1/3. oral manifestations during chemotherapy for acute lymphoblastic leukemia: a case report.A 14-year-old, male patient was referred for the treatment of mucositis, idiopathic facial asymmetry, and candidiasis. The patient had been undergoing chemotherapy for 5 years for acute lymphoblastic leukemia. He presented with a swollen face, fever, and generalized symptomatology in the mouth with burning. On physical examination, general signs of poor health, paleness, malnutrition, and jaundice were observed. The extraoral clinical examination showed edema on the right side of the face and cutaneous erythema. On intraoral clinical examination, generalized ulcers with extensive necrosis on the hard palate mucosa were observed, extending to the posterior region. Both free and attached gingivae were ulcerated and edematous with exudation and spontaneous bleeding, mainly in the superior and inferior anterior teeth region. The tongue had no papillae and was coated, due to poor oral hygiene. The patient also presented with carious white lesions and enamel hypoplasia, mouth opening limitation, and foul odor. After exfoliative cytology of the affected areas, the diagnosis was mixed infection by candida albicans and bacteria. Recommended treatment was antibiotics and antifungal administration, periodontal prophylaxis, topical application of fluor 1.23%, and orientation on and control of proper oral hygiene and diet during the remission phase of the disease.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/3. Painful oral mucosal ulcers in a patient with small cell carcinoma of the lung.This case illustrates the development of multiple painful oral ulcers caused by methotrexate that was one of a combination of chemotherapeutic drugs administered for the treatment of small cell carcinoma of the lung. Although the oral mucositis is self-limiting and resolves when the drug dose is reduced or therapy is discontinued, severe pain and discomfort may cause physical debilitation. Moreover, the risk of secondary oral infections is high in patients undergoing such therapy, and if the appropriate treatment is not instituted, fatal systemic dissemination of the infection may occur.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/3. Stress, anxiety and the dental patient: the missing specification.The importance of stress and anxiety as contributing to the complex aetiology of dental disease is becoming more widely recognized. Clinical examples of organic dental disease which were relieved when their psychological causes had been uncovered are described. It suggested that specialized psychiatric skills are not always necessary in dealing with such cases. The dentist's own personal life experience, his human understanding and his interest his patients' well-being are usually sufficient. Equal attention must be given to all data in both physical and psychological spheres if the patient's best interests are to be served.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |