- keratinization of the mucous membrane, which occurs as a reaction to a constant stimulus. The reasons may be:

Smoking;
Permanent damage - the sharp edge of the filling, dentures;
Frequent use of strong alcohol;
hot or cold food;
Taking certain medications.

Treatment begins with the removal of the source of the lesion. Sanitation of the oral cavity is carried out, restorative applications are prescribed.

halitosis- Bad breath. It occurs for many reasons: with diseases of the gastrointestinal tract, respiratory organs (especially with the formation of purulent plugs in the tonsils), kidney disease, diabetes mellitus. But the most common is the inflammatory process in the oral cavity. The smell itself arises from putrefactive processes, the accumulation of a large number of dead bacteria and dead cells. To eliminate an unpleasant odor, you need to cure the underlying disease, caries and other dental diseases, remove inflammation of the gums.

Sialadenitis- Infectious inflammation of the salivary glands. It is provoked by sources of infection, postoperative conditions, injuries of the salivary glands. The disease begins with swelling, followed by suppuration and necrosis. These phenomena are accompanied by fever, pain. Antibiotics, vitamin therapy, local rinses and applications are prescribed for treatment.

Candidiasis occurs when the immune system is weakened, with excessive reproduction of Candida fungi, with prolonged use of antibiotics. Among the reasons - wearing prostheses and a large amount of carbohydrate food. The mucosa is covered with a white coating, the patient experiences dry mouth. Sometimes there is pain. In addition to local therapy, in most cases, antifungal drugs are needed.

Xerostomia. Dry mouth is a concomitant disease. It occurs with direct damage to the salivary glands, their atrophy in old age, as well as in some diseases of the brain and nervous system. It often occurs as a result of nasal congestion - when a person breathes through his mouth for a long time, and the mucous membrane dries up. In addition to treating the underlying ailment, applications with an oily solution of vitamin A and physiotherapy are prescribed.

hypersalivation- increased salivation - occurs with inflammation and irritation of the mucous membrane, as well as a symptom of other diseases - gastrointestinal, brain diseases, poisoning.

cheilite- inflammation of the border of the lips. It is characterized by the formation of dry fragments, when exfoliating, a reddened mucosa opens, sometimes it bleeds a little. It occurs with cracking of the lips with constant licking, with weakened immunity, allergies, thyroid diseases. Treatment is related to the treatment of the underlying disease.

periodontal disease

Periodontal disease is a fairly rare disease. It is characterized by generalized dystrophy of all periodontal tissues. This process is accompanied by severe hypoxia and tissue degeneration. Patients do not experience pain. For this reason, the disease often goes unnoticed, without contacting a specialist. However, in the expressed stages, periodontitis develops.

The main symptoms of periodontitis can be called anemic gums, bare necks and even roots of teeth become visible, interdental papillae are atrophic, there is also mobility and displacement of teeth.

Treatment of this disease includes filling of erosions, wedge-shaped defects, treatment of hypoxia. Treatment should be carried out jointly by the dentist and the therapist.

Periodontitis

This dangerous disease can be caused by such factors as: metabolic disorders, a decrease in the body's resistance, a lack of proteins and vitamins, and the presence of neuro-somatic diseases in a patient.

Insufficient, environmental and occupational hazards also have a negative impact. The nature of nutrition is also very important - if you eat only soft food, then self-cleaning of the teeth does not occur.

This disease can be expressed by symptoms of varying severity. Most often, the patient suffers from chronic periodontitis, which has arisen as a consequence of gingivitis. With periodontitis, the patient notices the appearance of bleeding gums, bad breath. Tartar builds up quickly. If the disease is started, then the person begins to experience pain, abscess formation and loosening of the teeth occur.

With an exacerbation of this disease, it is urgent to contact the dentist. If the disease is chronic, then the patient should be observed by dentists, therapists, surgeons, orthopedists. It is very important to follow all the rules of oral hygiene.

Flux on the gum

Flux is otherwise called odontogenic periostitis. It is often caused by caries, but it is also provoked by injuries, inflammation of the gum canals, and improper oral hygiene.

The disease is caused by the activity of infectious cells that enter the spaces between the teeth and gum tissues. As a result, the formation of pus begins, which affects the periodontium, destroys the bone tissue of the tooth.

If timely assistance is not provided, pus can spread to the jawbone, enter the internal organs or the brain as a result of penetration into the blood.

Lichen planus

It manifests itself in the oral cavity in the form of plaques, blisters or sores, redness. Lichen planus of the oral cavity can occur in combination with damage to other parts of the mucous membrane and skin surface, or appear locally. The disease is usually combined with diabetes, diseases of the liver, stomach.

