Miss Duerden's lectures Flashcards
1
Q
What is the duct of the largest salivary gland?
A
The Stenson’s Duct
2
Q
What is geographical tongue?
A
multiple circular or pink areas on the top of tongue. Sometimes depilation can occur.
3
Q
What is Linea alba?
A
A common condition that appears as white slightly raised keratotic line along the occlusal plane of the buccal mucosa.
4
Q
What is morsicatiobaccarum?
A
Cheek biting
5
Q
How can coeliac disease present orally?
A
Glossitis, angular cheilitis and enamel hyperplasia.
6
Q
How can Chron’s disease present orally?
A
swellings of the lips, mucosal tags, oral ulceration and full width gingivitis.
7
Q
What is ulcerative colitis?
A
An inflammatory condition which effects the colon.
8
Q
What is GORD?
A
Where there is an increased frequency and duration of reflux causing damage to the oesophageal mucosa by regurgitation of the gastric contents.
9
Q
How does GORD present orally?
A
Dental erosion
10
Q
How does hepatic disease effect the patient orally?
A
Bilirubin in the submucosa affects the mucosa on the soft palate and sublingual region. Excessive gingival bleeding and prolonged bleeding.
11
Q
What is anaemia?
A
A reduction in the level of haemoglobin or a decreased number of erythrocytes.
12
Q
How does anaemia present orally?
A
Pallor of the oral mucosa, glossitis, oral candidiasis, exacerbation of RAV and plummer vision syndrome.
13
Q
What is acute leukaemia?
A
A malignant neoplasm of blood forming tissues characterised by abnormal proliferation of leukocytes originating in bone marrow.
14
Q
How does acute leukaemia present orally?
A
Gingival swelling, oral ulceration, leukemic deposits, oral petechiae and purpura.
15
Q
What are some functions of thrombocytes?
A
Secrete vasoconstrictors, form temporary platelet plugs, dissolve blood clots, secrete growth factors.
16
Q
What are purpura?
A
The typical result of platelet disorders, it is bleeding into the mucous membrane.
17
Q
What are some causes of platelet diseases?
A
Idiopathic thrombocytopaenia, connective tissue diseases, leukaemia and HIV infection.
18
Q
What is the clotting cascade?
A
Platelets bind to collagen and make a plug, adhesion is strengthened by the vWF it is a temporary measure while the clotting cascade is triggered to make a stronger clot.
19
Q
What is the intrinsic pathway in the clottingcascade?
A
The intrinsic pathway is activated by damage directly to the blood vessel and the exposure of collagen to the circulating platelets within the blood.
20
Q
What is the extrinsic pathway in the clotting cascade?
A
The extrinsic pathway is activated by many things including damage directly to the blood vessel, tissue damage, tissue damage outside of the blood vessel and inflammation.
21
Q
What is the common pathway?
A
Factor 10 is the start of the common pathway. Fibrin traps the platelets and is clotting factor 1. Thrombin activates all the other clotting factors and is clotting factor 2.
22
Q
What is warfarin?
A
It is a vitamin K antagonist and blocks vitamin K dependent clotting factors.
23
Q
What are some non vitamin K oral anticoagulants?
A
Dabigatran and rivoraxaban.
24
Q
What is dabigatran?
A
It is a direct thrombin inhibitor.
25
What is rivoraxaban?
It is a direct inhibitor of activated factor X.
26
What are some clinical manifestations of haemophilia A + B?
prolonged bleeding
27
What is Von Wilbrand's disease?
A hereditory disease caused by a deficiency of the vWF.
28
How does von wilbrand's disease present?
Mucocutaneous bleeding with varying severity.
29
What is systemic lupus erythematosus?
A multi system autoimmune disease.
30
How does lupus present orally?
Purpura and ulceration of the buccal mucosa and gingiva.
31
What is rheumatoid arthritis?
A common multisystem autoimmune inflammatory disease?
32
Why may a person with rheumatoid arthritis have decreased OH?
Inflammation in the synovial tissue of the joints of the hands and wrists reduce the ability to brush the teeth.
