It’s been inspiring to see the kinds of changes businesses have made over the last 12 months to improve safety for employees, clients, and customers. Everyone seems to be intimately familiar with the symptoms of COVID and knows where and how to get tested—but there are many other diseases that patients may not even realize they have. Many of these have symptoms that manifest in the oral cavity as lesions or blisters. Here are just a few to look out for:
Herpes simplex virus (HSV)
The herpes simplex virus can be transmitted several ways, including through saliva (HSV-1), and will remain in the body for life, though often it will be asymptomatic. Many patients may therefore be unaware that they are afflicted with the virus. However, when the virus does flare up, it can cause painful red ulcers in and around the mouth and lips (Fig 1). These symptoms generally occur during primary infection of the virus, but the virus can be reactivated by various stimuli.
Fig 1 Primary herpetic gingivostomatitis in a teenaged patient. The area demonstrated gingival erythema and multiple erosive areas or ulcers in the palate (a) and labial mucosa (b).
Human papillomavirus (HPV)
There are over 100 types of HPV, and it can be spread though skin-to-skin contact, sexual contact, and oral contact. It is an extremely common condition, though vaccines are available for certain types. Like HSV, HPV can be asymptomatic, and patients may not be aware that they have it. Though HPV often goes away on its own without treatment, certain strains may have oral symptoms such as oral lesions or warts, and certain strains of HPV can lead to cancer, including oropharyngeal cancer and cervical cancer.
Varicella zoster virus
Though most patients are familiar with the skin lesions associated with chickenpox, oral lesions may occur as well. It is even possible for oral lesions to manifest prior to skin lesions. Varicella zoster most commonly occurs in children, and though a chickenpox vaccine has been available since 1995, less severe breakthrough cases may occur even in vaccinated patients.
Hand-foot-and-mouth disease
Like chickenpox, this is most common in children, especially young children. Hand-foot-and-mouth disease often includes oral sores and blisters as well as skin rash. This viral infection also usually goes away on its own without treatment.
Oral candidiasis
Oral candidiasis is common and can be caused by Candida albicans as well as other Candida species. Table 1 and Fig 2 describe the different types of oral candidiasis as well as predisposing factors. It is important to identify and resolve the predisposing factors as a component treatment; treating only the symptoms will likely just result in recurrence.
Table 1 Most common types of oral candidiasis and Candida-associated lesions.
Fig 2 Predisposing factors to oral candidiasis.
This information came from the pathology chapter of our brand new comprehensive textbook Periodontics: The Complete Summary by Fernando Suárez López del Amo, available now. The chapter also includes information on developmental disorders, local soft tissue lesions, autoimmune diseases, pigmented disorders, potentially malignant disorders, neoplasms, odontogenic cysts and tumors, and other bone lesions. And that’s just the tip of the iceberg of this in-depth text, the purpose of which is to review everything aspiring periodontists need to know in a single place.
To see what else is covered, check out our preview here.
Periodontics: The Complete Summary
Edited by Fernando Suárez López del Amo
This expansive textbook covers a broad range of topics to prepare aspiring periodontists for exams as well as serving as a guide or reference for more senior practitioners. Concepts are explained in language simple enough for students but technical enough to communicate the important points and subtleties of the topic. Over 100 vocabulary words are clearly defined and explained in context to facilitate understanding of the material, and the text is accompanied by a great variety of tables, diagrams, and illustrations to allow readers to visualize the area and provide additional context for the information. The textbook begins with a basic overview of periodontal anatomy, then leads the reader through the process of diagnosis, identifying different diseases and potential risks before obtaining a prognosis and creating a treatment plan. This is followed by over a dozen chapters on various treatment methods from SRP to complex surgery and then maintenance. The book concludes with additional concepts important for young dentists to know, including an overview of relevant medications as well as abnormalities and emergencies that may be encountered in daily practice. Nothing is left out in this handy study guide, and both current students and recent graduates will find it invaluable in beginning their careers.
ISBN: 978-0-86715-960-8; 9780867159608; 368 pp (softcover); 270 illus; $118
Fernando Suárez López del Amo, DDS, MS, received his dental degree from the European University of Madrid in Spain and completed his Certificate and Master’s degree in periodontics at the University of Michigan in Ann Arbor. After graduation, Dr Suárez continued serving as an adjunct clinical assistant professor and research fellow at the University of Michigan, before becoming an assistant professor at the Department of Periodontics—University of Oklahoma. In addition to being a Diplomate of the American Board of Periodontology, Dr Suárez has been the recipient of several awards from the American Academy of Periodontology, the American Academy of Periodontology Foundation, and the Department of Periodontics and Oral Medicine at the University of Michigan. He has published numerous articles in peer-reviewed journals and serves as a reviewer for a number of journals in the fields of periodontics and implant dentistry. Dr Suárez currently works in private practice in Tacoma, Washington.