Doctors consider immunity disorders to be the main prerequisite for its appearance. It is believed that there is a genetic predisposition to lichen planus. The course of the disease can be acute (up to 1 month), subacute (up to 6 months), long-term (over 6 months).

Dysbacteriosis

The cause of various kinds of inflammation, leading to the development of any disease, has recently been considered dysbacteriosis. The mentioned problem is a natural consequence of taking antibiotics, local antiseptics in the treatment of various types of respiratory diseases.

Symptoms of oral dysbiosis may seem minor at first. This is the formation of painful cracks in the corners of the lips, bad breath. Its development leads to loosening of the teeth, contributes to the occurrence of periodontal disease. A lot of plaque appears on the teeth, damaging the enamel surface of the teeth. An unfavorable environment is created in the cavity for the functioning of the tonsils, tongue receptors, and ligaments. The restoration of a healthy microflora of the mucosa is required in order to erect a barrier to the path of most pathogenic microbes.

A healthy mucosa is an effective barrier to oral disease. Therefore, at the first symptoms of any problems, it is strongly recommended to visit a doctor for a competent diagnosis and prescribing an adequate course of therapy.

For citation: Inflammatory diseases of the oral cavity and pharynx // RMJ. 1999. No. 12. S. 586

The oral cavity of a healthy person is inhabited by many different microorganisms: green streptococcus, anaerobes, fungi of the genus Candida, etc. Subject to a decrease in local and general body resistance (diabetes mellitus, tumors of the blood system, AIDS, Crohn's disease, as well as smoking, etc.), exposure to these microbes can cause inflammatory and destructive diseases of the oral cavity and pharynx.

Diseases involving periodontal tissues combine pathological processes affecting the gums (gingivitis), bone alveoli and other structures surrounding the tooth root (periodontitis proper), and are the main cause of tooth decay and loss in adults.

Diseases affecting periodontal tissues

Gingivitis

The initial, early phase of periodontitis is gingivitis - inflammation of the gums, which occurs in almost all cases as a result of inadequate oral care . The most common causative agents are anaerobic Gram-negative organisms (eg. Prevotella intermedia). Sticky plaque, composed primarily of bacteria, accumulates along the edge of the gums and in places that are difficult to clean. After 72 hours, the remaining plaque may thicken with the formation of tartar, which cannot be removed with a conventional toothbrush.

During pregnancy, menstruation, during puberty, with the use of contraceptives, the incidence of gingivitis increases. In addition, it is noted that taking certain medications (eg, phenytoin, cyclosporine, nifedipine) often accompanied by gingivitis . The hyperplasia of the gum tissue caused by these drugs makes it difficult to remove plaque and promotes inflammation. In such cases, drug withdrawal is necessary, and often surgical correction (removal of hyperplastic tissue) is also necessary.

A similar situation is observed for idiopathic hereditary gingival fibromatosis .

Exposure to heavy metals (bismuth) can also cause gingivitis.

Symptoms of simple gingivitis include redness and swelling of the gums that bleed easily when eating and brushing. Pain is usually absent. The gums may recede from the surface of the tooth. Formation gum abscesses most characteristic of patients with decompensated diabetes mellitus.

Gingivitis on the background hypovitaminosis C (scurvy, scurvy) is accompanied by severe bleeding. niacin deficiency (pellagra) , in addition, is characterized by a high tendency to develop other infections of the oral cavity.

Acute herpetic gingivitis , stomatitis proceeds with the outlined pain syndrome. The presence of multiple superficial ulcerations on the oral mucosa is characteristic.

Gingivitis during pregnancy develops against the background of changes in the hormonal profile. Often, the presence of nausea in the first trimester does not allow proper oral care. Under the influence of weak irritants (tartar or rough edge of the filling), a tumor-like growth of gum tissue occurs in the interdental space ( "tumor of pregnancy" ), which bleeds easily on contact. Perhaps the formation of pyogenic granulomas. Treatment should include removal of the "tumor", tartar, instrumental cleaning of the surface of the teeth from plaque, correction of the condition of the fillings.

Desquamative gingivitis , developing during menopause , is characterized by insufficient formation of keratin-containing cells of the epithelium of the gums, their increased vulnerability, the appearance of bleeding and pain. Desquamation of the epithelium may be preceded by the formation of vesicles. Replacement therapy with sex hormones leads to subsidence of the phenomena of gingivitis.

Similar symptoms may occur when pemphigus vulgaris and pemphigoid , in some cases as a paraneoplastic process. Treatment requires systemic administration of corticosteroid hormones (with the exclusion of cancer).

Gingivitis may be the first manifestation leukemia (up to 25% of cases in children). It develops as a result of infiltration of the gums by tumor cells, as well as against the background of an existing immunodeficiency. Thrombocytopenia accompanied by severe bleeding gums.