33
What is Sjogren's syndrome?
An autoimmune disease affecting fluid secreting glands..
34
What are the symptoms of Sjogren's syndrome?
Dry eyes/mouth, parchment-like mucosa and lobulated tongue.
35
What is scleroderma?
It is progressive fibrosis from increased collagen deposition in interstitium and intima of small arteries and connective tissues.
36
How is scleroderma relevant to dentistry?
Opening of the mouth becomes restricted, widening of the periodontal ligament and trismus.
37
What is TB?
It is a bacterial infection, presenting as a typical lesion that is painful and is on the tongue.
38
What is COPD caused by?
Smoking and recurrent respiratory infections.
39
How is COPD relevant in dentistry?
It may be linked to periodontal disease and some dental treatments may trigger airway problems.
40
What is lichen planus?
Bilateral white striations on the buccal mucosa, tongue or gingiva.
41
What are the types of lichen planus?
Reticular, erosive, atrophic, bullous or plaque like.
42
What is desquamative gingivitis?
Red, inflamed, smooth gingivae.
43
What is Erythema Multiforme?
An uncommon acute reaction affecting mucocutaneous tissues seen in young males.
44
How does oral EM present?
Macules which evolve to blisters and ulcers, lips become swollen.
45
What is pemphigus vulgaris?
Chronic diseases characterised by epithelial blistering affecting cutaneous and mucosal surfaces.
46
What are the symptoms of PV?
Blisters that first develop in the mouth and move onto the skin. The blisters can burst and become painful sores.
47
What is Bullous Pemphigoid?
It is an autoimmune type of disorder with a genetic predisposition characterised by autoantibodies against the connections between epidermal cells.
48
What is Psoriasis?
A common relapsing skin disease on the lips, tongue palate and buccal mucosa.
49
What is diabetes?
A common endocrine disease.
50
How can diabetes manifest orally?
Dry mouth, compromised periodontal health, oral candidiasis and swelling of the salivary glands.
51
What affect do sex hormones have on gingival health?
Recurrent aphthae, burning tongue, fibrous hyperplasia.
52
What are the three types of epiludes?
Pregnancy, fibrous and giant cell carcinomas.
53
How does pregnancy epiludes occur?
It occurs in the mouth as an inflammatory response to plaque.
54
How can angina present orally?
Angina may present as tooth ache in the lower left quadrant.
55
What are some ways that HIV can present orally?
Angular cheilitis, oral hairy leucoplakia, varicella zoster and herpes simplex.
56
What are some bacterial lesions in HIV?
Associated with gingivitis and periodontitis (ANUG)
57
What is an ulcer?
A breach in the oraal epithelium which typically exposes nerve endings i nthe underlying lamina propria resulting in pain or soreness.
58
What are the most important features of oral ulceration?
Whether it is single, multiple or persistent.
59
What may a single persistent ulcer be?
Neoplasia, chronic trauma, chronic skin disease or chronic infection.
60
What may multiple non persistent ulcers be caused by?
Skin diseases, GI disease, blood disease, drugs or an immune defect.
61
What are the main causes of ulcers?
Trauma, infections, drug therapy and systemic disease.
62
What is traumatic ulceration?
Can be physical, chemical or factitious. Usually sensitive to hot, spicy or salty foods. Irregular border with yellow margins. usually heal in 10-14 days.
63
Detail mechanical trauma.
Often found on the buccal mucosa, caused by ill fitting prosthetics, and biting oneself.
64
Detail chemical ulcerations.
Can be on any area of the oral mucous membrane. Usually resolve.
65
Detail thermal ulceration.
Related to hot foods and typically occurs on the posterior buccal mucosa and the palate.
66
What is recurrent apthous stomatitis?
Outbreaks are sporadic and decrease with age.
67
What are minor aphthae?
The most common stomatitis, they are small, well defined shallow ulcers with slightly raised erythematous borders.
68
What are major aphthae?
1cm in diameter, more frequent recurrence, frequently heal with scarring.
