1. Caries
   1. Etiology
      1. Strep mutans
      2. Lactobacillus
   2. Progression
      1. Bacteria + CHOs =
         1. acid
            1. proteolysis
            2. decalcification of enamel
            3. exposes dentin
      2. Pain
         1. Loss of tooth
            1. Infection
            2. Death
   3. Gross Morphology
      1. Dental plaque
         1. sugar matrix
            1. protects bacteria
   4. Risk Factors
      1. acidic saliva
      2. high sugar diet
         1. processed foods high in CHOS
      3. Xerostomia
      4. Heredity
   5. Protective Factors
      1. Good oral hygiene
      2. Mineral nutrition
      3. Fluoride
         1. makes enamel less susceptible to acid decalcification
2. Pulpitis
   1. Pulp of tooth
      1. Infected
         1. Throbbing toothache
            1. form w/ or w/out
            2. caries
3. Gingivitis
   1. Inflammation and/or infection of the gums
      1. assoc. w.
         1. poor oral hygiene
   2. Etiology
      1. 1. Fermentable CHOs
         1. feed
            1. baceria
            2. produce
            3. acid
            4. demineralization
      2. 2. Plaque
         1. builds up
            1. under gumline
            2. causing
            3. inflammation
         2. (oral bacteria + salivary proteins + desquamated epithelial cells = plaque)
         3. if not removed
            1. tartar
            2. calculus
   3. Morphology
      1. gingival erythema
      2. edema
      3. bleeding
      4. altered contour
   4. Physical Exam
      1. Gums
         1. swollen
            1. red
            2. bleeding
            3. painful
         2. between
            1. teeth
            2. deep crevices
            3. aka
            4. pockets
   5. Prognosis
      1. may progress
         1. loss of supporting bone
            1. periodontal dz
4. General
   1. Gingival sulcus
      1. 1-3 mm
      2. >3mm
         1. pockets
   2. Periodontal Ligament (PDL)
      1. binds cementum to bone
   3. Dr. Rau
      1. Swiss
         1. Paracelsus Institute
         2. Organ-emotional chart
            1. http://www.oasisadvancedwellness.com/tools/tooth-chart.html#
5. Periodontal Dz
   1. Etiology
      1. folic acid deficiency
      2. Vit C def.
         1. scurvy
   2. Definition
      1. affects supporting structures of the teeth
         1. periodontal ligaments
         2. alveolar bone
         3. cementum
      2. Incidence
         1. age 35 or >
   3. Pre-dispositions
      1. poor oral hygiene
      2. DM
      3. Hyperparathyroidism
      4. Crohn's dz
      5. Immunocompromised
   4. Prognosis
      1. BONE AND TOOTH LOSS
         1. if untreated
            1. destruction of
            2. periodontal ligament
   5. Clinical
      1. gums bleed
         1. even w. gentle brushing
      2. receding gum line
      3. give Abx before dental procedures
         1. Reduces risk of bacterial endocarditis dt Strep viridans
6. Trench Mouth
   1. Definition
      1. necrotizing ulcerative gingivitis
         1. non-contagious
      2. caused by multiple microbial infections
         1. fusiform bacteria
      3. Incidence
   2. Etiology
      1. Poor oral hygiene
      2. Poor Nutrition
      3. Tobacco
   3. Pre-dispositions
      1. Immunocompromised
      2. Stress
         1. soldiers
   4. Clinical Presentation
      1. Gingiva & Inter-dental papillae
         1. inflammed
         2. ulcerated
         3. bleeding
7. Geographic Tongue
   1. Definition
      1. papillae
         1. affected
   2. Etiology
      1. Idiopathic
      2. benign
   3. Clinical Presentation
      1. Tongue
         1. red, smooth areas
            1. denuded of papillae
         2. White patches
            1. overgrown papillae
         3. Fissures
            1. often co-exists
      2. Diet
         1. certain foods will cause pain
8. Fissured Tongue
   1. Definition
      1. aka
         1. Furrowed tongue
            1. Lingua plicata
            2. Scrotal tongue
      2. benign
   2. Etiology
      1. poor oral hygiene
      2. genetic
   3. Physical Exam
      1. Tongue
         1. dorsum
            1. deep fissures
   4. Treatment
      1. Oral hygiene
         1. prevents infection as food and debris mb trapped
9. Glossitis
   1. ON BOARDS
   2. Definition
      1. Tongue Papillae
         1. atrophy
            1. shrink
      2. Mucosa
         1. thins
            1. exposes underlying vasculature
   3. Etiology
      1. Nutrient deficiencies
         1. B2
            1. B3
            2. B6
            3. B12
         2. Iron
      2. Dentures
         1. rubbing against tongue
      3. Inhalation burns
      4. Corrosive chemicals
   4. Pre-dispositions
      1. Celiac dz
      2. Syphilis
   5. Clinical Presentation
      1. Tongue
         1. beefy red
         2. ulcerative lesions
   6. Plummer-Vinson syndrome
      1. 1. Iron deficiency Glossitis
      2. 2. Laryngeal webs
      3. 3. Esophageal webs
      4. 4. Dysphagia
   7. Prognosis
      1. if untreated
         1. ulceration
10. Hairy Tongue
    1. Definition
       1. elongated papillae
       2. benign
    2. Etiology
       1. Unknown
    3. Pre-dispositions
       1. antibiotic therapy
    4. Physical Exam
       1. Papillae
          1. yellow
          2. or
          3. brown/black
11. Systemic Conditions with Oral Manifestations
    1. Immun.
       1. Lupus
          1. blistering
             1. ulcers
             2. hard palate, cheeks and gums
       2. Leukemia
          1. thrush
          2. swollen gums
       3. HIV
          1. thrush
    2. GI
       1. Celiac
       2. IBD
       3. parasites
       4. nutritional deficiencies
    3. Drugs
       1. antibiotic therapy
       2. Dilantin
          1. anti-seizures
          2. swollen gums
    4. Melanotic pigment on lips and cheeks
       1. Addison's dz
       2. Peutz-Jeghers syndrome
       3. Albright syndrome
       4. Hemochromatosis