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CHEMICAL INJURIES OF THE ORAL CAVITY.

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ORAL CAVITY. CHEMICAL INJURIES OF ... Cancer chemotherapeutic agent Groups of drugs and agents, ... - No specific treatment for the oral lesions which although severe – PowerPoint PPT presentation

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Title: CHEMICAL INJURIES OF THE ORAL CAVITY.


1
CHEMICAL INJURIES OF THE ORAL CAVITY.
2
CHEMICAL INJURIES OF THE ORAL CAVITY
  • The oral cavity frequently manifests a serious
    reaction to a wide variety of drugs and
    chemicals.
  • The tissue reaction is that of a local response
    to a severe irritant or even a caustic used
    injudiciously.

3
Contd.
  • Allergic phenomenon is the most common reactions
    to drugs or chemicals.
  • The two main types that are of dental interest
    are
  • 1.Drug allergy or stomatitis
  • 2.Contact stomatitis

4
NONALLERGIC REACTION TO DRUGS AND CHEMICALS USED
LOCALLY.
  • Irritants or caustics which are used by the
    dentist in various therapeutic are technical
    procedures induces a non allergic reactions when
    used locally.
  • Some of these substances are discussed separately
    below
  • 1.Aspirin (Acetylsalicylic Acid)
  • 2.Endodontic Materials.

5
Contd.
  • 2. Sodium Perborate.
  • 3.Hydrogen Peroxide.
  • 4. Phenol.
  • 5.Silver Nitrate.
  • 6. Trichloroacetic Acid.
  • 7. Volatile Oils.
  • 8. Miscellaneous Drugs and chemicals.

6
ASPIRIN (ACETYLASALICYLIC ACID)
  • Uses
  • It is especially used for the relief of
    toothache.
  • Effects
  • Particularly harmful to the oral mucosa if
    applied locally.
  • Separation and sloughing of the epithelium and
    frequently bleeding.

7
ASPIRIN BURNS
8
ASPIRIN BURNS
9
Endodontic materials
  • Effects
  • Dangerous to oral soft tissues.
  • Damage or deep spread of inflammation and
    necrosis if injected into hard tissues.
  • Examples
  • Paraformaldehyde,sodium hypochlorite, hydrogen
    peroxide etc.

10
Sodium Perborate
  • Uses
  • Used as a mouth-wash and in dentrifices.
  • Effects
  • Produced an erythema of the oral mucosa.
  • Sloughing of the tissues.

11
Hydrogen peroxide
  • Uses
  • Prevention of periodontitis.
  • Effects
  • Epithelial necrosis.
  • Sloughing of the epithelium.

12
PHENOL
  • Uses
  • Cavity sterilizing agent.
  • Cauterizing agent.
  • Effects
  • Severe painful burns of the oral mucosa and skin.

13
DENTAL STAIN DUE TO LONG TERM USE OF
CHLORHEXIDINE MOUTHWASH
14
Volatile oils
  • Effects
  • Produce mild burns of the mucous membranes.
  • Examples
  • Oil of cloves.
  • Oil of winter green.
  • Eucalyptus oil.

15
TETRACYCLINE
  • Effects
  • Discoloration of deciduous or permanent teeth.
  • Affinity for deposition in bones and tooth
    substance.
  • Moffitts contributions
  • Critical period for tetracycline induce
    discoloration in the deciduous dentition is
  • 1. 4 months in utero.
  • 2. 3 months in postpartum for maxillary and
    mandibular incisor.

16
Contd..
  • 3. 5 months in utero to 9 months postpartum for
    maxillary and mandibular canines.
  • 4. 3 to 5 months postpartum is necessary for
    permanent maxillary and mandibular incisor and
    canines.
  • Grossmans contribution
  • tetracycline therapy diminishes tooth
    discoloration if its indicated in the pregnant
    female or during 6 to 7 yrs of life.

17
TETRACYCLINE STAIN OF MANDIBULAR TEETH
18
MINOCYCLINE-ASSOCIATED PIGMENTATION
19
Contd..
  • Clinical features
  • Tetracycline
  • 1. Yellowish or brownish-gray diffuse bands of
    discoloration within the tooth structure.
  • 2. Fluoresces under ultra violet light.
  • Chlorotetracycline
  • 1. brownish gray colour within the tooth
    structure.

20
Contd..
  • Minocycline hydrochloride
  • 1. commonly stained in skin, nails, sclera,
    conjunctiva, thyroid, bones and teeth.
  • 2. dark colour of underlying bone through the
    thin translucent oral mucosa.
  • 3. reveal varying patterns of discoloration.

21
Cancer chemotherapeutic agent
  • Groups of drugs and agents, used for the
    treatment of malignant neoplastic diseases.
  • Function
  • - Destruction of malignant cells.
    Cytotoxic agent exert their effect
    preferentially against mitotic cells.
  • Side effect
  • - Normal mitotic cells of oral mucosa,
    bone marrow and skin are also prone to the
    cytotoxic and damaging effect of these agents.

22
Contd..
  • Clinical features
  • - few general manifestations of these agents
    due to their non specific nature
  • 1. Alopecia.
  • 2. Stomatitis.
  • 3. Radiation recall or radiation
    sensitisation.

23
Contd..
  • Oral manifestations
  • 1. mucosal erosion and ulceration in the
    mouth, frequently diffuse and multiple, often
    related to neutropenia.
  • 2. haemorrhage resulting from
    thrombocytopenia.
  • 3.hyper pigmentation of oral mucosa.

24
Contd..
  • Treatment
  • - No specific treatment for the oral lesions
    which although severe, must be considered, of
    only secondary importance to the patients major
    problem.

25
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