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Ears, Nose, and Throat – Mouth Problems
Whiteboard Animation Transcript
with Doug Angel, MD
https://medskl.com/Module/Index/mouth-problems
Oral health is often overlooked in routine clinic visits. Signs and symptoms affecting the oral cavity can potentially indicate a serious mouth condition or can be a sign of systemic illness.
Bad breath (halitosis) is usually accompanied by other oral conditions, such as dental caries and periodontal disease. Promoting good oral hygiene practices can help alleviate halitosis in most patients.
Halitosis can also be a sign of disease process elsewhere. The two most common non-oral causes of halitosis are post-nasal drip and gastroesophageal reflux.
Pain in the oral cavity can be due to infection, inflammation, trauma, or even referred pain. The most common type of painful ulceration is an aphthous ulcer; a self-limiting condition. However, any persistent area of ulceration warrants a biopsy to rule out malignancy. Oral cancers typically present as an area of irregularity or ulceration that can be painful or painless. Referred otalgia (ear pain) is often an accompanying symptom.
Excessive salivation, or sialorrhea, in patients above the age of four can indicate an underlying pathology. These include:
Anatomic causes, such as macroglossia and dental malocclusion;
Hypersecretion secondary to reflux, inflammation, or medication;
Neuromuscular dysfunction, such as cerebral palsy and Parkinson’s disease
Dry mouth, or xerostomia, is a common symptom in the elderly population. It is often a side effect of polypharmacy, but can also be due to an underlying disease process, such as Sjogren’s syndrome. Patients who have been treated with radiation for head and neck cancers often have a severe degree of xerostomia as well.
Ulcers and plaques in the oral cavity can be cause for concern in some patients. These are often secondary to treatable conditions, such as stress, infection, or vitamin deficiencies. However, any non-healing ulcers, especially in patients who smoke or drink heavily, can be a sign of oral cancer and should be ruled out immediately with a biopsy.
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