Makindo Medical Notes

Related Subjects: |Macroglossia |Microstomia |Glossitis |Medical Teeth |Gum hypertrophy |Angular Stomatitis - Cheilitis |Oral Aphthous Ulcers |Oral Leukoplakia

About

• Microstomia is a condition characterized by an abnormally small mouth opening, which can significantly impact oral function and aesthetics.

Aetiology

• Typically caused by constriction or scarring of the labial skin, mucosa, or orbicularis oris muscle, leading to limited mouth opening.

Causes

• Congenital: Seen in genetic conditions such as Freeman-Sheldon syndrome (also known as “whistling face syndrome”), which includes microstomia as a characteristic feature.
• Systemic Diseases: Systemic sclerosis or CREST syndrome can cause fibrotic changes leading to reduced mouth opening.
• Trauma and Burns: Direct, electrical, or chemical burns around the mouth can lead to scarring and contraction, resulting in microstomia.
• Epidermolysis Bullosa: This rare genetic condition causes fragile skin and mucous membranes that can scar easily, leading to microstomia.
• Other Rare Associations: Occasionally seen with Down’s syndrome, though not commonly as a primary feature.

Clinical

• Limited oral access, making dental care challenging and possibly impacting speech.
• Feeding difficulties, though usually manageable with adaptive techniques.

Management

• Conservative Management: Early interventions like oral stretching exercises or assistive devices to maintain mouth opening may be helpful.
• Surgical Correction: In more severe cases, surgical intervention may be considered to improve mouth opening. Techniques may include Z-plasty or skin grafting.
• Multidisciplinary Support: Collaboration with dental, plastic surgery, and speech therapy teams can help optimize outcomes and function.

Conclusion

Microstomia is a significant clinical condition that can affect both functional and aesthetic aspects of oral health. Early diagnosis and intervention are essential to manage the condition effectively and to prevent further complications. A multidisciplinary approach involving dental care, physical therapy, and, when necessary, surgical intervention ensures comprehensive management, thereby improving the patient's quality of life.

References

• Kumar, V., Abbas, A. K., & Aster, J. C. (2020). Robbins and Cotran Pathologic Basis of Disease (10th ed.). Elsevier.
• Fischer, E. (2012). Histology for Pathologists (3rd ed.). Springer.
• Murray, P. R., et al. (2018). Medical Microbiology (8th ed.). Elsevier.
• American Dental Association (ADA). Systemic Health and Oral Health. Available at: https://www.ada.org
• Mayo Clinic. Dental Health and Systemic Diseases. Available at: https://www.mayoclinic.org
• National Institutes of Health (NIH). Oral Health and Systemic Disease. Available at: https://www.nih.gov
• World Health Organization (WHO). Oral Health. Available at: https://www.who.int