morphological variations of oral mucosa Flashcards
geographic tongue - aetiology
unknown
geographic tongue - clinical
appear, heal, develop elsewhere
demarcated erythema - desquamation of filiform papillae
surrounding white/yellow serpentine borders - filiform papillae in regeneration
often anterior 2/3
geographic tongue - what systemic condition may it be linked with?
psoriasis
geographic tongue - histology
red area - atrophic filiform papillae
white area - hyperkeratosis and acanthosis
geographic tongue - tx
none
reassure
avoid spicy food
mild topical CS if severe
fissured tongue and crenations - clinical
1 deep central +/- radial fissures: dorsum
crenations - lateral border indentations due to extended/forceful contact with teeth
fissured tongue and crenations - what oral condition can it be associated with?
geographic tongue
fissured tongue and crenations - tx
none - asymptomatic
avoid spicy/acid food if sore
fissured tongue and crenations - links to other diseases
Melkersson-Rosenthal syndrome
Down syndrome
Cowden Syndrome
psoriasis
Melkersson-Rosenthal Syndrome
facial/lip swelling (granulomatous cheilitis)
facial paralysis
fissured tongue
hairy tongue - aetiology
smoking poor OH AB therapy c albicans MW systemic steroids radiotherapy
hairy tongue - clinical
dorsum hairlike appearance
yellow/brown/black depending on diet and cause, bacterial pigmentation
sometimes gagging sensation/metallic taste
debris between elongated papillae = halitosis
hairy tongue - histopathology
hypertrophy of filiform papillae, subjacent inflammation
linked to excessive keratin production/failure of epithelial cells or keratin layer to desquamate
hairy tongue - tx
none
eliminate RFs
brush tongue with Na bicarb and water
lingual fimbriae
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
what are lingual varices?
enlargement of small veins ventral tongue (rarely lips and FOM)
tx of lingual varices
none - asymptomatic
lingual varices factors
- ageing - degeneration of collagen elastic fibre
- hypertension
- dentures
ankyloglossia pathogenesis
developmental anomaly
inferior frenulum too short, restricts tongue movement
- complete/partial fusion with STs FOM
varying severity - length of frenulum
ankyloglossia tx
mild - none
severe - frenuloplasty
- newborns if preventing breastfeeding
lingual tonsil hypertrophy
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
taste bud hypertrophy - which papillae is it usually?
circumvallate
taste bud hypertrophy - why may they be more prominent?
acid reflux allergies infections irritation smoking spicy/sour foods vit deficiency
taste bud hypertrophy - effect
can sometimes make eating painful
taste bud hypertrophy - resolution
usually goes away on its own
taste bud hypertrophy - tx
none
may tx underlying conditions
good OH, stop smoking, avoid spicy/acidic foods
which papillae are in the centre of the tongue?
filiform
which papillae go across the back of the tongue?
circumvallate
which papillae go in lines along the side of the tongue at the back?
foliate
which papillae lie on the edges of the tongue?
fungiform
physiologic pigmentation cause
racial - African, Afro-American, Asian
increased melanocyte activity (not by increased number of melanocytes)
physiologic pigmentation presentation
vary
uniform, unilateral, bilateral, multifocal, mottled, macular, may involve entire mucosa
physiologic pigmentation tx
none - asymptomatic
other causes of pigmentation
post-inflammatory
Addison’s disease
leukoedema - aetiology
unknown
more common African/African-American - may be associated with racial pigmentations
leukoedema - clinical
normal anatomic variant white opalescent buccal/vestibular mucosa always bilateral disappears when stretched
leukoedema - histology
hyperparakeratosis
acanthosis
intracellular oedema
leukoedema - tx
none - asymptomatic
Fordyce granules aetiology
unknown
what are Fordyce granules?
ectopic sebaceous glands
should be associated with hair follicles usually
Fordyce granules clinical presentation
white/yellow rice-like granules
can be confluent
Fordyce granules tx
none - asymptomatic
linea alba appearance clinically
white horizontal line buccal mucosa, along occ plane, usually bilateral
from retro-commisural area to posterior part of buccal mucosa
linea alba histology
hyperparakeratosis
prominent granular layer
acanthosis
linea alba likely cause
friction/sucking trauma from facial surfaces of teeth
linea alba tx
none
exostoses
benign bony overgrowths of facial bones - midline HP - palatal torus - lingual mandible - mandibular tori single/multiple freq asymptomatic
what are exostoses covered by?
normal epithelium
indications for SR of exostoses
overlying mucosa continuously traumatised causing pain and bleeding
pt needs removable prosthesis