At pericoronitis a tooth (usually an erupting wisdom tooth) is partially or completely hidden by swollen gum tissue. In the gum "trap" fluid, bacteria, pieces of food accumulate. The infection can spread to the throat and cheek.

General rules for the treatment of gingivitis include the removal of plaque, tartar, oral hygiene, and the elimination of other contributing factors. For persons with an increased predisposition to inflammatory periodontal diseases, it is advisable to prophylactically clean their teeth from plaque instrumentally at the dentist (from 2 times a month to 2-4 times a year), use drugs that promote local protection of the oral mucosa (imudon).

Acute necrotizing ulcerative gingivitis (Vincent's angina) accompanied by pain in the mouth, bleeding, rapidly progressive ulceration of often large areas of the mucous membrane. Sometimes it proceeds in a gangrenous form, resembling noma (see below), with damage to both soft tissues and bone structures. Emotional and physical overwork, exhaustion, especially in conditions of insufficient oral hygiene, and smoking predispose to the development of this form of gingivitis. The pathogenesis of the disease is associated with the aggressive influence of anaerobic microorganisms - inhabitants of the oral cavity, such as Prevotella intermedia, spirochetes. Often, Vincent's angina is a manifestation of AIDS. The onset of the disease is quite acute. There are bad breath, pain in the gums, ulceration of the interdental gingival papillae. The affected surface is covered with a gray necrotic coating, it bleeds easily. These manifestations are accompanied by subfebrile fever.

Therapeutic measures include careful removal of necrotic tissue and plaque in the maximum sparing mode, under local anesthesia. The patient needs rest, adequate nutrition and fluid replenishment.

Locally applied antibacterial agents and antiseptics (for example, lubrication with Metrogyl Dent gel 2 times a day, frequent rinsing with 1.5% hydrogen peroxide solution). During the first day, appoint analgesics .

In severe cases (fever, an increase in the area of the lesion), systemic use is required. antibiotics effective against gram-negative anaerobes (penicillin intramuscularly at a dose of 500 mg 4 times a day, erythromycin orally 250 mg 4 times a day or intravenously at 0.5–1 g 3 times a day, tetracycline orally 250 mg 4 times a day, clindamycin orally 150– 450 mg 4 times a day or IV 0.6-0.9 g 3 times a day; a combination of penicillin at the same dose with metronidazole orally at a dose of 500 mg 3 times a day or 500 mg IV 3 times a day is highly effective ).

Effective combination of antibiotic therapy with immunostimulating drugs acting in the oral cavity. These drugs include imudon, which is an immunostimulant of bacterial origin. Imudon activates phagocytosis, increases the content of lysozyme in saliva, known for its antibacterial activity. Imudon stimulates immunocompetent cells, increases the amount of secretory IgA in saliva and slows down the oxidative metabolism of neutrophils. The optimal dose is 6 - 8 tons per day. Contraindication to use is hypersensitivity to the drug.

Periodontitis

Periodontitis is an inflammatory-destructive lesion of the structures surrounding the tooth root. The gradual accumulation of plaque and the deposition of tartar in the gum pocket contribute to its deepening, as a result, the infected content penetrates into the gap between the wall of the bone alveoli and the root of the tooth. Favorable conditions are created for the reproduction of anaerobic microflora. There is a melting of the ligaments of the tooth, its loosening and loss.

Symptoms of periodontitis are redness, bleeding, and soreness of the gums; formation of deep gum pockets. Radiography allows you to clarify the condition of the bone tissue surrounding the root of the tooth.

Localized juvenile periodontitis , associated with Actinobacillus actinomycetemcomitans, Capnocytophaga, Eikenella corrodens,Wolinella recta and other anaerobes, causes a rapid pronounced formation of gingival pockets, destruction of bone tissue. It has been established that hereditary defects in neutrophil chemotaxis and tissue damage by microbial toxins (leukotoxin, collagenase, endotoxin) are involved in the pathogenesis of this disease. Adult periodontitis associated with aggression Porphyromonas gingivalis,Prevotella intermedia, other gram-negative organisms against the background of a decrease in the mechanisms of local protection.

Treatment of periodontitis carried out by a specialist dentist (cleaning deep gum pockets, trimming exfoliated gums). In the case of abscess formation, it may be necessary to use local and systemic antibiotics (lubrication with Metrogyl Dent gel 2 times a day, penicillin V orally 500 mg 4 times a day, benzylpenicillin intramuscularly at a dose of 500 mg 4 times a day, erythromycin orally 250 mg 4 once daily, tetracycline 250 mg orally 4 times daily, clindamycin 150–450 mg orally 4 times daily or 0.6–0.9 g intravenously 3 times daily; penicillin plus metronidazole 500 mg orally 3 times a day or intravenously at 500 mg 3 times a day). The use of imudon in combination with antibiotics is promising.

