LO 1 Flashcards
1
Q
Define disease
A
- An interruption, cessation, or disorder of body functions, systems, or organs, or a morbid entity characterized usually by at least two of these criteria: recognized etiologic agent(s), identifiable group of signs and symptoms, or consistent anatomical alterations.
- Oral–systemic connection -Periodontal/oral infections may impact heart disease, stroke, diabetes, respiratory disease, and preterm low-birth-weight babies.
2
Q
Describe oral medicine
A
- Designed to expand the scope and depth of knowledge and skills in pathophysiology, pharmacology, diagnosis, and primarily nonsurgical management of medically complex patients including those with medically related conditions affecting the oral and maxillofacial region.
- Emphasis is placed on treating patient from a “whole body” perspective.
3
Q
What are the objectives for clinical evaluation?
A
- Screen for oral cancer
- Determine whether the patient is well enough to continue dental treatment
- Determine the need for medical or other consultations
- Enable early diagnosis of pathology
- Determine possible treatment modifications
- Prepare and record baseline patient assessment
- Review and update baseline assessment information
- Determine whether additional diagnostic procedures are necessary
4
Q
What is the DH tole in describing and recording clinical findings?
A
- Detailed descriptions - History, location, distribution, definition, size, shape, color, consistency, and surface texture
- Photographs are excellent for documenting the appearance and progression or resolution of lesions.
- History—medical/dental history may provide clues to the etiology and history of the problem (diabetes, recent illnesses, and medications).
- Location—record the location on a diagrammatic representation or describe location using appropriate terminology; Pick fixed point of reference close to the lesion to start the description.; Use a probe to measure the distance from the point of reference and size of the lesion.
5
Q
Describe a bulla
A
- A circumscribed, elevated lesion that is more than 5 mm in diameter
- Usually contains serous fluid (clear), and looks like a blister
6
Q
Describe a macule
A
- An area that is usually distinguished by a color different from that of the surrounding tissue
- It is flat and does not protrude above the surface of the normal tissue
- A freckle is an example of a macule
7
Q
Describe a papule
A
- A small, circumscribed lesion usually less than 1 cm in diameter
- It is elevated or protrudes above the surface of normal surrounding tissue
8
Q
Describe a pustule
A
Variously sized circumscribed elevations containing pus
9
Q
Describe a vesicle
A
A small, elevated lesion less than 1 cm in diameter that contains serous fluid
10
Q
Describe a pedunculated lesion
A
Attached by a stemlike or stalk-like base similar to that of a mushroom
11
Q
Describe a Sessile lesion
A
Describes the base of a lesion that is flat or broad instead of stemlike
12
Q
Describe a nodule
A
- A palpable solid lesion up to 1 cm in diameter found in soft tissue
- Can occur above, level with, or beneath the skin surface
13
Q
Describe palpatation
A
- The evaluation of a lesion by feeling it with the fingers to determine the texture of the area
- Descriptive terms for palpation are soft, firm, semi-firm, and fluid filled
14
Q
Describe the possible colours of a lesion
A
- Most frequent color descriptions: Red, pink, salmon, white, blue-black, gray, brown, and black
- Colour may be incorporated into general descriptions
- Erythema - An abnormal redness of the mucosa or gingiva
15
Q
Describe Erythroplakia
A
- A clinical term used to describe an oral lesion that appears as a smooth red patch or granular red and velvety patch
- Less common than leukoplakia
16
Q
Describe pallor
A
Paleness of the skin or mucosal tissues
17
Q
Describe Leukoplakia
A
A clinical term for a white, plaque like lesion on the oral mucosa that cannot be rubbed off or diagnosed as a specific disease (often premalignant)
18
Q
How do you describe the size of a lesion?
A
- Always use a standardized probe to measure lesions + include units of measure
- Centimeter (cm) - One hundredth of a meter; equivalent to a little less than one-half inch
- Millimeter (mm)- Most common measurement; easy to do using perio probe
19
Q
How can you describe the surface texture of a lesion?
