Intraoral exam Flashcards
what is the gold standard for diagnosing oral cancer
biopsy
what percent of cancers does oral cancer make up
3%
what percentage of people diagnosed with oral cancer have a 5 year survival rate
57%
what gender is more affected by oral cancer
men twice as much
what percent of oral cancer is found in stage 1 or 2
40%
what is the survival rate of stage 1 or 2 oral cancer
80-90%
what is the survival rate of state 3 or 4 oral cancer
33%
what is the recurrence percentage in stage 3 or 4 oral cancer in 2 years
67%
how do you describe cancerous lesions
-number
-size
-shape
-color
-profile
-base
-border
texture
what are the risk factors for oral cancer
-tobacco #1
-alcohol #2
-viruses HPV and HIV
-sun exposure
-inadequate nutrition
-genetic predisposition
-chronic inflammation
-radiation exposure
-carcinogen exposure
what percentage of oral cancer could be prevented by eliminating tobacco and alcohol use
75%
what percent reducation after 5 years without tobacco
35%
how do you avoid oral cancer
-eliminate tobacco and alcohol
-lip balm with sunscreen
-HPV vaccine
-diet rich in fruit and veggies
what are the high risk areas for oral cancer
-floor of mouth
-lateral border of tongue
-ventral surface of tongue
-oropharynx
what are signs and symptoms of oral cancer
-nonhealing ulcer
-bleeding
-lymphadenopathy
-hardness
-parasthesia
-drooling
what is induration
firm but not as hard as bone
describe a routine oral cancer exam
-question pt about risk factors
-examine face
-palpate lymph nodes
-palpate lips
-palpate labial and buccal mucosa
-examine bimanually palpate floor of mouth
-examine/palpate tongue
-examine hard and soft palate
-examine tonsils and oropharynx
what is compressible
pressure alters its shape
what is doughy
returns slowly to original shape
what is spongy
returns quickly to original shape
what is collapsing
contents expressed usually fluid like -abscess
what is pitting
soft and leaves indentation- edema
what is blanching
color change
what is discrete
separate, not running together or blending
what is confluent
running together, merging, blended
what is verrucose
covered with wart like growths, cauliflower like surface
what is sessile
attached to the surface on a broad base
-immobile, fixed, firmly attached
-lacks a stalk
what is a pedunculated lesion
elevated lesions having a narrow stem which acts as a base, elongated stalk
where do pedunculated squamous papilloma occur
on the soft palate, tonsil, or epiglottis
what is erythema
red area of variable size and shape usually in patches
what are petechiae and what are they caused by
round red pinpoint areas of hemorrhage caused by trauma, viral infection or bleeding problem
what are macules
-small circumscribed area of color change
-brown, black, blue,red
-not elevated or depressed
-ex: a freckle
what is an eschar
a sloughing of epithelium caused by disease trauma or chemical burn
what is a torus
bony elevation or prominence
what is a patch
-large area of color or texture change
-not elevated or depressed
what is an ulcer
an area extending below the basal layer
-gradual tissue disintegration
-usually painful
what is crust
an outer layer covering or scab from a coagulation of blood, serum, pus or any combination
what is plaque
a solid, flat, area often keratinized
what is a papule
a superficial elevated solid lesion, any color, solid base or pedunculated
what is a vesicle
smal fluid filled, elevated lesion with a thin surface covering
what is a pustule
small vesicular type lesion containing purulent material rather than clear fluid
-creamy white or yellow
what is a nodule
an elevated deep solid lesion
-overlying mucosa not fixed
what is an irritation fibroma classified as and why
a tumor because this lesion is persistent and increases in size
what is a bulla
a large vesicle, contains serum, usually at the mucosal, submucosal junction
what is linea alba
-white line on inner cheek
-parallel to oclussal plane, asymptomatic, atypical, caused by chewing
what is leukodema
milk white surface blue or grey, symmetrical, atypical, doesnt rub off, disappears when stretched
what population are leukodemas more popular in
african americans
what is lichen planus
common inflammatory disease involving the skin and mucous membranes
-interlacing white striae with erythema of the surrounding mucosa
-usually bilateral
-painful erythematous erosions and ulcers may also occur
- on skin appears as purplish, itchy, flat bumps
what gender is lichen planus more common in
women
what are fordyce granules
-sulfur colored
-asymptomatic
-atypical
- 1-3 mm papules in oral cavity or lip vermillion
describe torus palatinus
-bony lumps
-asymptomatic
-atypical
what percentage of people have torus palatinus
20-30%
what is ratio of females to males with torus palatinus
2:1
what percentage of people have torus mandibularis
8-16%
what gender is more likely to have torus mandibularis
they are equal
what is nicotine stomatitis
-lesion of hard palate
-white , rough, asymptomatic, leathery appearing
contains red dots or macules