Periodontal tissue infections can cause transient bacteremia and complications (eg, bacterial endocarditis) after tooth extraction. In such cases, it is advisable to "cover" dental intervention with antibiotics.

Inflammatory diseases

mucous and soft tissues

oral cavity

At recurrent aphthous stomatitis on the oral mucosa periodically (with remissions up to several years or with continuous relapses) single or grouped whitish painful ulcerations appear, surrounded by a halo of hyperemia, with a diameter of less than 5-10 mm. The central part is an area of necrotic epithelium. Ulcerations persist for several weeks, sometimes heal with scar formation. The appearance of aphthae on mobile areas of the oral mucosa, devoid of keratin (the inner surface of the cheeks, tongue, pharynx, soft palate), distinguishes them from herpetic rash, which also covers keratinized areas (gums, hard palate).

Therapeutic measures are symptomatic (local anesthetics, analgesics, protective paste with carboxymethyl cellulose, silver nitrate, CO 2 laser, tetracycline suspension). With widespread lesions, a continuously relapsing course, prednisolone is prescribed at an initial dose of 40 mg in combination with imudon.

Angina Ludwig - cellulitis of the sublingual or submandibular space, characterized by rapid spread. It usually occurs as a complication of periodontitis of the lower molars. Febrile fever, salivation appear. Swelling of the sublingual space with upward and backward displacement of the tongue can lead to airway obstruction. Therapeutic surgical measures are aimed at draining the oral tissue. Assign antibiotics active against streptococcus and anaerobic microflora of the oral cavity: ampicillin / sulbactam (1.5–3 g intravenously or intramuscularly 4 times a day) or penicillin in a high dose intramuscularly or intravenously in combination with metronidazole (500 mg 3 times a day). day intravenously). In critical situations, there is a need for a tracheostomy.

noma - lightning-fast gangrene of the tissues of the oral cavity or face, more often developing in extremely weakened and malnourished patients or in children. Considered as a very severe form of Vincent's angina. The etiological factor is anaerobes living in the oral cavity, especially often fusospirochetes ( Fusobacterium nucleatum). The principles of treatment include debridement, administration of high-dose penicillin (500 mg 4 times a day intramuscularly or intravenously) in combination with metronidazole (500 mg 3 times a day intravenously), correction of the patient's general condition.

herpetic rash ("cold" sores, vesicles) is localized more often on the mucous membrane of the lips, sometimes on the mucous membrane of the cheeks, tongue. The rash persists for 10-14 days. The prognosis of the disease is favorable, but dehydration often develops due to the inability of the patient to receive an adequate amount of fluid against the background of pain. Symptomatic treatment: the use of local anesthetics - 2-20% benzocaine ointment, 5% lidocaine solution 5 minutes before meals, analgesics (acetaminophen). In the prodromal period, it is advisable to prescribe acyclovir 200 mg 5 times a day per os. Lubrication of the elements of the rash every 2 hours with a 1% cream containing penciclovir contributes to a more rapid disappearance of painful manifestations.

Candidal stomatitis caused by fungi of the genus Candida, develops mainly in a state of immunodeficiency (against the background of immunosuppressive therapy, HIV infection, severe general condition) or as a complication of antibiotic therapy. On the mucous membrane of the oral cavity, spots of milky white plaque are found, upon removal of which the eroded surface is exposed. Characterized by a metallic taste in the mouth. In addition to eliminating factors predisposing to the development of candidiasis, antifungal agents are prescribed topically (nystatin suspension) or oral fluconazole (200 mg on the 1st day, then 100 mg per day). Given the leading role of saprophytic and opportunistic microflora in the pathogenesis of a wide range of inflammatory diseases of the soft tissues of the oral cavity, gums and periodontal structures, an effective combination drug has been developed for the treatment and prevention of these diseases - Gel Metrogyl Denta . It combines metronidazole (which has antiprotozoal and antibacterial action against anaerobic protozoa and anaerobic bacteria that cause gingivitis and periodontitis) and chlorhexidine (an antiseptic with bactericidal action against a wide range of vegetative forms of gram-negative and gram-positive microorganisms, yeast).

With the participation of intracellular transport proteins of anaerobic microorganisms and protozoa, the biochemical reduction of the 5-nitro group of metronidazole (nitroimidazole derivative) occurs. In this case, the metronidazole molecule acquires the ability to interact with the DNA of microorganisms, inhibiting the synthesis of their nucleic acids, which ultimately leads to the death of pathogens.

Salts of chlorhexidine dissociate in a physiological environment, and the cations released in this process bind to the negatively charged shells of bacteria. At low concentrations, chlorhexidine can cause an imbalance in the osmotic balance of bacterial cells, loss of potassium and phosphorus, which is the basis of the bacteriostatic effect of the drug. Chlorhexidine retains its activity in the presence of blood and pus.

