Pharyngitis, glossitis, gingivitis
Introduction
Introduction The oral mucosa is a covered organ that separates the interior of the mouth from the submucosal organs. The role of the oral membrane is to protect the submucosal organs and to receive and transmit stimuli from the external environment. Since the oral cavity is the portal of the digestive system and bears the functions of chewing and language, the oral mucosa is easily damaged by mechanical, chemical and bacterial diseases, and mucosal erosion can often occur. In addition, oral mucosal damage occurs early in some systemic diseases. Clinically, different names are given depending on the extent and location of the lesion. If the lesion spreads to many mucous membranes in the mouth, it is called stomatitis. Only those who invade the gingival mucosa are called gingivitis. Those who appear on the tongue mucosa are called glossitis.
Cause
Cause
Causes of pharyngitis, glossitis, and phlegm
In the mouth of a normal person, due to contact with the outside world, various microorganisms are often present, and the resident microorganisms are shared by the population, and generally do not cause disease. However, when certain conditions can cause changes in internal and external environment, and the body's defense ability declines, the bacteria in the mouth proliferate actively, the virulence increases, and the imbalance of the flora causes oral mucosal inflammatory lesions. These conditions are:
(i) Nutritional deficiency diseases
Such as vitamin deficiency can cause poor oral tissue structure, easy to hemorrhage, and infection.
(two) blood system diseases
Leukemia cell mass can cause capillaries, such as leukemia. The small arteries are occluded and cause tissue infarction. Necrotic molting of the mucous membrane also hinders capillary blood supply and causes tissue ischemic necrosis to form ulcers.
(3) Systemic infectious diseases
Such as measles, scarlet fever, flu, etc. due to fever, dry mouth, poor oral hygiene, systemic resistance is reduced and easy to develop stomatitis.
(4) Metabolic and endocrine disorders
For example, the increase of sugar in saliva of diabetic patients is beneficial to the growth of bacteria. The increase of calcium content is easy to form stones and cause local irritation. In addition, diabetic vascular disease causes tissue metabolism and structural changes, which may lead to inflammation of oral mucosa and gums. Increased progesterone secretion during pregnancy, increased capillary permeability, promote gingival edema, and prone to phlegm.
(5) Allergic reaction of the body
Application of sulfa, salicylic acid, barbiturate drugs, can produce oral rash drug rash.
(6) Flora imbalance
Such as chronic illness, long-term use of antibiotics can cause abnormalities in the oral flora and cause thrush.
(7) Mechanical damage and chemical burns
Due to mechanical stimuli, the integrity of the oral mucosal epithelium is destroyed, forming superficial erosions and ulcers. Some chemical substances such as strong acid, strong alkali, etc. are mistaken for the oral cavity, or the oral treatment is inadvertently used. The drugs such as phenol, silver nitrate and arsenic trioxide are exposed to the normal oral mucosa, which can cause burns on the mucous membrane.
(1) Infectious factors
1. Bacterial infections such as cocciditonitis, gangrenous stomatitis, etc.
2. Viral infections such as herpetic stomatitis, cold sores, etc.
3. Others such as candida stomatitis.
(2) Physical and chemical damage
Such as hemorrhoids stomatitis, tobacco stomatitis and so on.
(3) Oral manifestations of systemic diseases
1. Infectious diseases such as measles, scarlet fever and other secondary stomatitis, glossitis.
2. Nutritional deficiency diseases such as vitamin B deficiency, vitamin C deficiency, etc. caused by gingivitis, glossitis and the like.
3. Hematological diseases such as leukemia, agranulocytosis, and other secondary gingivitis and oral mucosal necrosis.
4. Metabolic and endocrine disorders secondary to diabetes mellitus, pregnancy gingivitis, menstrual gingivitis and so on.
5. Others such as allergic stomatitis, mercury toxic phlegm and so on.
(4) Unexplained factors
Such as recurrent oral ulcers.
Examine
an examination
Related inspection
Otolaryngology CT examination pinch nose closed mouth exhalation method oral X-ray examination oral endoscope
Examination and diagnosis of pharyngitis, glossitis and phlegm
(1) medical history
1. To understand whether the systemic manifestations of stomatitis, glossitis, and phlegm are closely related to the general condition, only a small part is caused by local causes. Therefore, it is necessary to fully understand the occurrence and development of the disease during the consultation. In addition to the oral condition, whether it is accompanied by symptoms and lesions in other parts of the body, as well as treatment.
2. The onset of acute chemical burns, stomatitis caused by radiation damage, and drug allergic stomatitis are generally more acute. Stomatitis caused by systemic diseases is slower.
3. The onset process and onset time of recurrent oral ulcers have a history of recurrent episodes and self-limiting, generally healed 7-10 days. Traumatic stomatitis has no history of recurrent episodes, has a history of trauma, and can heal a few days after removing the stimulating factors. Oral manifestations of blood disorders often occur before severe systemic symptoms appear.