69
What are some associated diseases with aphthous ulcers?
Iron deficiency, GI disturbance, immune disturbances and NSAIDs.
70
What do you do if you find a persistent ulcer?
Refer for full blood count, serum B12 and folate.
71
What is Behget's syndrome?
A rare, chronic and sometimes a life-threatening disorder as a result of inflammation of blood vessels.
72
What is the clinical diagnosis for Behget's syndrome?
Any two of the following: -
Recurrent genital ulcers
eye lesions
skin lesions
pathergy
73
What is the treatment for Beghet's syndrome?
Needs a multidisciplinary approach. Oral ulcers are treated as aphthae. Thalidomide.
74
What is herpetiform aphtae?
Multiple pin sized discrete ulcers that occur frequently and heal within 7-10 days.
75
What do you do to when malignancy is suspected in ulceration?
Patients with a single persisting ulcer for more than three weeks needs a specialist opinion.
76
What are hyperplastic lesions?
They are a result from chronic irritation, infection, proliferation of granulation tissue and progressive fibrosis.
77
What is fibroepithelial polyps?
Slow growing, sessile fibrous lumps which are usually firm and painless.
78
What are histological features of Fibroepithelial polyps?
Non-encapsulated nodular mass of dense, fibrous tissue.
Covered by stratified squamous epithelium - excision required.
79
What is a peripheral giant cell granuloma?
They are red haemorrhagic and soft. Occasional superficial bone erosion.
80
What is a Pyogenic granuloma?
Gingival margins have an ulcerated appearance on the top of the 'lump'. shoudl excise.
81
What is dental hyperplasia?
Associated with chronic irritation from a denture, should excise.
82
What is papillary hyperplasia?
Small, multiple nodules from variable inflammation. usually in the palatal vault.
83
What can jaw swellings be?
unerupted teeth, Tori and multiple exotoses.
84
What are Tori?
Slow growing and asymptomatic overgrowth of bone. Excise or reduce if there is denture difficulties.
85
What are multiple Exotoses?
It is the formation of a bone mass on the outer side of the maxilla.
86
Squamous cells papilloma?
A benign epithelial tumour.
87
What is n adenoma?
A common benign salivary gland tumour.
88
What is a fibroma?
Hard or soft and usually broad based. Can be leaf shaped. Very common under dentures and should excise.
89
What is a neuroma?
Asociated with multiple endocrine neoplasia and may be traumatic.
90
What is a lipoma?
A benign tumour of adipose tissue, rare, slow growing, painful masses on the the buccal mucosa.
91
What is a haemangioma?
A developmental lesion of blood vessels, present at birth. Can grow, remain static or regress.
92
What is a lymphangioma?
A benign tumour of lymphatic channels. It is a rare, colourless lesion but can be purple if bleeding. Must excise.
93
What is a dental abscess?
Most common cause of oral swelling. Chronic inflammatory and granulomateous disorders can present with lumps or bumps.
94
What is gingival fibromatosis?
A group of diseases idiopathic or hereditary with generalised fibrous enlargement of the gingivae.
95
What is Nefidepine?
Calcium channel blocker.
96
What is pheytoin?
An anticonvulsant
97
What is Cyclosporin?
Immunosupressant.
98
What are neoplasms?
Malignant tumours which may present as swellings. Occasionally metastatic.
99
What is Erythroplakia?
Red velvety patches commonlyon the soft palate FOM or buccal mucosa.
100
What is Erythroplakia?
Red velvety patches commonly on the soft palate FOM or buccal mucosa.
101
What is Erythroplakia?
Red velvety patches commonly on the soft palate FOM or buccal mucosa.
102
What should you do if you suspect Erythroplakia?
View with suspicion and biopsy unless there is an obvious source of irritation present.
103
What are leucoplakias?
Lesions of greatest malignant potential are speckled, nodular or verrucous. Associated with Candida.
104
What is Proliferative verrucous leucoplakia?
White speckled or nodular plaque. Strong associations with HPV and candida.
105
What is speckled leucoplakia?
