The human oral cavity performs many specific functions. An indicator of the well-being of the oral cavity is the condition of the mucous membrane. On the mucosa, all diseases of the oral cavity usually appear. Most pathological processes are associated with diseases of various organs and systems of the individual, changes in his immune status.
Partial or complete absence of them in elderly patients is still a typical condition and that a significant part of the population is the "proper and normal" state of this stage of life. They should be taught that neither is the most advanced system of prosthetic rehabilitation. gum tongue. Wipe thoroughly with a brush and rinse with running water. besides improving chewing.
It is an ingrained belief that a good overall denture solves your dental problems. in any of its types. saving as much as possible more teeth in the mouth. lunch and food, no matter how aesthetic and sophisticated. The possible appearance of ulcers is easy to resolve by contacting a dentist. In the case of a partial denture. but also because the teeth have an important function of proprioceptive sensitivity. The education provided should include various measures to control bacterial plaque. If the patient is completely edentulous.
The following factors can provoke diseases of the oral mucosa:
- Problems associated with the condition of the teeth;
- Illiterate antibiotic treatment;
- Diseases internal organs and main systems;
- The damaging effects of hot and spicy food, alcohol, smoking;
- Various infections;
- Dehydration of the body;
- Avitaminosis of various types;
- Hormonal fluctuations;
- genetic predisposition.
In a normal state, microorganisms that belong to the category of opportunistic pathogens live in the oral cavity. Under the influence of negative factors, some types of microflora can increase their virulence. So they go into a pathogenic state.
Rinse your mouth before placing your denture because it adheres better to moist gums. When a denture is in or out, place a container that holds it on a towel so it doesn't break if dropped, and at night, remove the denture and place it in a glass of water. Daily use of fluoride toothpaste Daily or weekly use of mouthwash according to the patient's ability and needs indicates special accessories such as dental floss.
You should perform a fine cleaning of the gum that covers the alveolar ridge at least after each meal. Brushes with wide bristles and soft bristles. it should have a fundamentally preventive approach and focus on education for both the patient and the staff or family responsible for their care. under the supervision of a dentist.
Conditionally pathogenic flora causes diseases of the oral cavity and tongue, called endogenous infectious diseases. And creates conditions for external infections. At infectious diseases on the mucosa, viral diseases are often manifested.
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.
That is, an adult adult should visit the dentist periodically to rule out any violations. Factors affecting oral health in the elderly, such as diabetes. Periodontal disease, which is the most common disease, contributes to the rapid deterioration of the oral cavity.
The maxillofacial structure of a person changes over time. Over the years, the entire facial structure grows and the lower jaw advances both in length and in the transverse direction; This happens up to a certain age. In order for this growth to occur, the presence of dentition in the alveolar processes is fundamental, and if these are lost, the alveolar bone is reabsorbed and the height of the face is reduced, causing the typical facies of the elderly to suffer from this loss.
- Catarrhal stomatitis is 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 the full depth. Ulceration is accompanied by an increase in lymph nodes, weakness, headaches. Occurs in people with peptic ulcer stomach or chronic enteritis.
- Aphthous stomatitis is characterized by multiple aphthae (erosions) 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, possible increase temperature, and only then aphthae appear.
Viral 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.
It is very common for older people to get to the dentist with a few missing teeth, poor fetuses and decline due to accumulation of damage to their oral health over the course of a lifetime and limited dental care coverage, especially among the adults they are served in the system. public health. Sometimes patients come in who were able to access dental care during their lifetime, but we can see great rehabilitation systems in them. Unfortunately, it is common for older patients to be without any dental products and, even worse, without rehabilitation prostheses or with them in their pockets due to the lack of ridges that allow the prosthesis to be validated.
Herpes of the oral cavity is localized by aphthae on the palate, cheeks, tongue, inner surface 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 as a result of the appearance in the human body, and in particular in 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.
In short, the most common are partially edentulous patients who bring a denture in poor condition and complete edentulous patients who are usually rehabilitated with a full denture with good esthetics. appearance their upper prosthesis and their lower jaw prosthesis, which they cannot normally use.
Both injuries can be prevented with effective oral hygiene and good quality, ongoing and regular dental care. Unfortunately, the availability of adequate dental services in Chile is very limited, resulting in a high incidence of caries and periodontal disease, with subsequent biological, psychological and social damage. The absence of teeth leads to the following consequences.
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 is 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 it, an unusually thick layer of inseparable plaque in the form of plaques or nodules is present on the affected surface. 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.
