Treatment of disorders of the oral mucosa, salivary glands and jaw bones

The treatment used for lesions of the oral mucosa will depend, absolutely, on the etiology or cause of the lesion.

If we are faced with an infection of the oral mucosa, the first item to inquire would be its specific etiology: viral, bacterial, fungal ... This will determine the treatment in an absolute way, since only if it is bacterial in origin, will treatment with antibiotics be indicated.

Other common and banal processes are canker sores. Without treatment they heal on their own in 7-10 days but there are symptomatic treatments that relieve pain and speed up the resolution process, for example rinses with chamomile or salt water.

In case of mucositis due to radiotherapy or chemotherapy, we can perform prophylactic rinses with a specific solution (one liter of water with two tablespoons of bicarbonate or one of bicarbonate and one of salt).

In the case of the so-called «dry mouth», associated or not with systemic pathology (Sjögren's syndrome) or due to congenital or acquired alterations of the salivary glands, artificial saliva, xylitol chili peppers or symptomatic measures such as taking ice, to keep the mucous membranes hydrated.

The treatment of pathologies such as maxillary cysts will also depend on their etiology, and may require antibiotic treatments associated with endodontic treatments (dental origin) and surgical interventions with the removal of the removes.

Sialolithiasis such as sialadenitis, ranulae or mucoceles, their treatments will be analgesics and antibiotics in case of complications due to bacterial superinfection. In some of these cases, surgical intervention will be necessary.

When there are properly epithelial disorders, increases in the size of the salivary glands or bulging of the jaws, the study is of vital importance and, if necessary, its biopsy to proceed to the specific and more appropriate treatment for that particular lesion (as already mentioned in the corresponding chapter). Once a malignant tumor process has been confirmed and its extension study carried out, the case should be studied in a specific and isolated way for that particular patient. For this, interdisciplinary sessions are held where the different therapeutic resources (surgery, radiotherapy, chemotherapy ...) and their combined use are evaluated to optimize the results obtained.

From an exclusively surgical point of view, the treatment of a tumor must be radical and aggressive (as long as the location allows it) in order to remove the entire tumor and a safety peritumoral area to prevent its recurrence. Subsequently, the possibility of reconstructive surgery for aesthetic purposes and to alleviate the defect left by the tumor resection will be considered.

We will also mention dry socket, an entity of unknown cause that appears as severe pain after tooth extractions. Its course is self-limited without treatment to about 10-15 days. There is no established common criterion for its treatment. The use of antibiotics and antiseptics such as chlorhexidine are the most widely used.