morphological variations of oral mucosa

Question 1

geographic tongue - aetiology

Answer 1

unknown

Question 2

geographic tongue - clinical

Answer 2

appear, heal, develop elsewhere
demarcated erythema - desquamation of filiform papillae
surrounding white/yellow serpentine borders - filiform papillae in regeneration
often anterior 2/3

Question 3

geographic tongue - what systemic condition may it be linked with?

Answer 3

psoriasis

Question 4

geographic tongue - histology

Answer 4

red area - atrophic filiform papillae

white area - hyperkeratosis and acanthosis

Question 5

geographic tongue - tx

Answer 5

none
reassure
avoid spicy food
mild topical CS if severe

Question 6

fissured tongue and crenations - clinical

Answer 6

1 deep central +/- radial fissures: dorsum

crenations - lateral border indentations due to extended/forceful contact with teeth

Question 7

fissured tongue and crenations - what oral condition can it be associated with?

Answer 7

geographic tongue

Question 8

fissured tongue and crenations - tx

Answer 8

none - asymptomatic

avoid spicy/acid food if sore

Question 9

fissured tongue and crenations - links to other diseases

Answer 9

Melkersson-Rosenthal syndrome
Down syndrome
Cowden Syndrome
psoriasis

Question 10

Melkersson-Rosenthal Syndrome

Answer 10

facial/lip swelling (granulomatous cheilitis)
facial paralysis
fissured tongue

Question 11

hairy tongue - aetiology

Answer 11

smoking
poor OH
AB therapy
c albicans
MW
systemic steroids
radiotherapy

Question 12

hairy tongue - clinical

Answer 12

dorsum hairlike appearance
yellow/brown/black depending on diet and cause, bacterial pigmentation
sometimes gagging sensation/metallic taste
debris between elongated papillae = halitosis

Question 13

hairy tongue - histopathology

Answer 13

hypertrophy of filiform papillae, subjacent inflammation

linked to excessive keratin production/failure of epithelial cells or keratin layer to desquamate

Question 14

hairy tongue - tx

Answer 14

none
eliminate RFs
brush tongue with Na bicarb and water

Question 15

lingual fimbriae

Answer 15

normal
small filiform flanges ventral tongue
parallel to and on either side of lingual frenulum
represent non-completely absorbed tissue during tongue development
if hyperplastic can confuse with squamous papillomas

Question 16

what are lingual varices?

Answer 16

enlargement of small veins ventral tongue (rarely lips and FOM)

Question 17

tx of lingual varices

Answer 17

none - asymptomatic

Question 18

lingual varices factors

Answer 18

• ageing - degeneration of collagen elastic fibre
• hypertension
• dentures

Question 19

ankyloglossia pathogenesis

Answer 19

developmental anomaly
inferior frenulum too short, restricts tongue movement
- complete/partial fusion with STs FOM
varying severity - length of frenulum

Question 20

ankyloglossia tx

Answer 20

mild - none
severe - frenuloplasty
- newborns if preventing breastfeeding

Question 21

lingual tonsil hypertrophy

Answer 21

non-pathologic
likely due to chronic low-grade infection of tonsils
back margin of tongue
often bilateral, asymptomatic
usually resolves few days/weeks
if persistent and progressive S+S - biopsy to rule out malignancy

Question 22

taste bud hypertrophy - which papillae is it usually?

Answer 22

circumvallate

Question 23

taste bud hypertrophy - why may they be more prominent?

Answer 23

acid reflux
allergies
infections
irritation
smoking
spicy/sour foods
vit deficiency

Question 24

taste bud hypertrophy - effect

Answer 24

can sometimes make eating painful

Question 25

taste bud hypertrophy - resolution

Answer 25

usually goes away on its own

Question 26

taste bud hypertrophy - tx

Answer 26

none may tx underlying conditions good OH, stop smoking, avoid spicy/acidic foods

Question 27

which papillae are in the centre of the tongue?

Answer 27

filiform

Question 28

which papillae go across the back of the tongue?

Answer 28

circumvallate

Question 29

which papillae go in lines along the side of the tongue at the back?

Answer 29

foliate

Question 30

which papillae lie on the edges of the tongue?

Answer 30

fungiform

Question 31

physiologic pigmentation cause

Answer 31

racial - African, Afro-American, Asian | increased melanocyte activity (not by increased number of melanocytes)

Question 32

physiologic pigmentation presentation

Answer 32

vary | uniform, unilateral, bilateral, multifocal, mottled, macular, may involve entire mucosa

Question 33

physiologic pigmentation tx

Answer 33

none - asymptomatic

Question 34

other causes of pigmentation

Answer 34

post-inflammatory | Addison's disease

Question 35

leukoedema - aetiology

Answer 35

unknown | more common African/African-American - may be associated with racial pigmentations

Question 36

leukoedema - clinical

Answer 36

``` normal anatomic variant white opalescent buccal/vestibular mucosa always bilateral disappears when stretched ```

Question 37

leukoedema - histology

Answer 37

hyperparakeratosis acanthosis intracellular oedema

Question 38

leukoedema - tx

Answer 38

none - asymptomatic

Question 39

Fordyce granules aetiology

Answer 39

unknown

Question 40

what are Fordyce granules?

Answer 40

ectopic sebaceous glands | should be associated with hair follicles usually

Question 41

Fordyce granules clinical presentation

Answer 41

white/yellow rice-like granules | can be confluent

Question 42

Fordyce granules tx

Answer 42

none - asymptomatic

Question 43

linea alba appearance clinically

Answer 43

white horizontal line buccal mucosa, along occ plane, usually bilateral from retro-commisural area to posterior part of buccal mucosa

Question 44

linea alba histology

Answer 44

hyperparakeratosis prominent granular layer acanthosis

Question 45

linea alba likely cause

Answer 45

friction/sucking trauma from facial surfaces of teeth

Question 46

linea alba tx

Answer 46

none

Question 47

exostoses

Answer 47

``` benign bony overgrowths of facial bones - midline HP - palatal torus - lingual mandible - mandibular tori single/multiple freq asymptomatic ```

Question 48

what are exostoses covered by?

Answer 48

normal epithelium

Question 49

indications for SR of exostoses

Answer 49

overlying mucosa continuously traumatised causing pain and bleeding pt needs removable prosthesis