CHEMICAL INJURIES OF THE ORAL CAVITY.

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CHEMICAL INJURIES OF THE ORAL CAVITY.
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CHEMICAL INJURIES OF THE ORAL CAVITY

• The oral cavity frequently manifests a serious
  reaction to a wide variety of drugs and
  chemicals.
• The tissue reaction is that of a local response
  to a severe irritant or even a caustic used
  injudiciously.

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Contd.

• Allergic phenomenon is the most common reactions
  to drugs or chemicals.
• The two main types that are of dental interest
  are
• 1.Drug allergy or stomatitis
• 2.Contact stomatitis

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NONALLERGIC REACTION TO DRUGS AND CHEMICALS USED
LOCALLY.

• Irritants or caustics which are used by the
  dentist in various therapeutic are technical
  procedures induces a non allergic reactions when
  used locally.
• Some of these substances are discussed separately
  below
• 1.Aspirin (Acetylsalicylic Acid)
• 2.Endodontic Materials.

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Contd.

• 2. Sodium Perborate.
• 3.Hydrogen Peroxide.
• 4. Phenol.
• 5.Silver Nitrate.
• 6. Trichloroacetic Acid.
• 7. Volatile Oils.
• 8. Miscellaneous Drugs and chemicals.

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ASPIRIN (ACETYLASALICYLIC ACID)

• Uses
• It is especially used for the relief of
  toothache.
• Effects
• Particularly harmful to the oral mucosa if
  applied locally.
• Separation and sloughing of the epithelium and
  frequently bleeding.

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ASPIRIN BURNS
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ASPIRIN BURNS
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Endodontic materials

• Effects
• Dangerous to oral soft tissues.
• Damage or deep spread of inflammation and
  necrosis if injected into hard tissues.
• Examples
• Paraformaldehyde,sodium hypochlorite, hydrogen
  peroxide etc.

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Sodium Perborate

• Uses
• Used as a mouth-wash and in dentrifices.
• Effects
• Produced an erythema of the oral mucosa.
• Sloughing of the tissues.

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Hydrogen peroxide

• Uses
• Prevention of periodontitis.
• Effects
• Epithelial necrosis.
• Sloughing of the epithelium.

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PHENOL

• Uses
• Cavity sterilizing agent.
• Cauterizing agent.
• Effects
• Severe painful burns of the oral mucosa and skin.

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DENTAL STAIN DUE TO LONG TERM USE OF
CHLORHEXIDINE MOUTHWASH
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Volatile oils

• Effects
• Produce mild burns of the mucous membranes.
• Examples
• Oil of cloves.
• Oil of winter green.
• Eucalyptus oil.

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TETRACYCLINE

• Effects
• Discoloration of deciduous or permanent teeth.
• Affinity for deposition in bones and tooth
  substance.
• Moffitts contributions
• Critical period for tetracycline induce
  discoloration in the deciduous dentition is
• 1. 4 months in utero.
• 2. 3 months in postpartum for maxillary and
  mandibular incisor.

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Contd..

• 3. 5 months in utero to 9 months postpartum for
  maxillary and mandibular canines.
• 4. 3 to 5 months postpartum is necessary for
  permanent maxillary and mandibular incisor and
  canines.
• Grossmans contribution
• tetracycline therapy diminishes tooth
  discoloration if its indicated in the pregnant
  female or during 6 to 7 yrs of life.

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TETRACYCLINE STAIN OF MANDIBULAR TEETH
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MINOCYCLINE-ASSOCIATED PIGMENTATION
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Contd..

• Clinical features
• Tetracycline
• 1. Yellowish or brownish-gray diffuse bands of
  discoloration within the tooth structure.
• 2. Fluoresces under ultra violet light.
• Chlorotetracycline
• 1. brownish gray colour within the tooth
  structure.

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Contd..

• Minocycline hydrochloride
• 1. commonly stained in skin, nails, sclera,
  conjunctiva, thyroid, bones and teeth.
• 2. dark colour of underlying bone through the
  thin translucent oral mucosa.
• 3. reveal varying patterns of discoloration.

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Cancer chemotherapeutic agent

• Groups of drugs and agents, used for the
  treatment of malignant neoplastic diseases.
• Function
• - Destruction of malignant cells.
  Cytotoxic agent exert their effect
  preferentially against mitotic cells.
• Side effect
• - Normal mitotic cells of oral mucosa,
  bone marrow and skin are also prone to the
  cytotoxic and damaging effect of these agents.

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Contd..

• Clinical features
• - few general manifestations of these agents
  due to their non specific nature
• 1. Alopecia.
• 2. Stomatitis.
• 3. Radiation recall or radiation
  sensitisation.

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Contd..

• Oral manifestations
• 1. mucosal erosion and ulceration in the
  mouth, frequently diffuse and multiple, often
  related to neutropenia.
• 2. haemorrhage resulting from
  thrombocytopenia.
• 3.hyper pigmentation of oral mucosa.

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Contd..

• Treatment
• - No specific treatment for the oral lesions
  which although severe, must be considered, of
  only secondary importance to the patients major
  problem.

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THE END