A
- Corrugated - wrinkled
- Fissure - A cleft or groove, normal or otherwise, showing prominent depth
- Papillary - Resembling small, nipple-shaped projections or elevations found in clusters
- Coalescence - The process by which parts of a whole join together, or fuse, to make one larger lesions. Ex. Herpes
- Diffuse - Describes a lesion with borders that are not well defined, making it impossible to detect the exact parameters of the lesion
20
Q
Describe multilocular
A
- Rad term
- Describes a lesion that extends beyond the confines of one distinct area
- Defined as many lobes or parts that are somewhat fused together
- A multilocular radiolucency is sometimes described as resembling soap bubbles
21
Q
Describe radiolucent
A
- Describes the black or dark areas on a radiograph
- Radiant energy can pass through these structures
- Less dense tissue, such as pulp, is seen as a radiolucent structure
22
Q
Describe radio opaque
A
- Describes the light or white area on a radiograph that results from the inability of radiant energy to pass through the structure
- The denser the structure, the lighter or whiter it appears on the radiograph
23
Q
Describe a lesion that is radiolucent and radiopaque
A
- A mixture of light and dark areas within a lesion
- Denotes a stage in lesion development
24
Q
Describe root resorption
A
- Radiographically, the apex of the tooth appears shortened or blunted and irregularly shaped
- Occurs as a response to stimuli, which can include a cyst, tumor, or trauma
25
Describe external root resorption
Arises from tissue outside the tooth, such as the periodontal ligament
26
Describe internal root resorption
1. Triggered by pulpal tissue reaction from within the tooth
2. The pulpal area can be seen as a diffuse radiolucency beyond the confines of the normal pulp area
27
A radiolucent lesion that appears to extend up the periodontal ligament and between the roots is called ___________
Scalloping around the root
28
Having one compartment or unit that is well defined or outlined as in a simple radicular cyst is called _________
Unilocular
29
Having many compartments or units that are well defined or outlined is called __________
Multilocular
30
_________ is used to describe a lesion with borders that are NOT specifically defined and you cannot clearly see the exact margins and extent
Poorly defined borders
31
__________ is used to describe a lesion with borders that are specifically defined and in which one can clearly see the exact margins and extent
Well circumscribed
32
Describe endophytic
Grows into the surrounding tissues with little or no observable swelling
33
Describe exophytic
Lesion grows outward from the body
34
Describe anomaly
Something that deviates from what is standard or normal
35
Describe dysphagia
Difficulty swallowing
36
Describe dysphonia
Difficulty speaking
37
Describe dyspnea
Difficulty breathing
38
Describe atrophy
Reduction in the size of individual cells- results in decreased size
39
Describe Hypertrophy
Enlargement of individual cells- results in increased size
40
Describe Hyperplasia
An increase in the number of cells-results in increased size
41
List the elements of the diagnostic process
1. Clinical diagnosis
2. Radiographic diagnosis
3. Historical diagnosis
4. Laboratory diagnosis
5. Microscopic diagnosis
6. Surgical diagnosis
7. Therapeutic diagnosis
8. Differential diagnosis
42
What aspects of a lesion need to be described?
1. Color
2.Shape
3. Location
4. Size
5. Border definition
6. Texture
7. History of lesion
43
Describe radiographic diagnosis
1. In a radiographic diagnosis, the radiograph provides sufficient information to establish the diagnosis
44
Describe historical diagnosis
1. Personal history
2. Family history
3. Past and present medical and dental histories
4. History of drug ingestion
5. History of the presenting disease or lesion
45
Describe laboratory diagnosis
1. Clinical laboratory tests, including blood chemistries, organismal cultures, and urinalysis, can provide information that contributes to a diagnosis
2. Laboratory cultures are also helpful in determining the diagnosis of oral infections
46
Describe microscopic diagnosis
1. Often the main component of the definitive diagnosis
2. Skill of practitioner is important
3. Adequate tissue sample is necessary
4. Additional screening technologies can also be used to detect changes in tissues
5. **Brush test can be used to obtain information from oral mucosal epithelium** - A circular brush is used to obtain cells from the full thickness of epithelium; The results of this test may help determine whether a scalpel biopsy is needed to establish a definitive diagnosis
6. A white lesion cannot be diagnosed on the basis of clinical appearance alone - The microscopic appearance can vary from a thickening of epithelium to epithelial dysplasia, which can be premalignant
47
Describe surgical diagnosis
1. Diagnosis is made using the information gained during the surgical procedure
2. e.g. Traumatic bone cyst - May appear as a radiolucency that scallops around the roots; When the lesion is opened surgically, an empty void is found
3. Diagnosis is made using the information gained during the surgical procedure
48
Describe therapeutic diagnosis
1. Nutritional deficiencies are common conditions to be diagnosed by therapeutic means
2. e.g. Angular cheilitis - May be associated with a deficiency of B-complex vitamins; Most commonly a fungal condition and responds to topical application of an antifungal cream or ointment such as Nystatin
49
Describe differential diagnosis
1. That point in the diagnostic process when the practitioner decides which test or procedure is required to rule out the conditions originally suspected and to establish the definitive or final diagnosis
2. OUR ROLE
50
What is the DHs role in differential diagnosis?
