introduction to oral medicine Flashcards
Why might a patch be white? (3)
- Abnormal or increased keratin
- Increased epithelial thickness
- Candida
What is this?
Pseudomembranous candiasis
4 risk factors for oral candida infection?
- Immunocompromised patient
- Dentures
- Smoking
- Inhaler use
What 3 medications can be used to treat oral candidiasis?
- Fluconazole
- Miconazole
- Nyastatin
How else can you manage candidiasis?
- in smokers - smoking cessation
- inhaler use - rinse after use and use spacer
- denture wearer - denture hygiene
What is this?
Traumatic keratosis
What might cause traumatic keratosis?
Trauma leading to increased keratin deposition
What are the 6 types of oral lichen planus and oral lichenoid reactions relating to appearance?
- Reticular
- Atrophic
- Papular
- Erosive
- Plaque like
- Bullous
Describe appearance of lichen planus?
Reticular
Describe appearance of lichen planus?
Atrophic
Describe appearance of lichen planus?
Papular
Describe appearance of lichen planus?
Erosive
Describe appearance of lichen planus?
Plaque like
Describe appearance of lichen planus?
Bullous
What is oral lichen planus
A chronic inflammatory condition leading to destruction of basal keratinocytes by CD8+ T Cells
Which cells are responsible for destruction of basal keratinocytes in lichen planus?
CD8+ T cells
If oral lichen planus is symptomatic , how would you describe the pain?
burning or stinging
What is the difference between Oral lichen planus and Oral lichenoid tissue reaction?
- Oral lichen planus is generalised and idiopathic
- Oral lichenoid tissue reaction is localised and may be a response to medicines or allergens
What is the malignant potential of lichen planus over 10 years?
1%
What 3 things of the patient medical history would you ask for investigating lichen planus?
- Lupus
- Graft versus host disease
- recent cancer therapy
What 4 drugs may cause Oral lichenoid reactions?
- Antihypertensives
- Antimalarials
- NSAIDs
- Lithium
What 3 materials may cause OLR?
- Gold
- Nickel
- Amalgam
- Composite resin
A patient presents with symptomatic lichen planus/OLR , What advice would you give to relieve symptoms?
- Avoid trigger factors such as spicy foods and fizzy drinks
- Rinse with HSMW
A patient presents with symptomatic lichen planus/OLR , What would you prescribe to relieve symptoms?
- Local anaesthetic ( benzydamine, lidocaine)
- Steroid mouthwash ( betamethasone MW , beclomethasone inhaler)
A patient presents with symptomatic lichen planus/OLR , What else would you other than changing restorations, providing advice and medication for symptomatic relief?
- Refer for biopsy
- inform risk of cancer
- Investigate and manage cause
What is this?
Hairy leukoplakia which is a non removable white patch most commonly affecting the lateral borders of the tongue
What 2 viruses are commonly associated with hairy leukoplakia?
- EBV
- HIV
What group of patients are more prone to hairy leukoplakia?
immunocompromised patients
When might a red patch malignancy rate increase?
If there is no clear cause
What is this?
Erythmatous candidiasis
What is this?
Desquamative gingivitis
What is this?
Granulomatosis with polyangitis caused by systemic vasculitis
What is used to manage granulomatosis with polyangitis?
immunosuppressants
What 4 symptoms associated with granulomatosis with polyangitis?
- fever
- weight loss
- ear, nose or throat manifestations
How would you describe this patch colour?
Erythroplakia , red and velvety
What to do if a patient presents with erthroplakia?
Refer urgently as high malignancy rate
What is this?
Oro-facial granulomatosis disease