Oral Pain

34 Oral Pain

Mark H. Terris

The symptom of oral pain, although nonspecific, can be an indicator of localized or systemic dysfunction. Oral pain can be associated with a myriad of disorders and diseases. Thorough history taking and evaluation of the oral cavity during the otolaryngological examination can often aid the clinician in establishing a definitive diagnosis. Many times, however, laboratory testing is required to confirm the clinical suspicion.

In evaluating the etiologies of oral pain, it is convenient to consider the various conditions by the areas or systems affected, which is the approach taken in this chapter. Oral pain can be a result of diseases affecting the tongue (glossitis), lips (cheilitis), or any other region of oral mucosa (stomatitis). Dental disorders can be an alternative source of oral pain. Similarly, it may be secondary to a salivary gland, pharyngeal, neurological, or psychological disorder. Individual descriptions of the disorders are beyond the scope of this text.

The differential diagnosis of etiologies affecting the lips, tongue, or oral cavity mucosa causing pain is vast. Certain infectious causes of oral pain may result in fever or leukocytosis. Systemic diseases with oral manifestations will often have symptoms and signs of disease outside the oral cavity that can be elicited with a thorough history, physical examination, and laboratory testing. Although many of the conditions following here are benign, the cause of oral pain secondary to precancerous or malignant lesions must always be considered. Suspicious lesions should always be considered neoplastic until otherwise determined. Biopsy with histopathological analysis is often necessary. Most infectious lesions listed here will have other findings, such as ulceration, blistering, or mucosal change, which are covered in detail in Chapter 36.

image Infectious Disease

image Viral

image Herpetic gingivostomatitis

image Varicella

image Herpangina (Coxsackie A or B)

image Hand, foot, and mouth disease (Coxsackie A)

image Human papilloma virus

image Human immunodeficiency virus (HIV)

image Bacterial

image Staphylococcus/Streptococcus

image Tuberculosis

image Syphilis

image Diphtheria

image Gonorrhea

image Rhinoscleroma

image Leprosy

image Fungal

image Candidiasis

image Actinomycosis

image Blastomycosis

image Histoplasmosis

image Sporotrichiosis

image Inflammatory Disease

image Aphthous ulcers

image Lichen planus: Lichen planus (LP) is a cell-mediated immune response that causes pruritic, papular eruptions. Lesions are most commonly found on the tongue and the buccal mucosa; they are characterized by white or gray streaks forming a linear or reticular pattern on a violaceous background.

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Jun 5, 2016 | Posted by in OTOLARYNGOLOGY | Comments Off on Oral Pain

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