Palatal perforations: past and present. Two case reports and a literature review

Abstract

Syphilis and cocaine abuse are posing a growing public health problem on a global and national scale. Clinicians are increasingly likely to come across associated oral manifestations. We present two cases of palatal perforations caused by tertiary syphilis and cocaine abuse respectively. The literature review discusses issues specific to palatal perforations and those general to both conditions. The purpose of the report is to focus attention on syphilis and cocaine abuse as rising problems for the dental profession.

Cocaine and oral health

“…3 Another patient presented with three carious teeth which needed extraction. 38 This suggests that the caries risk may be increased, due to sugar used to 'cut' pure cocaine. 45 …”

“…44 described by five patients as comfortable or at least acceptable. 15,18,19,23,38 Consider ing the relatively poor outcome from surgical repair of cocaine-induced pala tal defects, the non-surgical conserva tive approach seems the better option.…”

“…Their speech becomes hypernasal and articulation may be so poor that they can not communicate effectively. 12,18,28,33,38,39 In addition, eating and drinking is dif ficult due to oronasal refl ux of both solids and liquids. 18,20,38 Some patients had resorted to obturating the defect by inserting chewing gum, 17 a piece of white bread 19 or a plug of tissue paper into the palatal defect.…”

“…12,18,28,33,38,39 In addition, eating and drinking is dif ficult due to oronasal refl ux of both solids and liquids. 18,20,38 Some patients had resorted to obturating the defect by inserting chewing gum, 17 a piece of white bread 19 or a plug of tissue paper into the palatal defect. 14 The initial treatment of a cocaine induced palatal defect is complete absti nence from the drug, and the exclusion of other potential causes of midline pala tal necrosis such as a tumour, Wegener's granulomatosis, trauma, chronic (fun gal) infection and tertiary syphilis.…”

Angiomatoid fibrous histiocytoma on the hard palate: case report

“…4). Clinically, palatal perforations occur due to various reasons such as trauma, infection, neoplasia, collagen vascular disease, and idiopathic conditions (Table 1) [5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”