Because the effective treatment depends on correct definition the causative agent of the disease, only a qualified doctor after a series of tests has the right to prescribe it.
Exclusion of social events such as meetings, parties or family dinners, either due to a lack of parts, or with poorly restored teeth, with a prosthesis that moves, which prevents them from using them safely. Research in Japan has shown that in patients who live in nursing homes, malnutrition problems are associated with a lack of oral rehabilitation; Chile has done some work to avoid this problem by providing food in the papilla. In taste perception: For most patients, the flavors do not match when the prosthesis covers the palate. Poor quality of life: there are studies that prove that poor oral rehabilitation causes a direct impact negative impact on the quality of life of people.
- Difficulty speaking.
- Difficulty chewing, which gives rise to digestive and nutritional problems.
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.
Only 37% of patients were able to wear a lower prosthesis despite a large number of completely edentulous patients. Women had the oldest dentures. This study also showed that the prevalence of sexual pathologies: caries, periodontal disease, lesions of the oral mucosa and edentylism in the elderly of the province of Santiago is high. So far, there are no published studies of oral health at the national level.
Oral pathology of the elderly
A study of Espinoza in the province of Santiago showed that 53% of those examined had some kind of lesion at the level of the oral cavity. This condition is especially evident in patients who wear acrylic dentures rather than metal-based dentures, and the mucous membranes are reddened or with patchy lesions.
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 may be acute form(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, in recent times consider dysbacteriosis. The mentioned problem is a natural consequence of taking antibiotics, local antiseptics in the treatment of various types of respiratory diseases.
In addition, patients may present with lesions in the lingual mucosa and changes in the taste of food. Irritant hyperplasia: observed in 9.4% of those examined. It represents damage to the oral mucosa secondary to poor tooth position, due to poor mucosal suction habit, at the mucosal margin associated with poorly adapted dentures.
Angular cheilitis: Present in 2.9% of participants as a lesion at the level of the labial commissures secondary to rehabilitation that has been maintained for a long time or in patients who have lost a prosthesis or are severely debilitated such that they have lost the vertical dimension of the occlusion. Proper rehabilitation changes the face of the patient, rejuvenates him, and angular cheilitis disappears. Lichen flat and lichen lesions: were found in 2.1% of patients, usually associated with autoimmune disorders.
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. Created in the cavity hostile environment for the functioning of the tonsils, tongue receptors, 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.
The patient sometimes reports a burning sensation in the mouth, which is sometimes unbearable and other times asymptomatic. Leukoplakia: in 1.7% of patients. Its clinical aspect is lesions such as spots or white plaques that appear at the level of the cheeks, on the lateral and lower border of the tongue and on the floor of the mouth or elsewhere. These lesions are considered cancerous. Leukoplakia can look similar to squamous or squamous cell carcinoma and it is important to make an early differential diagnosis as this type of cancer is very invasive.
Buccal cancer: 95% of mouth cancers are examined in people over 40 years of age. The treatment of this cancer causes great damage at the maxillofacial level and is difficult to rehabilitate due to both high cost and large loss of maxillary tissue. Bladder cancer diagnosed at an average age of 63 in Chile is more common in men and causes 4.4% of cancer deaths worldwide. When it appears on the floor of the mouth, it is very malignant because it can spread to other areas, and it presents as very difficult to treat ulcers.
A healthy mucous membrane 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.
What are diseases of the oral mucosa?
Diseases of the oral mucosa (stomatitis) are a fairly common problem. But their correct diagnosis is complicated by the fact that many diseases of the oral cavity occur with similar or even the same symptoms.
It can also compromise the salivary glands; in this case, salivation is reduced, especially associated with the effects of radiation therapy, which causes difficulties in handling prosthetic devices, burning of the tongue, sore throat, a very strong sensation of saliva, and difficulty speaking and chewing. Patients report that they need to drink water constantly in order to eat dry foods.
On the other hand, it was found that 15% of those over 75 reported that they could not eat heavy things like apples and carrots, and 9% reported that they did so with great difficulty. These results allow us to understand that important group older people can affect their quality of life, mainly related to their oral health problems.
Stomatitis is a wide range of different diseases of the tongue, lips or palate. Accordingly, they are called glossitis, cheilitis and palatinitis. When the mucous membrane of the mouth thickens, becomes horny and peels off, they speak of a special type of disease - leukoplakia.
Causes of diseases of the oral mucosa
The reasons why the oral mucosa is exposed to stomatitis are diseases of the gastrointestinal tract, cardiovascular problems, a decrease in the body's immune forces, metabolic disorders and factors that directly affect the oral mucosa.