Local application of the gel (on the gum area 2 times a day) provides a high focus of action with minimal side effects, as well as a reduction in the frequency of administration. With local application, the concentration of metronidazole in the gum area is significantly higher than with systemic administration.

The use of Metrogyl Dent is indicated for acute gingivitis, acute necrotizing ulcerative gingivitis of Vincent, chronic gingivitis (edematous, hyperplastic, atrophic / desquamative form), chronic periodontitis, periodontal abscess, recurrent aphthous stomatitis, toothache of infectious origin. After applying the gel for 15 minutes, you can not rinse your mouth and eat.

Inflammatory diseases of the pharynx and pharynx (pharyngitis, tonsillitis)

Pharyngitis in most cases, it develops against the background of a viral infection (rhinoviruses, coronaviruses, parainfluenza virus). Symptoms include sore throat, prodromal nasal congestion, cough, hoarseness, flushing, pinpoint follicle hyperplasia, and posterior pharyngeal edema. With influenza and adenovirus infection, fever and myalgia are expressed. With an adenovirus infection, exudate (usually of a mucous nature) may appear on the back of the pharynx.

Infectious mononucleosis, caused by the Epstein-Barr virus, in half of the cases it is accompanied by pharyngitis and tonsillitis with exudation, which makes it similar to a bacterial infection (“anginal form” of the disease). The peak incidence occurs at the age of 15–25 years. The disease is characterized by a gradual (within a week) onset. In addition to nonspecific symptoms of pharyngitis and tonsillitis, enlargement of the lateral cervical lymph nodes, specific signs are revealed: splenomegaly (50%), hepatomegaly and jaundice (5–10%), primary and secondary (in response to the prescription of penicillin antibiotics) rash, atypical mononuclear cells, absolute blood lymphocytosis, positive Paul-Bunnel reaction.

Herpangina (infection with Coxsackie viruses) accompanied by the appearance of vesicular rashes on the soft palate between the tongue and tonsils and symptoms of general intoxication.

Pharyngitis caused by herpes simplex virus resembles severe streptococcal tonsillitis, accompanied by the appearance of vesicles and erosions on the mucous membrane of the mouth and pharynx.

In the group of inflammatory diseases of the pharynx and pharynx of bacterial etiology deserve special consideration pharyngitis and tonsillitis (acute tonsillitis) against the background of infection with group A streptococci (Streptococcus pyogenes). Streptococcal pharyngitis is rare in isolation, usually combined with tonsillitis. The development of the disease is uncharacteristic for patients younger than 2 and older than 40 years. The onset is usually acute, with the onset of fever, severe sore throat, aggravated by swallowing and talking. Cervical lymphadenopathy, swelling and hyperemia of the pharynx and tonsils, accumulations of pus on their surface, leukocytosis in the peripheral blood are detected. According to the severity of the course, mild, moderate and severe tonsillitis are distinguished.

Streptococcal pharyngitis and tonsillitis are diagnosed by the results of a culture study of mucus from the pharynx or from the back of the pharynx, as well as recently developed methods for detecting streptococcal antigen. Positive results of a streptococcal antigen test are equivalent in significance to positive results of sowing mucus from the throat; a negative test result requires confirmation by a negative culture result.

Treatment is carried out with penicillins (ampicillin 0.5-1 g 4 times a day) or erythromycin (0.25-0.5 g 4 times a day) per os for 10 days or by a single injection of benzathinepenicillin intramuscularly (the required concentration of antibiotic remains in the blood for up to 3 weeks); it is possible to use other antibiotics (amoxicillin orally 0.5 g 3 times a day, cephalexin orally 0.5 g 4 times a day, cefuroxime intravenously 0.75–2 g 3 times a day). Paracetamol is prescribed as an anti-inflammatory agent. It is necessary to comply with bed rest, drink plenty of water, gargle. The use of immunostimulants (imudon) enhances the clinical effect of antibiotics.

Complications of streptococcal infection are divided into purulent (peritonsillar and retropharyngeal abscess) and non-purulent (scarlet fever, septic shock, rheumatism, acute glomerulonephritis). Antibacterial therapy reduces the risk of rheumatism, but does not affect the incidence of glomerulonephritis, the severity and duration of angina.

Pharyngitis of a bacterial nature can also be caused by streptococci of groups C And G, Neisseria gonorrhoeae, Arcanobacterium hemolyticum, Yersinia enterocolitica, Corynebacterium difteriae, Mycoplasma pneumoniae, Chlamydia pneumoniae.

