1. Disease of the Mouth

1.1 Missing Teeth

• description: permanent teeth are missing
• signs and symptoms:
  • altered bite, jaw pain (temporomandibular joint disorder)
  • bolting (inadequate chewing)
  • digestive disturbances (gastritis/constipation), loss of nutrient
  • changes of facial appearance
• etiology:
  • dental decay (most commonly due to periodontal disease)
  • dental injury
  • congenitally missing teeth (may present as a sign of certain rare inherited or systemic diseases)
• diagnostic procedures:
  • oral examination
  • x-ray (to determine whether the tooth is absent or impacted)
• treatment: aimed at restoring the occlusion
  • dental implants: a titanium post is placed in the jawbone, and a crown is placed over the root
  • dental bridges: a bridge consists of one or more false teeth anchored to adjacent healthy teeth
  • Dentures: removable dentures can replace one or more missing teeth

1.2 Impacted Third Molars (Impacted Wisdom Teeth)

• description: third molar becomes trapped in gum or jawbone

  • wisdom teeth begin developing between 8yr and 10yr
  • emerge or erupt between 17yr and 21yr

• signs and symptoms:

  • sometimes no symptoms develop
  • pain or swelling of jar or face
  • red, swollen, and bleeding gum
  • A bad taste in mouth & bad breath
  • difficulty opening your mouth all the way

• etiology:

  • bone structure/adjacent teeth blocked the eruption
  • an eruption of an angle causes a space to trap food, leading to pericornitis

• diagnostic procedures:

  • x-rays
  • examines to search for infection

• treatment

  • antibiotic (penicillin/amoxicillin)
  • analgesics (acetaminophen, ibuprofen, codeine combinations, hydrocodone combos, hydrocodone combos)
  • after infection clears up, impacted tooth must be extracted

1.3 Dental Caries (Dental Decay)

• description: infection resulting in the erosion of the tooth surface
• signs and symptoms: (from early stage to later stage)
  • white spots on the tooth surface
  • mild toothache, hypersensitivity to sweets and temperature
  • unpleasant taste in mouth
  • inflamed gum and persistent pain, stabbing pain in the jaw
  • abscess may form
• etiology:
  • bacteria break down sugars in foods and convert them into acid plaque/stomach acid from GERD/purging from bulimia
  • demineralization (acid plaque erodes the calcium in the tooth’s enamel)
• diagnosis:
  • oral examination
  • x-rays (to determine the extent of decay)
• treatment:
  • early stage: remove the diseased portion of the tooth enamel and pulp and fills the cavity with dental amalgam composite material
  • if advanced into the pulp: root canal procedure (infected pulp tissue is remoces and the canals in the roots of the tooth are filled, treated with antibiotics, and sealed)
  • if not salvageable: extraction + dental implant

1.4 Discolored Teeth

• signs and symptoms:
  • slight yellow, brown, gray; spots, patches, dark lines
• etiology:
  • age causes a slight yellowing of the teeth
  • smoking causes brown
  • a dead tooth turns gray
  • red wine, coffee, tea stain teeth
  • certain drugs taken in large quantities during childhood cause discolored enamel (tetracyclines)
  • antibacterial mouthwash (chlorhexidine)
  • sever attacks of pertussis & measles in children
  • fluoride cause white/brown spots
• prevention: avoid smoking & drinking coffee, tea, red wine
• diagnosis: oral examination
• treatment:
  • for superficial discoloration: polishing with a rotary polisher
  • deep discoloration: bleaching procedures/capping or crowning and by bonding a synthetic veneer to the tooth

1.5 Malocclusion

• description: specific angles of malposition & contact of the maxillary & mandibular teeth
• signs & symptoms: a protrusion/recession of the jaw & teeth that are turned/twisted out of position due to crowding
• etiology:
• diagnosis: visual exam + x-ray
• treatment: braces; extraction of tooth/teeth; surgical removal of portions of the jaw; crowns or bridges

1.6 Temporomandibular Joint Disorder (TMD)

• description: a symptom complex related to inflammation, disease, or dysfunction of the temporomandibular joint
• signs & symptoms: usually bilateral, with one side more painful than the other
• etiology:
• diagnosis:
• treatment:

1.7 Gingivitis

• description: inflammation and swelling of the gums
• signs & symptoms:
• etiology:
• treatment:

1.8 Periodontitis (Periodontal Disease)

• description: destructive gum & bone disease around one/more of the teeth
• signs & symptoms:
• etiology:
• diagnosis:
• treatment:

2. Diseases of the Esophagus

3. Disease of the Stomach

4. Disease of the Intestines

• diarrhea, constipation, changes in stool characteristics, secondary disease as a result of poor nutrition

5. Diseases of the Liver

5.1 Jaundice (Icterus)

• a yellow or orange discoloration of the skin, tissues, and the whites of the eyes
• et: a buildup of bilirubin (a yellow pigment derived from the breakdown of hemoglobin)
• cause: cirrhosis or hepatitis, inflammation of the gallbladder or bile ducts, gallstones, or hemolytic anemia