what is nicotine stomatitis caused by
extreme heat in the mouth
what is benign migratory glossitis
lesions heal in one area then move to a different part of the tongue
where is the most common place for cancer to occur on the tongue
lateral border and the base
what is leukoplakia
white or grayish thick keratotic patch like lesion on the mucosa which cannot be rubbed off
what is hairy leukoplakia caused by
epstein barr virus
where does hairy leukoplakia occur
on the lateral border of the tongue, white rough patches
what causes hairy tongue
-trapped debris from bacteria
-fungus
-coffee
-tobacco
-antibiotics and other drugs
what is the submandibular duct also called
whartons duct
what percentage of saliva does whartons duct account for
60%
what are xerostomia symptoms
-candidiasis
-angular chelitis
-burning tongue
-root and cervical caries
-stomatitis
-dysphagia
what is candidiasis
white plaque
-creamy white lesions
-rubs off but looks like hyperkaratosis
-found on buccal mucosa and lateral borders of tongue
where can thrush spread to
tongue
-hard and soft palate
-tonsillar region
what are the risk factors for candidiasis
-immunocompromised
-pregnancy
-poor oral hygiene
-smoking
-stress
-depression
-birth control
-long term antibiotics
-diabetes
-dentures that dont fit
-xerostomia
-iron B12 deficiency
what is acute pseudomembranous candidiasis
creamy white patches on tongue, buccal mucosa, floor
-easily wipe off leaving an erythematous base
-dysphagia
-white plaque
what is atrophic candidiasis
under dentures, red on palate or tongue
what is the treatment for candidiasis
-oral hygiene
-yogurt
-avoid alcohol and simple sugars
-antifungal medications like nystatin and ketaconozole
what population is herpes gingivomatitis most seen in and what is it caused by
children caused by HS1 mostly
what are severe primary herpes simplex infections with oral lesions accompanies by
high fever, malaise, cervical hymphadenopathy, and dehydration
where do vesicles in herpes gingivostomatitis occur
in the pharynx, palate, buccal mucosa, lips and or tongue. may extend into lips or buccal mucosa
how long does it take for herpes gingivostomatitis lesions to resolve without treatment
2 weeks
what percentage of the population gets herpes simplex, cold sores
50%
where are type 1 herpes simple located? type 2?
1: mouth, lips, face
2: genital
what are the prodromal signs of herpes simplex
tingling, itching, pain, burning. arise 6-24 hours before lesions develop
what is herpetic whitlow
infections of the thumbs or fingers
-grouped, fluid or pus filled
-usually itch and/or painful
what is the treatment for primary herpetic gingivostomatitis
antiviral medications
-acyclovir suspension during first 3 symptomatic days in a rinse and swallow techniques 5x/day for 5 days
when is recurrent herpes labialis best treated
in the prodrome phase
what does acyclovir ointment do
decreases number of herpes vesicles but not pain or healing time
what do you prescribe to patients with herpes recurrences associated with dental procedures
prescribe a regiment of 2g of valacyclovir taken 2x a day on day of procedure and 1g taken 2x the following day
what percentage of the population get apththous ulcer
60%
what are aphthous ulcers
canker sores
when do apthous ulcers start
10-20 years old
what are prodromal symptoms of aphthous ulcers
tingling or burning sensation usually 1-2 days before it appears
how long do aphthous ulcers persist
3 days pain, 7 days healed
what is the cause of aphthous ulcers
mucosal destruction causes T cell mediated immunologic reaction
when both parents have aphthous ulcers what chance is it that kids get it
90%
what are the clinical variations of aphthous ulcers
minor, major, herpetiform
where do minor apthous ulcers arise
almost exclusively on nonkeratinized mucosa. buccal and labial then ventral surface of tongue
describe minor aphthous ulcerations
-3-10 mm
- heal without scarring in 7-14 days
how large are major aphthous ulcers and how many lesions are there usually
1-3 mm. usually 1-10 lesions
which type of ulcer has longest duration
major
which type of ulcer has greatest number of lesions and most frequent occurence
herpetiform
what gender mostly suffers from herpetiform aphthous ulcers
women
what are treatment options for aphthous ulcers
- benzocaine, orajel, anbesol, (for symptoms)
-kenalog (local anti inflammatory)
-ameseal (sealing agent)
-aphthasol (apply 2-4x a day and start in prodromal stage)
how long do major aphthous ulcerations take to heal
2-6 weeks and may scar
when is the onet of major aphthous ulcerations
after puberty
how big are herptiform aphthous ulcerations and how many lesions are present at once
1-3 mm and as many as 100 ulcers at once
how long to herpetiform aphthous ulcers take to heal
7-10 days but recurrences are so closely spaced it can last for 3 years
what oral mucosa and gender is predominantly involved with herpetiform aphthous ulcers
any oral mucosa and females predominantly
when is the onset of herpetiform aphthous ulcers
adulthood