Peritonsillar abscess acts as a complication of streptococcal pharyngitis, tonsillitis. In its pathogenesis, anaerobic microorganisms - inhabitants of the oral cavity can also play a role. Sore throat, severe unilateral swelling and erythema in the pharynx with uvula deviation are the most characteristic symptoms. Urgent drainage of the abscess is necessary with the appointment of antibiotic therapy: penicillin in combination with metronidazole (500 mg 3 times a day orally or intravenously), clindamycin (orally 150-450 mg 4 times a day or intravenously 0.6-0.9 g 3 times a day) or ampicillin / sulbactam (1.5-3 g intravenously or intramuscularly 4 times a day). After subsiding of acute inflammatory phenomena, tonsillectomy is recommended.

parapharyngeal abscess - an inflammatory process in the parapharyngeal space, extending from the hyoid bone to the base of the skull, as a rule, is a complication of oral infections (tonsillitis, pharyngitis, periodontitis) or parotitis, mastoiditis. Symptoms of general intoxication, fever, sore throat at rest and when swallowing, protective tension of the neck muscles, often trismus are expressed. When examining the pharynx, swelling of its side wall, displacement of the tonsil are noted. The diagnosis is confirmed by computed tomography with contrast. Treatment consists of drainage of parapharyngeal tissue, the use of antibiotics (the treatment regimen is similar to that for peritonsillar abscess), and monitoring the state of breathing. Extremely dangerous complications are jugular vein thrombophlebitis, carotid artery erosion, mediastinitis, inflammation of the cranial nerves. In their recognition, magnetic resonance imaging is very informative.

Development retropharyngeal abscess can occur both due to direct and lymphogenous spread of infection from nearby foci. Sore throats intensify, symptoms of general intoxication appear, shortness of breath, speech is difficult (up to stridor). On examination, a bulging of the posterior pharyngeal wall is revealed. X-ray using soft radiation or computed tomography are auxiliary methods of diagnosis. Treatment includes immediate surgical intervention (opening and drainage of the abscess), the introduction of active against streptococcus, Staphylococcus aureus, H. influenzae antibiotics (ampicillin / sulbactam 1.5-3 g intravenously or intramuscularly 4 times a day; clindamycin intravenously 0.6-0.9 g 3 times a day in combination with ceftriaxone 1-2 g intramuscularly or intravenously 1-2 times a day).

Literature

3. A.G. Likhachev Diseases of the ear, nose and throat. M. "Medicine", 1985; 248 p.

4. Therapeutic handbook of the University of Washington: trans. from English / Ed. M. Woodley, A. Whelan. Moscow: Practice, 1995; 832 p.

5. Chow A. W. "Life - threatening infections of the head and neck" / Clin. Infect. Diseases 1992; 14:991.

Yu.A. Shulpekova

Chlorhexine + metronidazole:

METROGIL DENTA

(UNIQUE Pharmaceutical Laboratories)

Immunostimulant of bacterial origin:

IMUDON

(SOLVAY PHARMA)

Oral diseases are a very common problem. There is hardly a person who has not encountered certain diseases in his mouth at least once in his life. The causes of diseases, like the diseases themselves, are very diverse. Let's try to identify the most common of them and understand the symptoms and how to treat diseases of the oral cavity.

Disease symptoms

The symptoms depend on the underlying disease. Here are some common pathologies and their symptoms:

caries. Symptoms are the direct destruction of the enamel and the tooth itself;
stomatitis. It is characterized by the formation of one or more ulcers in the oral cavity, they are painful, there is a burning sensation. Stomatitis delivers a lot of negative sensations;
flux is an inflammation of the gums near the tooth, the accumulation of pus in it. There are pains when chewing or pressing on the tooth. In some cases, the cheek and chin swell, the lymph nodes increase;
ulcers on the tongue - the appearance of painful sores on the tongue. Wounds are painful, do not heal for a long time;
gingivitis - bleeding gums.

Causes

The causes of oral diseases can be as follows:

poor dental health, late visits to the dentist;
improper use of antibiotics;
diseases of internal systems;
spicy, acidic foods, alcohol, tobacco use;
hormonal disruptions in the body;
poor oral hygiene.

This list is not complete, other unknown causes may serve as diseases.

Inflammation and gum disease

Gum disease most often provokes untimely dental treatment and the use of inappropriate oral hygiene products (toothpastes, powders, brushes, dental floss). Inflammation occurs during the life of harmful microorganisms that can destroy the oral cavity.

Remember! Properly selected hygiene products and proper oral care will significantly reduce the risk of various diseases.