Be observant and collect data:
1. Patient’s medical and dental health histories
2. History of lesion
3. Clinical description and evaluation
4. Referral to appropriate medical professional
5. Biopsy and microscopy reports retained for treatment and future reference
51
List the common variants of normal
1. Fordyce granules
2. Torus palatinus
3. Mandibular tori
4. Melanin pigmentation
5. Retrocuspid papilla
6. Lingual varicosities
7. Linea alba
8. Leukoedema
52
Describe Fordyce granules
1. Clusters of ectopic sebaceous glands
2. Appear as yellow lobules in clusters
3. Commonly observed on vermilion border of lips and buccal mucosa
4. No treatment
53
Describe torus palatinus
1. An exophytic growth of normal compact bone
2. Observed clinically in midline of hard palate
3. Inherited, gradual formation
4. More common in women
5. May take on various shapes and sizes, may be lobulated, and is covered by normal soft tissue
6. No treatment unless they interfere with speech, swallowing, or a prosthetic appliance
54
Describe mandibular tori
1. Outgrowths of dense bone found on the lingual aspect of the mandible in the area of the premolars above the mylohyoid ridge
2. Usually bilateral
3. Often lobulated or nodular
4. Can appear fused together
5. Have no predilection for
either sex
55
Describe Melanin Pigmentation
1. The pigment that gives color to skin, eyes, hair, mucosa, and gingiva
2. Most commonly observed in persons with a darker skin tone
56
Describe lingual varicosities
1. Clinical appearance - Red-to-purple enlarged vessels or clusters
2. Usually observed on the ventral and lateral surfaces of the tongue
3. Most commonly observed in individuals older than 60 years
57
Describe linea alba
1. A “white line” extends anteroposteriorly on the buccal mucosa along the occlusal plane
2. May be bilateral
3. May be more prominent in patients who have a clenching or bruxing habit
58
Describe Leukoedema
1. A generalized opalescence on the buccal mucosa
2. Most commonly observed in black adults
3. If the mucosa is stretched, the opalescence becomes less prominent
59
Describe Lingual Thyroid
1. Undescended, trapped remnants of thyroid tissue
Clinical appearance
1. A mass in the midline of the dorsal surface of the tongue posterior to the circumvallate papillae in the area of the foramen cecum
2. Usually has a sessile base and is 2 to 3 cm in width
60
Describe Median Rhomboid Glossitis
1. Clinical appearance - Flat or slightly raised oval or rectangular erythematous area in center of tongue
2. May be associated with a chronic infection with Candida albicans
3. No treatment necessary, but antifungal treatment may be used
61
Describe Erythema Migrans
1. Erythematous patches surrounded by a white or yellow border
2. Diffuse areas devoid of filiform papillae
3. Distinct presence of fungiform papillae
4. There appear to be remission and changes in the depapillated areas
5. Genetic factors may play a role in presence
6. May be exacerbated by stress
7. Occasionally, the patient may complain of a burning discomfort
8. No treatment usually indicated
62
Describe Ectopic Geographic Tongue
Term used to describe “geographic tongue” found on mucosal surfaces other than tongue
63
Describe Fissured Tongue
1. The dorsal surface of the tongue appears to have deep fissures or grooves
2. Cause is unknown - Probably involves genetic factors, Seen in about 5% of the population
3. Home care - Direct the patient to brush the tongue gently with a toothbrush to remove debris
64
Describe White Hairy Tongue
1. Elongated filiform papillae are white
2. Result of either an increase in keratin production or a decrease in normal desquamation
3. Home care - Direct the patient to brush the tongue gently with a toothbrush to remove debris
65
Describe black hairy tongue
1. Papillae are brown-to-black because of chromogenic bacteria
2. Contributing factors - Tobacco, Foods, Hydrogen peroxide, Alcohol, Chemical rinses
3. Home care - Direct the patient to brush the tongue gently with a toothbrush to remove debris
