MOUTH

ORAL CANDIDIASIS (THRUSH) = fungal infection of oral cavity

ETIOLOGY SIGNS/SYMPTOMS MANAGEMENT & TREATMENT
Bacterial if infected, Foul smelling nasal Nystatin oral suspension applied to
Nasal polyps, sinusitis, discharge (possible oral mucosa 4 times/day for 10 days
tonsillitis, cystic fibrosis, bloody) If unresponsive, consider using oral
allergy, congenital Taste/small disturbance fluconazole
malformation, prolonged Anterior nares and upper Treat mother if breastfeeding
nasal decongestant use lip discoloration Check anus/diaper for concurrent rash
Clear rhinorrhea Sterilize nipples and pacifiers

CLEFT LIP/PALATE = failure of embryonic structures and or palatal shelves around oral
cavity to join
ETIOLOGY SIGNS/SYMPTOMS MANAGEMENT & TREATMENT
Genetic Separation of lip and/or Surgical repair (lip by 2 months,
(more common in males, palate palate by 9-12 months) by
Asians, or with maternal otolarygologist, plastic surgeon,
drug exposure) pediatric dentist, orthodontist, speech
therapist, speech therapist, genetic
counselor, social worker

DENTAL CARIES = demineralization of tooth secondary to production of organic acids by

bacterial fermentation of dietary carbohydrates
ETIOLOGY SIGNS/SYMPTOMS MANAGEMENT & TREATMENT
Streptococcus mutans Brown spots on teeth, Wean from bottle, pacifier, and breast
Leaving bottle in crib tooth sensitivity, Gingical at one year of age
Poor oral hygiene swelling, localized pain Brush/wipe teeth after each feed
Inadequate fluoride (may progress to abscess Fluoride supplement
if left untreated) Dental sealants
Dental visits starting a 12 months

HERPES LABIALIS (cold sore, fever blister) & HERPES SIMPLEX STOMATITIS:
ulceration and inflammation of oral mucosa from herpes virus
ETIOLOGY SIGNS/SYMPTOMS MANAGEMENT & TREATMENT
HSV-1 Initial onset presents as fever, Acetaminophen or ibuprofen for p
5-10 days after chills, irritability, tender ain
exposure to virus (only submandibular adenopathy, 1:1 mixture of diphenhydramine
50% develop ulcers) gingival/ mucosa ulceration. (Benadryl) with antacid (Maalox)
Subsequent cold sores Recurrent infection presents Can add 2% lidocaine in severe
appear with increase only as ulceration cases
exposure to sunlight, Ulcers have red base and Acyclovir if started within 72 hours
stress, fevers progress to vesicles which Resolves in about 2 weeks
bleed easily. OTC cold sore treatment

HAND, FOOT, MOUTH DISEASE: Acute viral illness presenting with vesicular exanthem on
tongue, gums, palatem oral mucosa with papulovesicular exanthem on hands, feet, legs, and
sometimes buttocks (more common in summer and fall)
ETIOLOGY SIGNS/SYMPTOMS MANAGEMENT & TREATMENT
Coxsackievi Small vesicles that erode to Fever/Pain control w/ acetaminophen & ibuprofen
rus A16most ulcers on buccal mucosa 1:1 mixture of diphenhydramine (Benadryl) with
common
, A5, tonsils, & tongue with antacid (Maalox)
A10,Enterov blanching lesions on arms, Can add 2% lidocaine in severe cases
irus 71 (if legs, palms, soles Increase fluid intake
more severe) Low-grade fever & Anorexia Resolves on it’s own in 1 week

HERPANGINA: Acute viral illness presenting with ulceration and inflammation of oral mucosa (more
common in summer)
ETIOLOGY SIGNS/SYMPTOMS MANAGEMENT & TREATMENT
Coxsackievirus Small vesicles or punched out Fever/Pain control with acetaminophen & ibuprofen
Group Amost common ulcers on soft palate and tonsillar 1:1 mixture of diphenhydramine (Benadryl) with
Coxsackievirus pillars that erode to ulcers antacid (Maalox)
B, Echoviruses Fever Can add 2% lidocaine in severe cases
Increase fluid intake