CHEMICAL INJURIES OF
THE
ORAL CAVITY.
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.
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
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.
Contd….
2. Sodium Perborate.
3.Hydrogen Peroxide.
4. Phenol.
5.Silver Nitrate.
6. Trichloroacetic Acid.
7. Volatile Oils.
8. Miscellaneous Drugs and chemicals.
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.
ASPIRIN BURNS
ASPIRIN BURNS
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.
Sodium Perborate
Uses:

Used as a mouth-wash and in dentrifices.
Effects:
 Produced an erythema of the oral mucosa.
 Sloughing of the tissues.
Hydrogen peroxide
Uses:
 Prevention of periodontitis.
Effects:
 Epithelial necrosis.
 Sloughing of the epithelium.
PHENOL
Uses:
 Cavity sterilizing agent.
 Cauterizing agent.
Effects:
 Severe painful burns of the oral mucosa and skin.
DENTAL STAIN DUE TO LONG TERM USE OF
CHLORHEXIDINE MOUTHWASH
Volatile oils
Effects:
 Produce mild burns of the mucous membranes.
Examples:
 Oil of cloves.
 Oil of winter green.
 Eucalyptus oil.
TETRACYCLINE
Effects:

Discoloration of deciduous or permanent teeth.

Affinity for deposition in bones and tooth
substance.
Moffitt’s 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.
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.
Grossman’s contribution:
 tetracycline therapy diminishes tooth
discoloration if its indicated in the pregnant
female or during 6 to 7 yrs of life.
TETRACYCLINE STAIN OF MANDIBULAR
TEETH
MINOCYCLINE-ASSOCIATED
PIGMENTATION
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.

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.
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.
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.
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.
Contd..

Treatment:
- No specific treatment for the oral lesions which
although severe, must be considered, of only
secondary importance to the patient’s major
problem.