Medical History. Oral Medicine and General Medicine
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1 Medical History Oral Medicine and General Medicine
2 Gingivitis herpetica acuta
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7 NECROTIZÁLÓ SIALOMETAPLASIA
8 SOOR
9 Medical History The life expectancy has recently increased and increasing By dental prevention programmes, the number of teeth also stay in elderly people. More and more patients visit the dentists with oral mucosal diseases. Dentists need expertise to recognise these diseases.
10 Origin of the mucosal complaints Oral complaints in elderly people could occur due to decreased normal turnover, or impaired regenerative potential It is epithelial atrophy Symptoms of general medical diseases Side effect of drugs taken for another disease Oral mucosal diseases
11 General Medical History Oral History
12 General Medical History The data of medical history (personal, familial and social) help in the summarisation of the patients complaints and help in the diagnosis. The printed and computerised data sheets facilitates an easier communication between doctor and patient. The important and not so important answers must be selected by the health care professionals
13 General Medical History If the dentist spends not enough time to listen to patients complaints will close a gate, which cannot be opened later The more complex medical problem, the more detailed medical history is needed. The data of medical history must be stored for a long period of time (at least for 5 years).
14 MEDICAL HISTORY Dentists must be careful in evaluating medical history Each prejudication cause misdiagnosis. Dentists must know many treatment protocols in general medicine and be familiar with the drugs taken by the patients at home.
15 The role of dentists in the recognition of general medicine diseases.
16 The role of dentists in the recognition of general medicine diseases. There are a lot of general medical diseases, which have early oral signs and symptoms: e.x. infectious diseases in the childhood. Scarlet: Red strawberry tongue. Whooping cough: (Pertussis) Lingual frenum erosions.
17 Haematological diseases The oral symptoms of RBC production are nonspecific. Iron deficient anaemia frequently can develop in young female and elder male. Pernicious type anaemia also shows early oral symptom (Möller-Hunter glossitis). Plummer-Vinson syndrome (iron deficient anaemia, oral and oesophageal epithelial atrophy) Iron deficient anemia Möller-Hunter glossitis
18 Diseases of leukopoietic system The role of dentist is more important in the recognition of leukopoietic system diseases. In agranulocytosis and acute leukemia ulcers develop migrating into the deep. In chronic myeloid leukemia damaged leukocytes are stored in parenchymal organs ex.. in the gingiva ( hyperplastic gingivitis).
19 Neuroendocrine diseases Many endocrine diseases have oral symptoms with high diagnostic value. In Addison disease melanotic plaques can be found on the oral mucosa. But the most important is: Diabetes Mellitus.
20 Diabetes Mellitus. As a result of decreased INSULIN level Produced by the beta cells in Langerhans islands of pancreas. Macrophages in the mandibular and maxillary bone differentiate into osteoclasts, the number of Gramnegative bacteria increased. In many cases decline the oral hygiene.
21 Lichen Oris According to Grynspan et al. (1963) lichen oris can be found in 36,4% of diabetic patients. (trial of Grynspan syndrome - Diabetes Mellitus - Oral Lichen Planus - Hypertension Among our own patients 51,6% have had sugar level on the upper border or over.
22 Candida Albicans infection in diabetic patiens The upper lobe of Parotid gland excrete the saccharose from circulation. By this way in the mouth of the diabetes patients particularly Candida infection can be found.
23 Autoimmune diseases Most autoimmune diseases are treated by glucocorticosteroid or other immunosuppressive drugs. Virus and fungal infections can develop in the patients oral cavity as a side effect. These diseases must treated by dentist. HSV infection in the oral cavity
24 Efflorescence Primary Secondary Tertiary
25 Morphological characterization of skin and mucosal diseases Efflorescence's are morphological criteria of diseases. They could be characterized on the basis of their: - color, - size, - form - consistency The secondary efflorescence's develop from primary form.
26 Circumscribed, flat discoloration that maybe brown, blue, red or hypo pigmented. Macule (primary lesion)
27 Papule (primary lesion) An elevated solid lesion up to 0.5 mm in diameter; color varies: papules may become confluent and form plaque. LICHEN RUBER PLANUS
28 A circumscribed, elevated, superficial, solid lesion more than 0.5 mm in diameter often formed by confluence of papules. Plaque (primary lesion)
29 Nodule (primary lesion) Circumscribed, elevated solid lesion more than 5 mm in diameter, a large nodule is referred as TUMOR.
30 Circumscribed collection of leukocytes and free fluids, which varies in size. Pustule (primary lesion)
31 Blisters (Vesicula-Bulla, primary lesio) Vesicle: Circumscribed, collection of free fluid up to 0.5 cm in diameter. Bulla: A circumscribed collection of free fluid more than 0.5 cm in diameter.
32 Herpes simplex Erythema Exudativum Multiforme Gingivostomatitis Herpetica Herpes zoster
33 Herpes simplex Eryíthaema Exudativum Multiforme Gingivostomatitis Herpetica Herpes zoster
34 A firm edematous plaque resulting from infiltration of the dermis with fluid: wheals are transient and may last only for a few hours. Wheal (hive) (primary lesion)
35 Excess, dead epidermal cells that are produced by abnormal keratinization and shedding. Scales (secunder lesion)
36 Crust (secondary lesion) A collection of dried sera and cellular debris: Scab.
37 Focal loss of epidermis: Erosion (secondary lesion) erosion do not penetrate below the dermoepidermal junction and therefore heal without scaring.
38 Ulcer (secondary lesion) A focal loss of epidermis over the basal membrane region. Heal with scar. Sutton aphtae
39 Fissure (secondary lesion) A linear loss of epidermis and dermis with sharply defined nearly vertical walls. Angular Cheilitis
40 Atrophy (secondary lesion) Depression in the skin resulting from thinning of epidermis and dermis.
41 Scar (secondary lesion) An abnormal formation of connective tissue implying dermal damage; after injury or surgery scars are initially thick and pink but with time become white and atrophic.
42 Recognition of efflorescence's helps doctors to diagnose a disease. the
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