Lesson 64 - Common disorders of the oral cavity

How do caustic substances affect the oral cavity?

chemical erosions or ulcerations of the oral mucosa

How fast do mucous membranes of the oral cavity heal?

generally heal rapidly

How do antibiotics affect the oral cavity?

may kill normal flora of the oral cavity

How does high blood glucose concentration affect the oral cavity?

may allow for colonization of sugar-loving organisms not generally present

What is an example of an issue caused by high blood glucose?

thrush caused by surface growth of Candida spp.

What is a portal of entry for the oral cavity?

mechanical penetration of oral mucosa

Why are oral infections relatively rare?

efficacy of oral secretions and the epithelial barrier

How is mechanical penetration a portal of entry?

allows pathogens to spread through submucosal tissues and enter vascular channels or lymphatic vessels

What happens to most pathogens that are introduced into the oral cavity?

halted and killed

What do some organisms need for multiplication?

epithelial surfaces and lymphoid tissues

What is an example of a virus that needs lymphoid tissues for multiplication?

canine parvovirus

What is an example of a pathogen that needs epithelial surfaces for multiplication?

bovine viral diarrhea

What is the importance of small lacerations in the oral mucosa?

allow for introduction of bacteria that can cause specific systemic disease

What is an example of an illness that uses small lacerations to cause systemic disease?

listeriosis

What are the defense mechanisms of the oral cavity?

stratified epithelial surface, taste buds, microbiota, saliva

How does the stratified epithelial surface act as a defense mechanism?

resistant to trauma and some irritants

How do taste buds act as a defense mechanism?

reject potentially toxic materials based on taste and tongue feel

How do microbiota act as a defense mechanism?

occupy attachment sites that would otherwise be available to pathogens

How does saliva act as a defense mechanism?

provides a flushing action, forms a protective coating of the mucosa, contains lysozymes and IgA

What are the categories of lesions of the oral cavity?

development anomalies, inflammation, disturbances of growth

What are the subcategories of disturbances of growth in the oral cavity?

neoplasia and hyperplasia

What are development anomalies of the oral cavity?

palatoschisis and cheiloschisis

What is palatoschisis?

cleft palate

What is cheiloschisis?

cleft lip

What happens structurally with palatoschisis?

failure of fusion of the lateral palatine processes of the maxilla

What cavities are communicating with palatoschisis?

oral and nasal cavities

What is the etiology of palatoschisis?

genetic/hereditary, toxic, teratogenic defect during gestation

What teratogenic compound could cause palatoschisis?

griseofulvin

What is the sequelae of congenital anomalies?

failure to suckle, prehension, mastication of food leading to starvation; aspiration pneumonia; malposition of teeth

What happens structurally with cheiloschisis?

incomplete fusion of the frontonasal process with the maxillary process

What is a normal case of a split upper lip?

rabbits; called hare lip

What is the term for oral cavity inflammation?

stomatitis

What is the term for gingiva inflammation?

gingivitis

What are ways that you can have loss of mucosa?

erosions, ulcerations, necrosis

What is the etiology of oral cavity inflammation?

infectious agents, chemical injury, trauma, intoxicants, autoimmune disease, systemic disease

What is a clinical sign seen if mastication is painful?

anorexia

What are clinical signs of inflammation?

anorexia, hypersalivation/ptyalism

What is the first and most common sign of FIV infection in cats?

gingivitis

What are the causes of vesicular stomatitis?

thermic and chemical agents, autoimmune disease, developmental defects, infectious

What are the specific infectious causes of vesicular stomatitis?

foot and mouth disease, vesicular exanthema in swine, swine vesicular disease, and feline calcivirus

What do the primary lesions of vesicular stomatitis look like?

vesicles

What do the secondary lesions of vesicular stomatitis look like?

erosions, ulcers, abscesses on the buccal mucosa

What does erosive and ulcerative stomatitis look like?

multiple ulcerated areas seen on the buccal mucosa from pin head to 5 cm in diameter

What are the causes of erosive and ulcerative stomatitis?

viral, uremia, indolent ulcer in cats, vesicular disease, trauma due to sharp teeth, chemical

What are viral causes of erosive and ulcerative stomatitis?

bovine viral diarrhea, malignant catarrhal fever, infectious bovine rhinotracheitis, bluetongue, rinderpest, herpesvirua, calicivirus, FLV, FIV

What are chemicals that can cause erosive and ulcerative stomatitis?

acids, alkalines, erosive salts

What are some causes in cats for ulcerative stomatitis and glossitis?

calicivirus, FIV, FLV, indolent ulcers

Where are sites of indolent ulcers in cats?

commissure of the upper lip, gingiva, tongue, palate, regional lymph nodes

What is chronic ulcerative paradental stomatitis also called?

