STOMATITIS AND RECURRENT LABIAL HERPES

"Stomatitis" is a general term used to denote inflammation of the oral mucosa. Two types of stomatitis are common in dentistry, they are herpetic gingivostomatitis and aphthous stomatitis. Herpetic gingivostomatitis usually occurs on the masticatory or keratinized tissues, while aphthous stomatitis usually occurs on the lining or nonkeratinized tissue. Both conditions are marked by the formation of small blisters and ulcers on the oral mucosa.

Recurrent labial herpes is caused by a virus that produces the so-called fever blister or cold sore. They are usually found on the lip and can easily be transmitted to others through casual contact.

Symptoms

A patient with recurrent labial herpes may complain of the following symptoms:

A painful swelling

A fever blister, cold sore, or canker sore

Pain when eating or drinking

A fever, headache, or rundown feeling (for herpetic gingivostomatitis ONLY)

Signs

Upon examination of a patient with recurrent labial herpes, you may observe the following signs:

Red, swollen areas with blisters or small craters formed in the center

Blisters or craters covered with a grayish-white or yellowish membrane

Treatment

Perform the emergency treatment guidelines and follow instructions given by the dentist. Instruct the patient NOT to smoke, eat acidic or hot foods, or drink alcohol or use products that contain alcohol such as mouthrises that will dry out the mouth.

POSTEXTRACTION HEMORRHAGE

Postextraction hemorrhage may occur any time from a few hours to several days after the extraction of a tooth. The bleeding from the extraction site may be light or heavy. Any form of hemorrhage is considered serious, so inform the dentist as soon as possible.

Symptoms

A patient with postextraction hemorrhage may complain of the following symptoms:

Bleeding that starts, or fails to stop, after an extraction

Large amounts of blood in the mouth

Weakness in conjunction with blood loss

Blood on the pillow after sleeping

Signs

When you examine a patient for postextraction hemorrhage, you may observe the following signs:

Blood oozing or flowing from a recent extraction site

Blood or a large blood clot in the patient's mouth

Treatment

Perform the emergency treatment guidelines and notify the dentist. Until the dentist arrives, monitor the patient's vital signs and watch for changes in his or her condition. To help stop the bleeding, place a pack of moistioned sterile gauze over the extraction site and instruct the patient to bite down firmly.

POSTEXTRACTION ALVEOLAR OSTEITIS

Postextraction alveolar osteitis is a condition commonly referred to as a dry socket. It normally results when a blood clot fails to form or washes out of the socket of a recently extracted tooth. This condition is very painful.

Symptoms

A patient who has recently had a tooth extracted may complain of the following:

Severe constant pain that can run from the ear to the lower jaw

Loss of blood clot

Signs

Upon examination of the patient, you may observe the following signs:

The absence of a blood clot

Food visible in the socket

Alveolar bone visible in the socket

A foul odor in the mouth

An elevated temperature

Treatment

To provide emergency treatment for postextraction alveolar osteitis, you may perform the following precautions:

Perform the emergency treatment guidelines.

Gently rinse the socket with a warm saline solution.

Moisten a small strip of iodoform gauze with eugenol. Blot the gauze dry on a 2 2 gauze pad. Place the strip of iodoform gauze loosely in the socket. Do not exert pressure on the socket.

Instruct the patient to return the next day for a dressing change