Seen as a combination of a transition from leucoplakia to erythroplakia. They have a higher rate of malignant change.
106
What is candidal leucoplakia?
Leucoplakia induced by chronic infection by candida albicans. Persistent lesions may require cryosurgery.
107
What is syphilitic leucoplakia?
A charechteristic complication of tertiary syphilis affecting the tongue and turning it white.
108
What is smokeless tobacco keratosis?
Development of the lesion is dependent on habit duration, early onset of use, total hours of daily use and number of sites used for tobacco placement.
109
What is Actinc cheilitis?
Caused by long term exposure to UV rays. Areas of induration and thickening ulceration should be biopsied.
110
What is oral submucous fibrosis?
It is tight vertical bands in the buccal mucosa that may lead to restricted opening. The affected mucosa may be pale and thin. It is caused by betel nut chewing and spice sonsumption.
111
What is discoid lupoid erythematosus?
A chronic photosensitive skin eruption which can be either be localised or widespread. It is confined to the skin and does not cause any systemic symptoms.
112
What are some risk factors for potentially malignant lesions?
Older than 45, combined alcohol and tobacco use, immunosuppression, sun exposure, HPV and digestive tract cancer.
113
What are neoplasias?
They are the disorders of cell proliferation and differentiation.
114
What do neoplasia's look like on a cellular level?
The cell population is highly regulated but for some reason, there is an escape from the normal control mechanism. This results in a mass made of a single type of cell in numbers inappropriate for that anatomical area.
115
What is the relationship of neoplastic cells to tissue?
The cells of the neoplasm grow as a compact mass as they expand or the cells invade the surrounding tissues and may even spread to distant sites.
116
What are some benign neoplasms?
Local invasions, no metastasis, expanding growth pattern and usually contained in a capsule.
117
What are malignant neoplasms?
Invade surrounding tissues, invade blood, grow in irregular pattern and no capsule.
118
What is the molecular progression of a neoplasm?
Squamous epithelium, squamous hyperplasia, dysplasia, carcinoma in situ, invasive carcinoma and metastasis.
119
What are genetically altered cells?
Genetic mutation prompts cells to proliferate instead of rest after their normal cycle of division.
120
What is dysplasia?
Additional mutations lead to excessive cell proliferation with abnormal cellular features and behaviour.
121
What is a carcinoma in situ?
Accumulating cell mutations cause further abnormal growth and appearance, restricted to the epithelium. The lesion may remain unchanged indefinitely or additional mutation may lead to the next stage.
122
What is invasive cancer?
Further genetic changes allow the malignant cells to invade underlying tissue and possibly enter the blood stream resulting in metastasis.
123
What causes host cells to become out of control?
Genetic factors, ultraviolet light, ionising radiation, HPV and chemicals.
124
What is immunosurveilance?
A term used to describe the action of the immune cells, including T cells as they move through the body and look for any abnormalities.
125
What do T cells do?
They recognise peptide antigens presented on their cell surface. If they are pre-cancerous and the immune system does not recognise them as abnormal they will continue to grow to form a tumour.
126
What are the risk factors of oral cancer?
Tobacco, alcohol, HPV, vitamin deficiency, betel chewing, sunlight and immune defects.
127
Why is the lingual aspect of the alveolar margin more likely to be affected by cancer?
It is likely that carcinogens pool in the lower mouth before swallowing.
128
What are some suspicious features that can be in the mouth?
Unexplained ulceration, induration, proliferation, changes in colour and texture, fixation to underlying tissue, lymph node involvement and pain.
129
When staging cancer, what is stage 0?
The pre-cancer stage where there are cancer cells but they are not contained with in the lining of the mouth, if not treated there is a higher risk of development.
130
In cancer staging, what is stage 1?
Earliest stage of invasive cancer, started to grow through the lining of the mouth into deeper tissues.
131
In cancer staging, what is a stage 2?
Cancer is more than 2mm across but less than 4cm, not spread to lymph.
132
In cancer staging, what is stage 3?
Cancer is bigger than 4cm but not spread or it is any size and has spread to one lymph.
