30 most common Flashcards
1 leukoplakia
intraoral white plaque, doesn’t rub off, not any well know entity.
may show benign hyperkeratosis, epithelial dysplasia, squamous cell carcinoma, carcinoma-in-situ.
remove potential causes and biopsy after 2 weeks.
diagnose by exclusion of other diseases.
premalignant: 5-25% dysplastic at biopsy
4% malignant transformation if allowed to grow.
etiology: tobacco, alcohol, sanguinaria, UV radiation, microorganisms & frictional keratosis.
white lesions that rub off
materia alba white coated tongue burn (thermal, chemical, cotton roll, etc.) pseudomembranous candidiasis toothpaste/mouthwash overdose
white coated tongue
asymptomatic
tongue scraping/brushing
looks like a white/yellow dirty tongue
thermal/electrical burn
most common burn is from microwaved foods.
children sometimes bite electrical cords.
aspirin burn
chemical coagulation necrosis
stop aspirin use
similar burns from peroxide, silver nitrate, phenol, endo material
toothpaste/mouthwash overdose
chronic overuse causes topical burn.
mucosa sloughs
listerine 21-27% ethanol
cotton roll burn
drying effect of cotton on mucosa.
chemicals may be absorbed by cotton against mucosa.
candidiasis
most common oral infection
fungal: candida albicans
2 forms: spore & hyphae
30-50% population (spores)
predisposing: immune deficient, medications, dentures
increases white cell count (neutrophils & myelocytes)
treat with antifungals (nystatin)
other candidiasis forms
white pseudomembranous red erythematous central papillary atrophy of tongue (median rhomboid glossitis) angular cheilitis denture stomatitis mucocutaneous
readily identifiable white plaques
linea alba leukoedema nicotine stomatitis oral hairy leukoplakia tobacco pouch keratosis lichen planus
linea alba
bilateral at occlusal plane of buccal mucosa.
no treatment
leukoedema
70-90% blacks
disappears when stretched
gray-white, milky appearance
no treatment
nicotine stomatitis
smoker’s palate, white hyperkeratotic hard palate from cigar/pipe smoking
males 45+yrs
fissured white mucosa, red punctate orifices of glands
stop smoking
oral hairy leukoplakia
epstein-barr virus related in AIDS patients.
white hyperkeratotic folds bilaterally on lateral tongue.
candidiasis on surface.
treat AIDS
tobacco pouch keratosis
young males (10-30yrs old)
white plaque, horizontal furrows in snuff pouch.
gingival recession & root caries.
dose response leads to verrucous carcinoma.
stop dipping
lichen planus
chronic mucocutaneous disease
middle aged, women 3:2 men
purple, pruritic, polygonal, papules on skin
oral: reticular & erosive
- reticular more common, posterior buccal mucosa bilaterally, striae of wickham, wax & wanes.
- erosive: less common, more symptomatic, needs steroid therapy, ulcers with radiating striae.
lichenoid drug reactions can produce similar appearance.
2 tori
palatal: 20-35% 2F:1M
mandible: 7-10% M>F
only treat for repeated trauma/ulceration or preprosthetic surgery
3 inflammation or irritation
traumatic ulcer
pericornitis
perio abscess
ANUG
4 fibroma
MOST COMMON BENIGN NEOPLASM OF ORAL CAVITY
buccal mucosa > labial mucosa > tongue > gingiva
surgical removal
smooth surface, pink, white, or gray
0.1-2.0cm elevation
asymptomatic
2F:1M, adults
fibroma look-a-likes
3 P's and FIFH: pyogenic granuloma peripheral giant cell granuloma peripheral ossifying fibroma focal inflammatory fibrous hyperplasia
pyogenic granuloma
excessive tissue reaction to irritation/trauma, red.
75% on gingiva, 25% on lips, tongue & buccal mucosa.
young adults, more female (‘pregnancy turmor’)
excision & scaling/root planing
peripheral giant cell granuloma
local irritation/trauma on alveolus, blue-purple.
31-41yrs old average, 60% female.
excision to bone & scaling/root planing
peripheral ossifying fibroma
mature pyogenic granuloma or peripheral giant cell granuloma?? sessile gingival mass, ulcerated often. 10-19 yrs old average, 67% female. bone with fibrous tissue. excision & scaling/root planing
focal inflammatory fibrous hyperplasia
local irritation cause increased fibrocytes and collagen production.
remove cause and hyperplastic tissue.
5 fordyce’s granules
ectopic sebaceous glands, 80% population.
yellow/white papules.
buccal mucosa > lips
no treatment
6 hemangioma
benign proliferative blood vessels, 60% in head & neck, 80% as single lesions.