The congress was organized by the Society of Geriatrics and Gerontology of Chile. Authors: Marianna Angelica Torres Valenzuela, Iris Espinoza Santander. Affiliation: Faculty of Dentistry, University of Chile, Santiago, Chile. Speaking of oral health these days, there is a topic that many people command a lot of "respect" for. different reasons, being the main fear that causes them. However, education and advances in this area of healthcare have allowed the topic to be more accepted, and going to the dentist is part of people's holistic health from an early age.
Stomatitis can also occur due to various dental reasons. For example, diseases often develop due to a person’s non-compliance with the rules of hygiene and oral care, decayed teeth and dental deposits play their role. Violations of the technique of dental procedures can also cause stomatitis, since dissimilar metals and chemical substances in the treatment of teeth and prosthetics, they can create microtraumas.
Oral health and general health When we talk about oral health, we include all tissues found in the oral cavity: teeth supporting dental tissues such as gum, bone and other anatomical structures present in the mouth such as tongue, palate, lips, cheeks, floor of the mouth and others. When assessing, all structures must be included and not just see the teeth. The reason for this is that the first symptoms and signs of some systemic diseases may be present in many cases in the mouth.
Saliva can be a diagnostic tool for drug levels, toxins, hormones, antibodies to detect diseases, or laboratory tests. The most common oral diseases that can be diagnosed are. Dental caries Periodontal disease Oral cancer. . Other common injuries such as herpes simplex, candidiasis, ulcers or canker sores, dry mouth syndrome, and other less common lesions.
Symptoms of diseases of the oral mucosa
Symptoms of diseases of the oral mucosa are directly dependent on the type of stomatitis.
Catarrhal stomatitis among diseases of the oral mucosa is the most common. It is caused by local factors, which include poor oral care, dental plaque and disease, oral dysbacteriosis and all kinds of pathological processes of the gastrointestinal tract (gastritis, duodenitis). When catarrhal stomatitis is caused by helminthic invasion, the mucous membrane of the mouth swells, becomes covered with white or yellow coating and becomes painful. The patient has noted increased salivation, gums may bleed, an unpleasant odor appears from the mouth.
Ulcerative stomatitis- a fairly serious disease of the oral mucosa. It develops both independently and as a complication of catarrhal stomatitis. Often this disease occurs in people suffering from a stomach ulcer or a chronic form of enteritis. The risk group also includes people suffering from infectious and cardiovascular diseases, blood diseases and poisoning. Ulcerative stomatitis affects not only the upper layer of the oral mucosa, but also its entire thickness. The initial symptoms resemble catarrhal stomatitis, but after a while they appear characteristics ulcerative lesions of the mucous membrane: body temperature rises to 37.5 degrees, the patient feels weakness, headache; lymph nodes may become enlarged and painful. eating is difficult due to severe pain.
Aphthous manifests itself with the appearance of aphthae (sores) on the mucous membrane of the mouth. Aphthae can be oval or round, red at the edges and greyish-yellow in the center. Aphthous stomatitis develops mainly due to diseases of the gastrointestinal tract, allergic reactions. Viral infections or rheumatism can also be causes. In addition to damage to the oral mucosa and its soreness, there is a general malaise, the patient's body temperature rises, and so on.
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Leukoplakia is a chronic lesion of the oral mucosa, which is based on increased keratinization of the epithelium (hyperkeratosis). It affects mainly men after 40 years and is localized on the mucous membrane of the cheek, in the corners of the mouth and on the lateral surfaces of the tongue. The causes of leukoplakia can be mechanical injuries of the mucous membrane: cuts with hooks from a denture, burns from hot or spicy food, and so on. This disease most often does not have pronounced symptoms, only sometimes the patient may feel slight itching and burning. But the danger of the disease lies in the fact that it can turn into malignant forms, so the patient needs to consult an oncologist.
Treatment of diseases of the oral mucosa
The basis for the treatment of diseases of the oral mucosa is the elimination of the causes that provoked them. The oral cavity is subject to sanitation, the sharp edges of the teeth are treated, and the denture is properly adjusted. The patient is advised to stop smoking and eating spicy and hot foods.
Tartar with stomatitis is removed, and the teeth are to be treated. It is necessary to rinse the oral mucosa with antiseptic agents (chlorhexidine or aminocaproic acid solutions). Also apply folk remedies: infusions and decoctions of chamomile and calendula. If signs of stomatitis persist after 5-10 days, most likely they were caused by a disease of the gastrointestinal tract or helminthic invasion. Then local treatment is combined with the general one.
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