30 Most Common Flashcards
What are some white lesions that CAN be scraped off?
materia alba, white coated tongue, burns, pseudomembranous candidiasis, toothpaste irritation
Pt presents with white plaque and erythematous tissue. Whats the dx and tx?
Dx: pseudomembranous candidiasis
Tx: Nystatin
What presents as a non-wipeable white area on the cheeks (common in black population)
leukoedema
When in doubt, ___ __ ___.
cut it out!
Is leukoplakia pre-malignant or no?
yes, it’s considered pre-malignant
How concerned should you be for mild dysplasia leukoplakia to progress to cancer?
Not too worried. <5% chance
What are the three most concerning sites for leukoplakia?
FOM, tongue, lip
What is a bony protuberance in the mouth?
Tori (palatinus, mandibularis, etc)
How did Dr. Trump tell us to treat a traumatic ulcer?
Inject Kenalog-10 into the ulcerated tissue (steroid injection)
Biopsy if this fails
What are four common examples of inflammation/irritation that comes into your dental office?
Traumatic ulcer, pericornitis, periodontal abscess, ANUG
What is the most common benign neoplasm of the oral cavity?
Fibroma
common spots for fibromas?
Buccal mucosa, labial mucosa, tongue, and maybe gingiva
What are ectopic sebaceous glands?
Fordyce granules (80% of population)
What is a spot of benign proliferation of blood vessels?
Hemangioma (it will blanch under pressure)
How to treat hemangioma?
observe with no intervention, surgical removal, or sclerotherapy
What tissue do RAUs occur on?
non-keratinized, non-bound mucosa
How do you treat RAUs?
topical steroids (aphthasol, betamethasone, decahedron, lidex, kenalog)
What appears as a little cauliflower in the mouth?
Papilloma
Where do papillomas frequently occur?
tongue, soft palate
How to treat papillomas?
surgical excision
What are variations of papillomas?
verruca vulgaris, condyloma accuminatum, focal epithelial hyperplasia, and sinonasal papillomas
What kind of papilloma looks broader and flatter?
condyloma accuminatum
Epulis fissuratum is classified as what?
focal inflammatory fibrous hyperplasia (from ill-fitting denture)
What do you do to treat epulis fissuratum?
surgical excision if relining or remaking the denture
Pt has numerous grooves on the tongue. Dx and Tx?
Dx: fissured tongue
Tx: brush the tongue and keep it clean
Pt has red patches on tongue that are sensitive to hot/spicy foods. Dx and Tx?
Dx: geographic tongue
Tx: nothing, educated pt
What causes papillary hyperplasia?
Constant irritation to gingiva, such as wearing a denture 24/7
How to treat papillary hyperplasia if severe?
surgical excision and relining of denture. If not severe then leave it but educate
Where do herpes occur intra-orally?
almost ALWAYS on the keratinized, bound mucosa (palate, attached gingiva)
How long does it take for oral herpes to heal?
7-10 days
What antivirals can you prescribe for herpes?
Acyclovir 5% ointment (6x/day), Acyclovir 200mg (5x/day), prophylaxis with Lysine 500mg
What is a mucocele on the FOM called?
A ranula
What is most common site of mucocele?
lower lip (because it gets bit most commonly)
How to treat a mucocele?
Surgical excision along with the associated gland
How to treat angular cheilitis?
antifungals, and increase the pt’s vertical dimension
What is an accumulation of blood within the tissues, secondary to trauma?
hematoma (no tx)
How to treat tobacco pouch keratosis?
cessation of dipping. Should resolve within 2 weeks. If it doesn’t then re-evaluate the lesion (possible biopsy)
What can tobacco pouch keratosis progress into if they don’t stop?
verrucous carcinoma
What does reticular lichen planus present with?
wickham striae
What are skin lesions like with Lichen Planus?
purple, pruritic, polygonal
How to treat lichen planus?
steroids (aphthasol 5%, betamethasone syrup, decahedron elixir 0.5mg/5ml, lidex 0.05%)
If you suspect an amalgam tattoo, what can you do as a quick check?
radiograph - amalgam will appear as a RO object
How to treat an amalgam tattoo?
no tx, but if you can’t rule out melanoma then a biopsy may need to be done
What is an oral melanotic macule?
an oral freckle
common places for oral melanotic macules?
lower lip > buccal mucosa > gingiva
How to treat oral melanotic macules?
No tx, unless melanoma cannot be ruled out - then do a bx
Pt has a red spot on the midline of their tongue. Dx and Tx?
Dx: median rhomboid glossitis
Tx: antifungals and tongue brushing
How to treat hairy tongue?
Scrape off the hyperkeratosis
What are causes of smooth red tongue?
pernicious anemia, medications, avitaminosis
Pt has a burning and painful tongue. it’s smooth upon exam. Dx and Tx?
Dx: smooth red tongue
Tx: find underlying cause and treat that
What is a cyst associated with inflammation of a hair follicle?
epidermoid cyst
Where do epidermoid cysts usually occur in the mouth?
midline FOM
How to treat epidermoid cysts?
surgical removal
Where are lipomas most commonly seen?
buccal mucosa > tongue > FOM > lips
How to treat a lipoma?
surgical excision
