Appendix 1 Flashcards
Erythroleukoplakia
Clinical Description: Red and white intermixed lesion that cannot be identified as anything else or rubbed off.
Etiology: Tobacco, Alcohol, Sanguinaria, UV radiation, Microogranisms
Treatment: Biopsy, surgical excision, frequent monitoring.
Other information: Biopsy reveals advanced dysplasia. Premalignant lesion.
Linea Alba
Clinical Description: white line located on buccal mucosa at the level of the occlusal plane
Cause: Pressure, irritation, or sucking trauma.
Treatment: No treatment Necessary
Other relevant information:10% of population. Jessica Alba is not one of them
Denture Stomatitis
Clinical Description: Erythematous lesion beneath an RPD or denture. No plaque to rub off, bright red patch.
Etiology: Erythematous Candidiasis. Do not remove denture - creates a moist environment.
Treatment: Treat both denture and soft tissues! Antifungal mouthrinse and soak denture in Nyastatin (antifungal medication)
Other information: Advise patient to remove denture at night to allow tissue to “breathe”
Leukoedema
Clinical description: diffuse, gray-white, milky, opalescent lesions found bilaterally on buccal mucosa that does not rub off.
Cause: Variation of normal edematous swelling
Treatment: None needed
Other Relevant Information: White appearance disappears when cheek is stretched and comes back when released. up to 90% of African Americans (racial pigmentation) and 50% of children
Smokeless Tobacco Pouch Keratosis
A brown-black extrinsic tobacco stain on the teeth is common (Typically localized, not generalized)
Appears fissured or rippled
NO: Induration, ulceration, pain
Treatment is alternating the site of tobacco placement
· Habit cessation leads to normal mucosal appearance in 98% of users, usually in 2 weeks
· A lesion remaining 6 weeks after habit req biopsy. (tobacco pouch keratosis)
Lichen Planus·
Common, chronic dermatologic disease that can affect the oral mucosa
Identifiable Wickham striae
2 forms of oral lesions:
- Erosive and Reticular
If confined to the gingiva it is Desquamative gingivitis
Tx:
- Oral topical corticosteroids are used for treatment just when ulcerated..but too much corticosteroid lead to candida..feeling pain..burning lesion.. yeast.
- Steroids make glucose shoot up so know if patient is diabetic
- Georaphic Tongue
- a.k.a. benign migratory glossitis, erythema migrans (when not on the tongue)
- Common inflammatory condition
- Dorsal and/or lateral tongue
- Asymptomatic (may burn or hurt)
- Often patients with fissured tongue are affected
- Clinical description: Superficial dilated veins detected by blanching with glass slide.
- Treatment:No treatment unless on lips or buccal mucosa because of thrombus formation or esthetics
- Clinical Description: Accentuated folds at the corners of the mouth
- Etiology: C. Albicans or Staph Aureus
- Treatment: Antifungal
Angular Chelitis
Leukoplakia
Clinical description: an intraoral white plaque that does not rub off and cannot be identified as any well known entity
Cause: Tobacco (80% are smokers), Alcohol (synergistic with tobacco), Sanguinaria, UV radiation, Microorganisms (treponema Pallidum), Trauma
Treatment: Biopsy. Mild dysplasia (alterations limited to lower ⅓), Moderate dysplasia (alterations limited to lower ½), severe dysplasia (alterations above ½)
Other Relevant Information: Precancerous (always keep monitoring), white because something is blocking redness of mucosa (80% of the time it is hyperkeratosis). PVL (proliferative verrucous leukoplakia) is highest risk of cancer.
White Coated Tongue
Clinical Description: White lesion that can be scraped off
Etiology: Oral hygiene, high carb diet
Tx: No tx needed,Tongue scraper
Pseudomembranous Candidiasis - THRUSH
Clinical Description:
- Best recognized/classic form of Candidiasis
- Adherent white plaques resemble “cottage cheese”
- Buccal mucosa, palate, dorsal tongue
- Can wipe off
Etiology:
- Abx (disrupts balance)
- Impaired immune system (i.e. Leukemia, HIV, Infants)
- Asthma inhalers
Tx:
- Antifungal (Nystatin)
Morsicatio Buccarum
Clinical Description:
- Bilateral white lesions on the anterior buccal mucosa that do not rub off
- Thickened, shredded white areas
Etiology: Chronic cheek chewing (parafunctional habit)
Tx:
- No tx needed
- 2 Wk test to confirm
Melanotic macule
- Oral counterpart to the ephelis
- Etiology: Brown asymptomatic macule produced by a focal increase in melanin production
- Treatment: Can’t be distinguished clinically from early melanoma, so biopsy is mandatory.
Smokers melanosis
- Etiology: Melanin production stimulated by nicotine
- Treatment: Cessation of smoking. Biopsy indicated if found in unexpected location or clinical changes.
Abcess
- Etiology: Accumulation of acute inflammatory cells (neutrophils) at apex
- Treatment: Root Canal Therapy
fordyce granule
What:
- “Ectopic” sebaceous glands in 80% of the population
- appear as yellow or yellow-white papular lesions
where:
- Buccal mucosa & lateral portion of vermilion of upper lip
treatment:
- sprinkle some magic moody dust on them (AKA no treatment required)
lymphoid hyperplasia (lingual tonsil)
What:
- enlargement of lymphoid tissue, typically from infection
- intraoral lesions are discrete, nontender, submucosal swellings
- yellow or normal in color
Where:
- lymph nodes, Waldeyer’s ring
- aggregates of lymphoid tissue are most commonly seen:
- oropharynx
- soft palate
- lateral tongue
- floor of mouth
Treatment:
- biopsy to diagnose. Then no treatment required.
lymphoepithelial cyst
What:
- lesion of the mouth that develops within oral lymphoid tissue.
- white or yellow
- asymptomatic
- submucosal mass less than 1 cm in diameter
Where:
- Waldeyer’s ring (palatine tonsils, lingual tonsils, pharyngeal adenoids)
- also found on the floor of mouth, ventral tongue, soft palate
treatment:
- surgical excision (biopsy) or clinical diagnosis
lipoma
What:
- benign tumor of fat
- most common mesenchymal neoplasm
- soft, smooth-surface nodular mass
- yellow or mucosal colored.
Where:
- 50% occur in buccal mucosa
Treatment:
- surgical excision