133
In cancer staging, what is stage 4a?
It has grown through tissues. Lymph nodes may or may not contain cancer cells.
134
What is stage 4b?
Any size and spread to one lypmh node or is bigger than 6cm.
135
What is stage 4c?
Has spread to other organs.
136
What can be some symptoms of oral cancer?
White/red patch, exophytic growth, non-healing ulcer, earache, difficulty swallowing and enlarged lymph.
137
What is SCC of the lower lip?
To one side of the vermilion border may look like blistering.
138
What is SCC of the tongue?
Presentation is often late and the tongue can be stiff.
139
What is a verrucous carcinoma?
A low grade variant of a squamous carcinoma. A white warty appearance forming a mass.
140
What is a melanoma?
a malignant neoplasm of melanocytic origin that arises form a benign melanocytic lesion. Looks nodular.
141
What is a basal cell carcinoma?
An ulcerative papule with a rolled border.
142
What are some early signs of oral cancer?
Persistent red and white patch, progressive swelling or enlargement, unusual surface changes, sudden tooth mobility and prolonged hoarseness.
143
What are the late signs of oral cancer?
Indurated area, paraesthesia of the tongue, airway obstruction, chronic earache, trismus, persistent pain and altered vision.
144
What are the preventative measures for oral cancer?
Smoking cessation, reduce betel chewing, reduce alcohol and good dietary practice.
145
How does screening for HPV-16 take place?
Toluidine blue, photodynamic diagnosis and clinical judgement.
146
Why is there an association between HPV-16 and cancer?
HPV-16 E6 antibodies in the blood indicate a very high risk of developing a HPV associated cancer.
147
What is toluidine blue?
It is used as a mouthwash or direct application to suspicious lesions. It stains for acidic lesions.
148
What is an urgent referral?
When unexplained red/white patches of the oral mucosa that are painful and swollen are spotted.
149
What are the risk factors of HPV in head and neck cancers?
HPV, alcohol, OH, diet, family history, age, gender and race.
150
What is HPV?
It is a DNa virus that preferentially infects squamous epithelial cells.
151
What are HPV positive head and neck cancers?
A distinct clinical entity that is poorly differentiated and cystic metastasis.
152
HPV positive head and neck cancers are...
clinically distinct, molecularly distinct, have risk factor profiles, a better prognosis and are increasing in incidence.
153
What is the epidemiology of HPV positive head and neck cancers?
Tonsils
Younger age
Higher economic class
Survival rates increasing
Basaloid SCC
Affecting males more
Risk factors are sexual behaviour
154
What is the epidemiology of HPV negative cancers?
All sites
Older age
Lower socioeconomic class
Survival rates decreasing
Keratinised SCC
Males
Risk factor is alcohol and smoking
155
What is the epidermis?
There are four layers to the epidermis: -
Basal
Spinous
Granular
cornified
156
What are the risk factors for skin cancer?
UV radiation, family history, skin type, age, immunosuppression and previous burns.
157
What is non melanoma skin cancer?
The most common form of skin cancer and includes basal and squamous cell carcinomas.
158
What is a basal cell carcinoma?
Clinically raised, pearly nodule with a central depression with a telangiectasia. Will occasionally bleed and present as an ulcer.
159
What are squamous cell carcinomas?
Crusting, ulcerated, bleeding and undurated.
160
What is the criteria for a lesion to be a melanoma?
asymmetrical, uneven border, more than one colour, >6mm in diameter and evolves.
161
What is the treatment targets for when a patient is referred?
any two week rule patients must have a diagnosis within 31 days. Definitive treatment must be started by day 62.
162
What is the management of head and neck cancers?
Radiotherapy, chemotherapy, surgery.
163
What is an oral complication of head and neck cancer treatments?
normal cell toxicity
164
What are some short term oral complications of head and neck cancer?
Xerostomia, mucositis, Candidal infections, pain, dysgeusia.
165
What are some long term oral complications of head and neck cancer?
Altered anatomy, dental caries, trismus, xerostomia.
