Iatrogenic, intrinsic irritation of the oral mucosa

The behaviour of a 78-year-old, edentulous female resident of a care home, suffering from dementia indicated to her care providers that she was experiencing oral pain. At the left (pre)molar region of the mandibular residual alveolar ridge, an irritated, red-coloured, sharply restricted mucosal area was seen, extending in width from the buccal to the lingual border of the ridge. Eventually it was identified as mucosal irritation, apparently due to hydroxylapatite cones that had previously been inserted to augment the residual alveolar ridge. Preservation and augmentation of an edentulous part of an alveolar ridge or of a fully edentulous alveolar ridge are both possible using alveolar implants and/or several surgical procedures. In the current case, such previous treatment was not known to have taken place. Consequently, the dentist was not able to provide treatment immediately. This case illustrates the need for general dental practitioners to keep an eye on their older patients and to provide all relevant information when the oral health care provision is taken over by another dentist.