(2) Physical examination
1. Oral examination to check the lesions of the oral mucosa should pay attention to identify the type, distribution, size, shape, number, depth, soft and hard. There are no stimuli such as residual crown, residual root or poor prosthesis. If the lesion is more limited, mechanical factors should be considered. A wide range of lesions should be considered due to chemical damage. Diffuse oral mucosal congestion, edema, burning pain, or the appearance of superficial ulcers and covered with pseudomembrane, often prompted by bacterial factors caused by stomatitis. Necrosis and gangrene are the main features of the oral cavity, such as walking horses, sputum stomatitis or blood diseases.
2. Skin examination for some stomatitis, tendinitis, glossitis with skin lesions. Therefore, the skin should be checked for any lesions, type, distribution and symptoms of the lesion. Scarlet fever and measles rash have decisive diagnostic significance, and skin bleeding tendency has an auxiliary value for the diagnosis of blood diseases.
(3) Laboratory inspection
1. Microbiological examination The bacterial infection caused by Gram-positive and negative cocci, Clostridium and F. sinensis was observed by Gram staining of the smear of the lesion. The candida albicans infection was diagnosed by adding a 10% potassium hydroxide solution to the smear and fixing it on the micro-flame to observe the presence or absence of Candida albicans hyphae and spores.
2. Exfoliative cytology can be used to smear the epithelial cells that have fallen off the bottom of the ulcer under local anesthesia, and can be confirmed by Papanicolaou staining.
3. Immunological examinations to detect changes in cellular and humoral plague function can help diagnose certain diseases. For infectious diseases, especially white candidiasis and viral infections, immune function can be low.
4. Hematological examination of infectious stomatitis should be checked for blood routine and white blood cell classification. When suspected of allergic diseases, white blood cell classification and direct counting of eosinophils should be checked. Iron, folic acid and vitamin B12 should be checked in the oral cavity when infected with Candida albicans. The content. A comprehensive blood test should be performed on patients with blood diseases.
Diagnosis
Differential diagnosis
Symptoms of pharyngitis, glossitis, and phlegm
1. Pharyngeal congestion and pharyngeal congestion may have pharyngitis. Pharyngitis is a very common upper respiratory tract infection, often caused by colds and colds. Almost everyone has had the experience of the disease in their lifetime. Some people are sicker, some are heavier, some have People are easy to get, and some people don't often get it.
2. Swallowing painful pharyngeal inflammation, the beginning of the throat dry, burning, and then pain, especially when swallowing.
3. Tongue and throat burning, the tongue and throat are dry, burning, and then pain.
(1) medical history
1. To understand whether the systemic manifestations of stomatitis, glossitis, and phlegm are closely related to the general condition, only a small part is caused by local causes. Therefore, it is necessary to fully understand the occurrence and development of the disease during the consultation. In addition to the oral condition, whether it is accompanied by symptoms and lesions in other parts of the body, as well as treatment.
2. The onset of acute chemical burns, stomatitis caused by radiation damage, and drug allergic stomatitis are generally more acute. Stomatitis caused by systemic diseases is slower.
3. The onset process and onset time of recurrent oral ulcers have a history of recurrent episodes and self-limiting, generally healed 7-10 days. Traumatic stomatitis has no history of recurrent episodes, has a history of trauma, and can heal a few days after removing the stimulating factors. Oral manifestations of blood disorders often occur before severe systemic symptoms appear.
(2) Physical examination
1. Oral examination to check the lesions of the oral mucosa should pay attention to identify the type, distribution, size, shape, number, depth, soft and hard. There are no stimuli such as residual crown, residual root or poor prosthesis. If the lesion is more limited, mechanical factors should be considered. A wide range of lesions should be considered due to chemical damage. Diffuse oral mucosal congestion, edema, burning pain, or the appearance of superficial ulcers and covered with pseudomembrane, often prompted by bacterial factors caused by stomatitis. Necrosis and gangrene are the main features of the oral cavity, such as walking horses, sputum stomatitis or blood diseases.
2. Skin examination for some stomatitis, tendinitis, glossitis with skin lesions. Therefore, the skin should be checked for any lesions, type, distribution and symptoms of the lesion. Scarlet fever and measles rash have decisive diagnostic significance, and skin bleeding tendency has an auxiliary value for the diagnosis of blood diseases.
(3) Laboratory inspection
1. Microbiological examination The bacterial infection caused by Gram-positive and negative cocci, Clostridium and F. sinensis was observed by Gram staining of the smear of the lesion. The candida albicans infection was diagnosed by adding a 10% potassium hydroxide solution to the smear and fixing it on the micro-flame to observe the presence or absence of Candida albicans hyphae and spores.
2. Exfoliative cytology can be used to smear the epithelial cells that have fallen off the bottom of the ulcer under local anesthesia, and can be confirmed by Papanicolaou staining.
3. Immunological examinations to detect changes in cellular and humoral plague function can help diagnose certain diseases. For infectious diseases, especially white candidiasis and viral infections, immune function can be low.
4. Hematological examination of infectious stomatitis should be checked for blood routine and white blood cell classification. When suspected of allergic diseases, white blood cell classification and direct counting of eosinophils should be checked. Iron, folic acid and vitamin B12 should be checked in the oral cavity when infected with Candida albicans. The content. A comprehensive blood test should be performed on patients with blood diseases.
