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Practical Oral Care for People With Developmental Disabilities – This booklet presents an overview of physical, mental, and behavioral challenges common in patients with developmental disabilities and offers strategies for providing oral care. This external link provides additional information that is consistent with the intended purpose of this site.
Linking to a non-federal site does not constitute an endorsement by NIH or any of its employees of the sponsors or the information and products presented on the site. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Oral herpes is easy to diagnose when a patient has visible sores or ulcers, but early stages of herpes on the face and mouth as well as on the genitals are harder to diagnose.
Herpes should be distinguished from herpes zoster, chicken pox, impetigo, and drug eruptions. Herpetic sores are classified as heat sores in TCM because the lesions are red and follow febrile disease conditions. As with all treatment protocols, be sure to tailor and modify the basic treatments below to fit your patient's specific constitution, root cause, and symptoms. Treatment principle: Drain Spleen and Stomach damp heat, nourish yin, drain deficient heat . Cash, checks and credit cards are also gratefully accepted if you prefer to donate in person.
Pain, emotional upheaval, fatigue, people who are burned out, folks who want to try esoteric acupuncture.
The Surgeon General's report on oral health highlights the relationship between oral and overall health, emphasizing that oral health involves more than dentition.1 Physicians regularly encounter oral health issues in practice. Fluconazole mouth-rinses for oral candidiasis in postirradiation, transplant, and other patients. A systematic review of the effectiveness of antifungal drugs for the prevention and treatment of oropharyngeal candidiasis in HIV-positive patients.
High-dose, short-duration, early valacyclovir therapy for episodic treatment of cold sores: results of two randomized, placebo-controlled, multicenter studies. Effective treatment of herpes simplex labialis with penciclovir cream: combined results of two trials. A double-blind study of topically applied 5% amlexanox in the treatment of aphthous ulcers. Thalidomide as therapy for human immunodeficiency virus-related oral ulcers: a double-blind placebo-controlled clinical trial.
Incidence of bloodstream infections due to Candida species and in vitro susceptibilities of isolates collected from 1998 to 2000 in a population-based active surveillance program.
Comparison of fluconazole and nystatin oral suspensions for treatments of oral candidiasis in infants.


Treatment of oropharyngeal candidiasis and candidal diaper dermatitis in neonates and infants: review and reappraisal.
A double-blind, placebo-controlled trial of continuous acyclovir therapy in recurrent erythema multiforme. A controlled clinical trial of the efficacy of topically applied fluocinonide in the treatment of recurrent aphthous ulceration. The clinical features, malignant potential, and systemic associations of oral lichen planus: a study of 723 patients. Red sores can appear on the roof of the mouth; they are sometimes on the outside of the lips, where they are called fever blisters. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. During active disease phases there are blisters on the skin which contain the infectious virus.
Recognition and diagnosis require taking a thorough history and performing a complete oral examination. A minority of persons develop a symptomatic primary infection, presenting with an acute outbreak of oral vesicles that rapidly collapse to form zones of erythema and ulceration. A common oral inflammatory condition of unknown etiology, it has an estimated prevalence of 1 to 3 percent. This condition results from inadequate desquamation or increased keratinization of the papillae. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.
Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Accompanying symptoms may include high fever and swelling of tenderness of the lymph nodes. Knowledge of clinical characteristics such as size, location, surface morphology, color, pain, and duration is helpful in establishing a diagnosis. In all cases, the gingiva is involved; in addition, other oral mucosal sites and the perioral skin may be affected. The reticular form can appear as bilateral asymptomatic, white, lacy striations (Wickham's striae) or papules on the posterior buccal mucosa (Figure 8). This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.
Crusting of the lesions begins after three to four days of onset and complete healing within three weeks.


Oral candidiasis may present as pseudomembranous candidiasis, glossitis, or perlA?che (angular cheilitis). Tongue lesions exhibit central erythema caused by atrophy of the filiform papillae and usually are surrounded by slightly elevated, curving, white-to-yellow borders (Figure 6). The erosive form manifests as zones of tender erythema and painful ulcers surrounded by peripheral white, radiating striae (Figure 9A). Viruses are transported along the sensory nerves to the nerve cell bodies where they go dormant and reside as long as the host is alive. Oral candidiasis is common in infants, but in adults it may signify immune deficiency or other illness. They may come out of dormancy because of a variety of triggers (one of which is immunosuppressant drugs).
Commonly used therapies include topical corticosteroids, such as fluocinonide gel (Lidex) and triamcinolone acetonide with carboxymethylcellulose paste (Kenalog in Orabase).
When it becomes active the virus multiplies, travels along the axon of the neuron to the nerve terminals in the skin and releases the virus particles. Recurrent aphthous stomatitis most often is a mild condition; however, severe cases may be caused by nutritional deficiencies, autoimmune disorders, or human immunodeficiency virus infection.
However, most individuals are asymptomatic and do not require treatment for this benign condition.
Most cases improve with avoidance of predisposing factors and regular tongue brushing using a soft toothbrush or tongue scraper.
Commonly used topical regimens include nystatin (Mycostatin; not absorbed), clotrimazole (Mycelex troche), and systemic fluconazole (Diflucan). For symptomatic cases, several treatments have been proposed, including topical steroids, zinc supplements, and topical anesthetic rinses. Hairy tongue represents elongation and hypertrophy of the filiform papillae and most often occurs in persons who smoke heavily.
Certain risk factors have been associated with each of these lesions, such as poor oral hygiene, age, tobacco use, and alcohol consumption, and some systemic conditions may have oral manifestations. Use of systemic antivirals for herpes labialis generally should be reserved for immunocompromised patients. Many recommended therapies for oral lesions are unsupported by randomized controlled trials.



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