10-12% children, most common birth mark, 3F:1M.
blanches under pressure, red = arteriolar, blue = venous.
associated with sturgeweber angiomatosis
surgery/lasers to remove
7 inflammatory ulcer
recurrent aphthous ulcer, canker sore (not cold sore/fever blister).
20-25% population
non-keratinized, non-bound down mucosa (never palate or attached gingiva).
1-2 lesions, 0.5-1.0cm
treat with steroids & antibiotics, but recurrent.
diagnose with location + size + number
8 papilloma
benign proliferation of squamous epithelium.
tongue > soft palate
wart-like pedunculation, soft, painless, finger-like projections.
0.1-1.0cm single lesion, M=F.
surgical removal
9 epulis fissuratum
inflammatory fibrous hyperplasia, ill-fitting denture.
folds of tissue in vestibule.
F>M, middle aged or elderly.
surgical removal, remake denture.
10 varicosities
dilated & tortuous veins
age (not disease) related
sublingual
no treatment
11 fissured tongue
scrotal tongue, deep grooves on dorsal tongue, 2-6mm.
2-5% population, increase with age
mild burning/soreness
brush tongue
12 geographic tongue
1-3% population, 2F:1M dorsal tongue, rarely ventral erythema due to atrophy of filiform papillae, moves around. asymptomatic no treatment
13 papillary hyperplasia
denture papillomatosis, 20% patients who wear dentures 24/7, candidiasis.
pebbly surface on hard palate.
asymptomatic
surgical excision, new denture
14 herpes viral infection
initial exposure 6months-5yrs old.
60-100% population exposed to HSV-1.
<1% require treatment.
chills, nausea, fever, ulcers, erythematous gingiva.
antiviral meds (acyclovir, best by day 3), resolution 10-14days.
cold sore or fever blister, 15-45% population.
UV light, trauma, hormones trigger.
pain, burning, itching, tingling before vesicular stage.
vesicles 2-4 days, vesicles rupture, scab, crust, dry up by 10-12 days.
palatal/gingival herpes: cluster of lesions (10-15) grows to ulcer.
diagnose with location + size + number
15 mucocele
rupture & spillage of saliva into soft tissue.
young adults, trauma related.
lower lip (60%), buccal mucosa, ventral tongue, floor of mouth, retromolar pad, soft palate.
ranula - mucocele of floor of mouth.
surgical excision
16 scar tissue
post trauma/surgery
no treatment
17 angular cheilitis
reduced vertical dimension, salivary pooling, candidiasis.
often bilateral
antifungals, increase vertical dimension.
18 lingual tonsil
lymphoid hyperplasia, posterior lateral tongue borders, bilateral.
discrete 1cm, enlarges with infection, red
no treatment
part of waldeyer’s ring
19 hematoma
accumulation of blood in tissues after trauma, blood blister.
no treatment.
20 tobacco pouch
gray-white lesion of mucosa at site of snuff pocket.
dose response changes, recession & root caries.
stop dipping before progression to verrucous carcinoma.
21 chronic cheek biting
2F:1M
irregular, ragged white mucosa
bite guard or no treatment
22 lichen planus
chronic mucocutaneous disease 3F:2M, middle aged purple, pruritic, polygonal, papules. striae of wickham steroid treatment
23 buccal exostoses
bony growth on buccal of max. or mand.
remove only with repeat trauma or preprostetic surgery.
rare: palatal, subpontic, subgraft
24 amalgam tattoo
amalgam in soft or hard tissue.
black, blue, grey soft tissue tattoo.
possible radiopacity, no treatment.
rule out melanoma with biopsy or radiograph.
25 oral melanotic macule
oral freckle, well-demarcated brown macule, 1-7mm.
2F:1M
lower lip > buccal mucosa > gingiva
biopsy to rule out melanoma, no other treatment
26 median rhomboid glossitis
central papillary atrophy of tongue.
asymptomatic red zone in posterior midline dorsal tongue.
antifungals, brushing tongue
27 black hairy tongue
elongated filiform papillae
0.5% population
usually asymptomatic, or bad taste, gagging.
tongue scraping or brushing.
smoking, antibiotics, poor hygiene, radiotherapy, breath mints
28 smooth red tongue
pernicious anemia (systemic problem), medications, avitaminosis.
burning and pain
treat underlying cause
29 epidermoid cyst
skin cyst, inflammed hair follicle.
oral cysts in midline floor of mouth.
slow growing, painless
surgical removal
30 lipoma
benign fat tumor
buccal mucosa > tongue > floor of mouth > lips.
yellowish soft nodular mass.
surgical excision