Among the main diseases are:

gingivitis. Symptoms are bleeding gums, they become soft and painful. There is an unpleasant smell from the mouth;
periodontitis. The gum in this disease becomes inflamed and moves away from the tooth, thereby exposing it. In a severe form, the gum bleeds heavily, the teeth become shaky, the root is destroyed;
periodontitis. Inflamed tissue around the root of the tooth. Symptoms - rapidly growing toothache. The patient's temperature rises, the lymph nodes in the chin area increase.

All diseases are characterized by inflammation. This is a dangerous process that can lead to complications. If the pain does not go away, you should contact the dental clinic.

What are toothaches

One of the most unpleasant pains is definitely a toothache. Dentists are afraid of fire, both adults and children. Depending on the disease, there are different types of pain. Sometimes the pain is sharp, unbearable, sometimes aching, haunting. Let's try to highlight a few of them:

with caries, the toothache is not too sharp, it appears and disappears. It occurs as a result of taking too cold, hot, spicy, sour food. Such pain is temporary and passes quickly;
if a flux has formed, the pain is of a moderate nature, manifested by pressing on the aching tooth;
if a disease such as periodontitis occurs, the pain is acute, throbbing. You clearly feel the aching tooth. Such pain does not go away on its own, relief comes after taking an anesthetic.

Caries

Caries is a process of tooth decay due to demineralization and softening of tooth enamel. A small hole appears in the tooth, over time it increases and can completely destroy the tooth. If you do not take action, the disease spreads to healthy teeth. Occurs due to a violation of the pH balance.

The reasons for this violation are:

cariogenic microbes;
improperly selected hygiene items;
excessive consumption of carbohydrates;
violations of the functions of salivation;
lack of fluorine in the body;
poor oral hygiene.

This disease has stages of development:

spot stage. A small stain appears on the surface of the tooth. The disease does not manifest itself in any way, proceeds without symptoms. At the initial stage, the stain is difficult to see and is diagnosed by a dentist;
superficial, middle stage. It is characterized by the appearance of a more noticeable spot. Bacteria affect not only enamel, but already dentin;
deep caries. A cavity is formed in the tooth. Enamel, dentin are destroyed, the disease affects the pulp.

Stomatitis

This is an inflammatory process in the oral cavity. The main reason for the occurrence is the lack of proper oral hygiene. But hygiene is not the only reason. Among the main ones are the following:

candidiasis or fungal stomatitis. In the words of the people - thrush. Appears due to the action of fungal bacteria Podacandida;
herpetic stomatitis - the result of the action of the herpes virus;
anaphylactic stomatitis. It is caused by allergic reactions of the body.

The symptoms are as follows:

the temperature rises to high levels;
poor appetite, irritability;
if it is a child, capriciousness, poor sleep;
white plaque on the oral mucosa;
the appearance of sores in the mouth (sores).

Important! Many people do not pay attention to the formation of wounds in the mouth. This is unacceptable and leads to complications such as bleeding gums, tooth loss and even laryngitis.

Flux

Flux is one of the most serious diseases in the field of dentistry. It leads to very undesirable consequences, up to blood poisoning. Let's take a closer look at the main causes of flux:

past illnesses, such as tonsillitis and furunculosis, can provoke a flux;
in case of damage to the gums (solid food, toothbrush, cutlery), gum flux may appear;
filling removed at the wrong time. It irritates the pulp and the result is the appearance of inflammation;
the introduction of microbes, for example, through an injection.

The main symptoms in the event of a disease: fever, severe pain in the area of inflammation when chewing and pressing on the tooth. The flux itself is a purulent bump on the gum, it can be easily seen. It quickly grows and becomes inflamed, the pain can be transmitted to the eye, chin, ear. In some cases, the cheek, lip and chin are very swollen.

Ulcer on the tongue

Ulcers can be both an independent disease and a consequence of other diseases. Consider the cases in which ulcers most often appear:

stomatitis. As a result of this disease, wounds can occur on the surface of the tongue. These unpleasant phenomena are accompanied by pain and burning;
tongue injury. Every day, the tongue is mechanically affected. Ulcers can be caused by hard food, bones, tongue biting, damage to a prosthesis or braces, or medical exposure. As a result of these injuries, wounds appear in the form of ulcers or erosions.
as a result of such serious diseases as tuberculosis, syphilis, ulcers in the mouth and tongue also form;
tongue cancer is a malignant tumor in the tongue.

It is very important to seek the advice of a dentist when sores appear on the tongue. Timely treatment will help prevent serious diseases and maintain your health.

Oral diseases in children

Children's mouth diseases are similar to those of adults. Let's try to classify them:

Divided by:

chronic recurrent aphthous stomatitis. This disease is characterized by the appearance of ulcers, several or a large number. They have a white coating, painful. Also characterized by relapses of the disease;
herpetic stomatitis. Can be light, medium and heavy. The disease is characterized by such symptoms as the appearance of temperature, inflammation of the mucous membrane, the appearance of wounds on the mucous membrane and tongue. Such complications are characteristic - bleeding gums, tooth loss, bad breath;
catarrhal stomatitis is a disease that occurs on the basis of medications. The reasons are taking antibiotics and some other drugs.