166
What is the role of a DT in managing patients with head and neck cancer?
Maintain good OH, dietary advice, topical fluoride, saliva replacement therapy and jaw exercises.
167
What can a DT advise for Peri-treatment and post-treatment management of head and neck cancer?
Dietary advice for oral mucositis, antifungals for fungal infections, sipping sugarless fluids for xerostomia.
168
What is a cyst?
A pathological cavity with a semi-fluid content, it may or may not be linedd with epithelium.
169
How are cysts classified?
Jaw cysts are of the orofacial region are usually defined as odontogenic or non-odontogenic and can present in hard or soft tissues.
170
What is a mucous cyst?
They affect the minor salivary glands they are called mucocele.
171
How does mucocele present?
They are identical to a 'normal' appearance. Should be removed.
172
How is a mucocele removed?
An outline of an eclipse is made around the cyst cutting through the mucosa to muscle. Should close with sutures.
173
What do cysts of the major salivary galnds present as?
They present as slow growing enlarged lumps, should excise.
174
What is a ranula?
A large mucocele arising from the sublingual gland. Large, tense and bluish on the anterior floor of the mouth.
175
What is a benign antral cyst?
Often routine findings on OPGs and can be monitered with no intervention.
176
What are sebaceous cysts?
Presents as lumps on the skin. Associated with hair baring areas. Tend to become infected should excise.
177
What is a dermoid cyst?
Arise from the inclusion of the ectoderm at lines of fusion. May contain hair.
178
What is a sublingual dermoid cyst?
Can be midline or sagittal. They are a slowly enlarged swelling below the tongue.
179
How can cysts be diagnosed?
History, examination, radiographs, MRI, aspiration and incisional biospy.
180
What will a history of pain look like with a person with a cyst?
Bleeding, pain, swelling, duration, paraesthesia, trismus and mobility of teeth.
181
Special investigations for those with cysts?
Radiographs, CT, MRI and angiography and bloods.
182
What do cysts look like on a radiographic assessment?
Defined margin, unilocular/multilocular, resorption of teeth and bony expansion.
183
What is a nasopalatine cyst?
Developmental cyst from residues of nasopalatine ducts. A fibrous capsule lined by respiratory squamous epithelium.
184
What is a globulomaxiallary cyst?
A pear shaped radiolucency between the upper lateral incisor and the canine.
185
What is a nasolabial cyst?
A developmental cyst. swelling of the buccal sulcus, may cause resorption.
186
What is a solitary bone cyst?
Common in the mandible, can spontaneously fill in, scalloped around the roots.
187
What is an aneurysmal bone cyst?
A rare painless swelling of the posterior mandible, a multiocular ballooning radiolucency.
188
What is an eruption cyst?
A bluish colour, usually rupture spontaneously, can be incised to allow eruption of the tooth.
189
What is a radicular cyst?
Associated with non vital teth, cana be treated by enucleation during surgical extraction, may become a residual cyst.
190
What is a residual cyst?
They are inflammatory odontogenic cysts that are asymptomatic and present on a post XLA site.
191
What is a dentigerous cyst?
Associated with the crown of an erupted tooth. Can be enucleated and tooth removed.
192
What is a Odontogenic keratocyst?
The cyst infiltrates bone and can spread into the soft tissues. They arise i tooth baring areas and in the ramus of the mandible.
193
What is an ameloblastoma?
A rare tumour of odontogenic epithelium.
194
What are the cyst treatment options that are available?
Surgical enucleation or marsupialisation.
195
What is enucleation?
The muco-periosteal flap in made and a curette is used to seperate the cyst from the lining of the adjacent bone.
196
What are the potential problems to occur with enucleation?
Cyst lining can be adherent to bone, can leave remnants, difficult access and secondary infections.
197
What is marsupialisation?
A incision is made and cyst lining is removed, packed with iodoform which is removed after 10 days, continually repack to build pressure so it re-epithelializes.
198
What is a bone metabolism?
A matrix of protein embedded in mucopolysaccharide ground substance.