CUPS; ulcerative stomatitis and lymphocytic-plasmacytic stomatitis

What dogs are susceptible to CUPS?

maltese and cavalier king charles spaniels

What is the etiology for CUPS?

apposition of "kissing ulcers" to dental plaque, immune system overreacting to chronic exposure to bacteria in plaque

What do lymphocytic-plasmacytic lesions suggest?

inflammation rather than infectious cause

What happens if you don't treat CUPS?

bone resorption

What can you see with healing from erosive and ulcerative stomatitis?

pale depressed foci on the mucosa

What can occur secondary to erosive and ulcerative stomatitis?

bacterial infection by fusobacterium necrophorum called oral necrobacillosis

What stomatitis results from oral necrobacillosis secondary to erosive and ulcerative stomatitis?

fibrinonecrotic stomatitis

What can be seen with proliferative stomatitis?

pustules and papules

What is a type of proliferative stomatitis in dogs?

canine oral papillomatosis

What is a type of proliferative stomatitis in cows?

bovine papular stomatitis

What causes bovine papular stomatitis?

parapox virus infection

Where can you see papules with bovine papular stomatitis?

nares, muzzle, oral cavity, esophagus, rumen

What do humans get when handling bovine papular stomatitis?

milkers nodules and hands and arm

What are some types of necrotizing stomatitis?

coagulative necrosis, noma/trench mouth, oral necrobacillosis

What does coagulative necrosis stomatitis look like?

dry yellow friable masses with fould odor

What animals get noma/trench mouth?

primates and dogs

What bacteria cause noma/trench mouth?

spirochetes and fusiform bacteria

What type of stomatitis is noma/trench mouth?

pseudomembranous or gangrenous stomatitis

What is another term for oral necrobacillosis?

calf diphtheria

What animals get oral necrobacillosis?

calves

What organism causes oral necrobacillosis?

fusobacterium necrophorum

What is the cause of lymphoplasmacytic stomatitis in cats?

idiopathic

What is associated with lymphoplasmacytic stomatitis in cats?

certain bacteria, calicivirus, FeLV, FIV

What does chronic lymphoplasmacytic stomatitis in cats look like?

red, inflamed gums, fetid breath, inappetance

What happens to the oral mucosa in lymphoplasmacytic stomatitis in cats?

hyperplasia and ulceration, infiltration of lymphocytes and plasma cells in the lamina propria

What are the types of hyperplasia disturbances of growth?

gingival hyperplasia and peripheral odontogenic fibroma

What does gingival hyperplasia look like?

hard, non-neoplastic focal or diffuse thickened gingival composed of reactionary proliferated fibrous connective tissue

What is another term for gingival hyperplasia?

fibrous hyperplasia

What is gingival hyperplasia secondary to?

chronic inflammation and periodontitis

What animals most commonly have gingival hyperplasia?

dogs specifically brachycephalic breeds, also seen in horses

What is familial in boxers over 5 years of age?

gingival hyperplasia

What is the differential diagnosis for gingival hyperplasia?

epulis

What is another term for peripheral odontogenic fibroma?

epulis

What does epulis mean?

tumor-like mass on the gingiva

What is a neoplasia growth of the epithelium in the oral cavity?

squamous cell carcinoma

Where do cats get squamous cell carcinomas?

tongue and gingiva

Where do dogs get squamous cell carcinoma?

tonsils and gingiva

What species get squamous cell carcinomas?

dogs, cats, cattle, horses

What is the most common oral neoplasm in aged cats?

squamous cell carcinoma

What do the lesions of squamous cell carcinoma look like?

small, granular to large, ulcerated cauliflower-like masses

What type of tumors are squamous cell carcinomas?

usually malignant

What is the most common oral tumor in dogs?

melanoma

Where do melanomas like to grow?

palate, tonsillar area, teeth alveoli

What types of tumors are melanomas?

typically malignant with poor prognosis

What do the lesions of melanomas look like?

black macule with firm, dome-shaped mass

What types of tumors are papillomas?

benign

What usually causes papillomas?

papilloma virus infection

What would you see in keratinocytes for papilloma virus infections?

intracytoplasmic inclusion bodies

What animals get papillomas?

young dogs and cattle

What happens to papillomas?

spontaneous regression within 1-3 months with long lasting immunity

Where do papillomas like to grow?

lips, cheeks, tongue, palate, larynx, esophagus,