Pediatric pyoderma

This is a streptostaphylococcal disease. It manifests itself on the mucous membrane, lips in the form of wounds and cracks. Often this disease affects children with weakened immune systems. Children who do not receive proper nutrition and vitamins also suffer.

Illness due to injury

Traumatic mucosal injury. Children often injure the oral cavity, it can be toys that they put in their mouths, inexperienced use of cutlery, the inability to properly use a toothbrush, and other factors.

Thrush (candidiasis)

A fungal infection causes this unpleasant disease. Most often occurs in infancy due to the inability of the children's mucosa to resist infection.

Oral diseases in the elderly

Nature is arranged in such a way that the human body ages, age-related changes occur in it. Metabolism deteriorates, immunity weakens. This is one of the important factors in the occurrence of various diseases, including diseases of the oral cavity. These include:

Xerostomia (feeling of dry mouth)

A symptom of the disease is a decrease in saliva production. Appears as a result of taking certain medications, chemical exposures. The decrease in protective functions leads to a decrease in protection against microbes and bacteria and leads to various diseases, such as caries, periodontitis;

Darkening and abrasion of teeth.

Long-term consumption of foods that can change the color of the enamel, and some other factors lead to pathological yellowness of the teeth. Teeth become sensitive to cold, hot, easily destroyed.

Root caries is a common disease leading to tooth decay.
Change in taste sensations. This pathology is caused by age, taking drugs, wearing a prosthesis, and some other diseases.
Periodontitis. A common disease in the elderly. In addition to age, it is caused by factors such as poor hygiene, untimely access to the dentist. This disease occurs in a severe form most often in the elderly.

Interesting to know! Many people, observing the rules of hygiene, manage to maintain healthy teeth until very old age. This makes them look younger.

Treatment at home

Most often, if there are no complications, oral diseases are treated at home. After visiting the doctor, you need to carefully follow the treatment regimen. The doctor prescribes drugs and procedures aimed at combating microbes and viruses, lowering the temperature and increasing the local immunity of the oral cavity.

The dentist prescribes a number of manipulations, the observance of which is important for a cure. It can be various ointments, rinses, adherence to a certain diet. To improve the result, you can use folk remedies.

Add a tablespoon of salt to a glass of warm water. Rinse your mouth with the solution for 1-2 minutes. You can repeat 5-6 times a day;
apply camphor alcohol on a bandage or cotton wool, apply for 5-10 minutes to the affected tooth. Alcohol is recommended to lubricate the gums;
cleaning teeth with a solution of laundry soap. This solution should be used in the morning and evening, only freshly prepared.

Mix a leaf of crushed aloe with olive oil (1 tbsp. Spoon). Apply this ointment for stomatitis 2-3 times a day;
chop the burdock root, add 100 grams of sunflower oil. Insist for 12 hours, then boil and boil over low heat for 20 minutes. Lubricate the affected areas of the mucosa with ointment;
dilute fresh carrot juice with boiled water, rinse your mouth with this drink 5-6 times a day.

mix equal amounts of salt and baking soda. Dilute with a glass of warm boiled water. Rinse your mouth with this solution 4-5 times a day;
mix oak bark, sage, St. John's wort in equal parts, brew with boiling water (1 liter). Rinse your mouth as often as possible, at least 6 times a day;
Add a tablespoon of salt to a glass of green tea. Rinse your mouth with this solution every hour.

Remedies for ulcers on the tongue and mouth

calendula grass (2 tbsp. Spoon) pour a liter of boiling water, cook over low heat for 15-20 minutes. Rinse your mouth 5-6 times a day;
elecampane leaves (2 tablespoons) pour a liter of boiling water, leave for 3-4 hours, rinse your mouth every 2-3 hours;
mix honey with chopped almonds, treat mouth ulcers with the resulting mixture 4-5 times a day.

Prevention

Among the preventive measures to combat diseases of the teeth and oral cavity, the following should be highlighted:

daily brushing of teeth, at least 2 times a day;
hygiene of toothbrushes and other accessories for the mouth;
choose the right toothbrush and paste;
follow proper nutrition, do not abuse foods that lead to the destruction of tooth enamel. Give up strong tea, coffee, too sour, salty foods. Nicotine is also bad for your teeth;
be careful when chewing solid foods.

Take care of the health of your teeth, keep oral hygiene, and a beautiful smile will stay with you for many years.

Extraction of any tooth is a rather problematic procedure, as it brings long-term pain as a result. Therefore, after this procedure, many patients are concerned about the question: ...