199
What is parathyroid?
Increases in excretion of phosphate via the kidney which leads to mobilisation of calcium and phosphate form bone.
200
What is calcitonin?
It is produced by the thyroid gland and lowers blood calcium.
201
On a radiograph, what does a radiolucency suggest?
That there is a developmental cyst?
202
On a radiograph what does a radio opaque area suggest?
Osteoms, tori and odontomes.
203
What is an oesteoma?
A benign radiopaque neoplasm characterised by proliferation of cortical bone.
204
What are odontomes?
A malformation of tissue, functional ameloblasts with two types compound andcomplex.
205
What are complex odontomes?
Are irregular masses with no similarity to teeth.
206
What are compound odontomes?
They have identifiable tooth shapes although they are small.
207
What is a class one osteomyelitis?
Acute suppurative, an apical infection which results in the inflammatory response.
208
What is a class two osteomyelitis?
Chronic focal sclerosing, unusual reaction of bone to infection.
209
What is class three ostemyelitis?
Garres, it is response to low grade apical infection.
209
What is class three ostemyelitis?
Garres, it is response to low grade apical infection.
210
What is cherubism?
Progressively painless asymptomatic swelling of the jaws.
211
What is hypothyroidism?
Increased excretion of phosphate and increased re-absorption of calcium.
212
What is Paget's disease?
Disease of the bone caused by the excessive breakdown and formation of bone.
213
What are some types of epithelial odontogenic tumours?
Ameloblastoma, adenoma and odontogenic tumour.
214
What is a benign cementoblastoma?
An irregular rounded mass of cementum that is attached to the tooth root, it should be enucleated.
215
What is an osteosarcoma?
Usually effects the mandible and is a painful swelling with rapid growth.
216
What are metastic tumours?
They are usually carcinomas.
217
What are the major salivary glands?
The parotid, sub mandibular and sub lingual.
218
What is the function of saliva?
It is made to lubricate the mouth during swalllowing mastication and speech. There are also some antibacterial buffers in it.
219
What is sialolithiasis?
Most common disease of the salivary glands.
220
How is sialolithiasis treated?
Removal of calculus and gland.
221
How is Sjogren's syndrome treated?
Pilocarpine.
222
How does radiation treatment induce xerostomia?
There is direct DNA damage which induces intracellular apoptosis.
223
How can radiation induced xerostomia be prevented?
Field sparing.
224
What is sarcoidosis?
A chronic multisystem of disease characterised by non-caseating granulomas in the involved organs.
225
How is a diagnosis of sarcoidosis made?
Where there is histological evidence of non-caseating granulomas in the absence of infection.
226
How is submandibular gland removed?
An external approach using a skin crease.
227
What are local disorders of facial pain?
Dentine hypersensitivity, pulpitis, apical periodontitis, sinusitis.
228
What are neurologial disorders of facial pain?
Trigeminal neuralgia, post herpetic neuralgia.
229
What is dentine hypersensitivity as a condition?
Transient pain arising from exposed dentine.
230
What are the characteristic features of dentine hypersensitivity?
A sharp intense pain that lasts as long as the stimulus.
231
What is reversible pulpitis?
Inflammation of the pulpal tissues but the pulp is vital.
232
What are some characteristic feature of reversible pulpitis?
Short duration, decreasing intensity poorly localised.
233
What is irreversible pulpitis?
Pulpal necrosis and the tooth is non-vital.
234
What is apical periodontitis?
Inflammation of the periodontal ligament associated with the apex of the tooth.
235
What is sinusitis?
Infection of the maxillary sinus.
236
What is trigeminal neuralgia?
Uncommon and affects the path of the trigeminal nerve. stabbing pain.
237
What is herpetic neuralgia?
Herpes zoster/varicella lies latent in the sensory nerve ganglion after chicken pox. Secondary activation is known as shingles.
238
What is temporal arteritis?
A febrile disease which effects the walls of the arteries in the elderly.
239
What is burning mouth syndrome?
No underlying cause usually from psycogenic origin such as IBS.
