Swish spit9/25/2023 ![]() Rx.: Fluocinonide Gel 0.05% mixed with equal parts plain Benzocaine 20%. ![]() Expect Candida overgrowth to occur and treat accordingly monitor the patient for opportunistic oral infections including candidosis – consider prophylactic antifungal therapy in certain patients, the elderly and denture wearers.Inflammation reduction (Topical steroid application is preferred).May be caused by stress, drug hypersensitivity or allergen exposure.– Sig: take one tablet twice daily (Disp. 42 tablets)ĭo NOT use for more than 14 days if lesions do not resolve following 14 days of therapy, patient should contact primary physician – Sig: take SIX tablets in the morning after breakfast then decrease dose by ONE tablet every other day. The goal of antiviral therapy is to shorten the clinical course of EM, prevent further complications and prevent recurrences and the development of latent viral infections and transmission This approach, if used, should be initiated prior to steroid therapy. Following a thorough medical history, if a link to viral infections is established 48 hours following experiencing the symptoms (rash), suppressive antiviral therapy should be considered due to interference of systemic steroids with the immune system.Inflammation reduction (systemic steroid therapy).Allergic reaction to antibiotics, e.g., penicillin.Severe form is called Stevens Johnson syndrome or Erythema Multiforme Major.Viscous lidocaine, 2% used to relieve pain.– Sig: 5 mL “swish and spit” four times daily for 4-5 days Discontinue when lesions become asymptomatic – Sig: rinse with 5 mL for 2 minutes four times daily and spit out. – Sig: apply to dried ulcer 2-4 times daily until healed Most ulcers heal spontaneously in 10-14 days.May be caused by stress, physical or chemical trauma, food sensitivity and infection.Aphthous Stomatitis (also known as canker sores) Topical steroids should be considered the first course of treatment. Topical steroid may reduce the severity of oral lesions, reducing pain and improving patient function and quality of life. Topical steroids are not curative but rather palliative. ![]() Synthetic steroids can be used in dentistry topically or systemically as a palliative measure to relieve pain, inflammation or edema. Synthetic steroids (i.e., hydrocortisone) are derivatives of cortisol. In addition, cortisol is the main hormone involved in the human stress response with levels being highest in the early morning. It plays a role in carbohydrate, protein, lipid and nucleic acid metabolism. Cortisol secretion is regulated via the hypothalamic-pituitary-adrenal axis (HPA axis) and by the circadian rhythm. The hormone cortisol is the principal corticosteroid. Steroids, often referred to as corticosteroids, are hormones produced by the adrenal cortex, the outer part of the adrenal gland. Clinicians are responsible to adjust the prescription dose, frequency and length of treatment based on the procedure performed, the medicine prescribed, and the patient conditions such as age, weight, metabolism, liver and renal function. NOTE: The pharmacologic management suggestions and sample prescriptions in this handbook represent a general recommendation. Chapter 8: Oral Lesions and Corticosteroids
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