Applied Oral Pathology
through Interactive
Learning
Infectious Diseases
Rachel S. Ennis
MDH707 Spring 2011
Infectious Diseases
Chapter 4 Objectives
 Inflammatory and immune response
 Causes of opportunistic infection
 Organisms involved in specific infectious
diseases
 Oral candidiasis; five forms
 Herpes labialis; clinical features
 Recurrent intraoral herpes simplex
infection; clinical features
 Minor aphthous ulcers; clinical features
Objectives continued:
 Herpes Zoster; clinical characteristics
 Epstein-Barr Virus; four associated
diseases
 Coxsackie virus and oral
manifestations
 Oral manifestations of HIV infection;
clinical appearance
Any ideas?
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Acute Necrotizing
Ulcerative Gingivitis
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Edematous and erythematous gingiva
Cratered or “punched out”
interdental papillae
Painful
Foul odor
Metallic Taste
Associated with decreased resistance
Caused by Fusiform bacilli,
and spirochetes
Inflammatory and Immune
Response
 Inflammatory response: body’s first
line of defense against tissue injury
and disease-producing
microorganisms
 Immune response: defends body
against injury, remembers past
instances of injury
Opportunistic Infection
 Alteration in the oral micro flora
 Organisms that are normally
nonpathogenic are able to cause
disease
Opportunistic infections of
the oral cavity
 Dental caries
 Periodontal disease
Infectious Diseases and the organisms
involved
 Impetigo: Staph Aureus, Staph pyogenes.
 Tonsillitis and Pharyngitis: Streptococci, Adenoviruses,
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Influenza, and Epstein-Barr virus
Tuberculosis: Mycobacterium tuberculosis
Actinomycosis: Actinomyces israelii
Syphilis: Treponima pallidum
Veruca vulgaris: Human papilloma virus
Condyloma acuminatum: Human papilloma virus
Primary herpetic gingivostomatitis: Herpes simplex virus
Acute Necrotizing Ulcerative Gingivitis: Borrelia vincentii
fusiform bacillus, and spirochete
Impetigo
Adult male with impetigo
on chin
Child with impetigo on chin
Syphilis chancre
Dorsal surface of tongue
Actinomycosis
Left mandible
Condyloma acuminatum
Lower lip
Oral Candidiasis
(thrush)
 Pseudomembranous
 Erythematous
 Denture stomatitis (chronic atrophic
candidiasis)
 Chronic hyperplastic candidiasis
 Angular cheilitis
Angular cheilitis
Commissure of lips
Pseudomembranous
candidiasis
Hard palate
Herpes Labialis
Caused by herpes simplex virus
Also called “cold sore or fever
blister”
Vermillion of lips
Herpes Labialis
Vesicles on lips and vermillion boarder
Herpes Labialis
Lower lip
Recurrent intraoral herpes
simplex infection
 Herpes simplex virus
 Keratinized mucosa (hard palate,
and gingiva
 May be caused by sunlight,
menstruation,fatigue,fever,stress
 Painful, focal crops of vesicles
 Prodromal symptoms:
pain,burning,tingling
Primary Herpes Simplex
Infection
Dorsal surface of tongue
Minor aphthous ulcers
 Nonkeratinized mucosa
 One to several ulcers present
 No vesicle preceding ulcer
 Pain
 <1cm
 Round to oval
 Can recur
Minor aphthous ulcer
Floor of mouth
Major Aphthous Ulcer
Soft palate
Herpes Zoster
 Shingles
 Unilateral, painful eruption of
vesicles along sensory nerve
 May affect three branches of
trigeminal nerve
 Prodromal symptoms: pain,
burning,paresthesia
 May last several weeks
Herpes Zoster
Shingles
Varicella Zoster
Lips and palate
Epstein-Barr Virus
 Infectious Mononucleosis
Palatal petichiae
kissing disease
 Nasopharyngeal carcinoma
 Burkitt lympoma
 Hairy Leukoplakia
usually on lateral border of tongue
Hairy Leukoplakia
Lateral boarder of tongue
Coxsackievirus
 Discovered in Coxsackie, NY
 Transmission by fecal-oral contamination,
saliva, respiratory droplets
 May cause:
Herpangina
Hand-Foot-and Mouth Disease
Acute Lymphonodular Pharyngitis
Coxsackie virus
Sores on dorsal surface of tongue and palate
HIV and Oral Lesions
 Candidiasis
 Herpes simplex infection
 Herpes Zoster
 Hairy Leukoplakia
 Human papilloma virus lesions
 Atypical gingivitis and periodontitis
 Kaposi sarcoma
 Non-Hodgkin lymphoma
 Aphthous ulcers
 Mucosal pigmentation
 Bacterial salivary gland enlargement and xerostomia
 Spontaneous gingival bleeding resulting from
thrombocytopenia
HIV associated thrush
Soft palate
Papilloma
Papilloma on soft palate
Papilloma
Lateral boarder of tongue
Papilloma
Buccal Mucosa
Kaposi sarcoma
HIV infection
!
References
Ibsen, O., Phelan, J.A. (2009). Oral pathology for the dental hygienist, 5thed.
St. Louis, MO: Saunders Elsevier.
Langlais, R. P. , Miller, C.S. , Nield-Gehrig, J. S. (2009) Color atlas of common
oral diseases, 4thed. Philadelphia, PA: Lippincott Williams and Wilkins.