Oral Conditions

Question 1

What is angular chelitis?

Answer 1

Aka angular stomatitis. Redness and cracking at the side of the mouth

Question 2

What causes angular chelitis?

Answer 2

An infection caused by candilus, staph, strep predisposed by anaemia/haematinic deficiency

Question 3

What is apthous stomatitis?

Answer 3

Ulceration inside the mouth - can indicate anaemia

Question 4

What are the signs of direct and indirect involvement of the mouth in Crohn’s?

Answer 4

Direct: Intraoral ulceration Indirect: Lip swelling, blood loss and malabsorption

Question 5

What are the oral manifestations of ulcerative colitis and coeliac disease?

Answer 5

Indirect signs of malabsorption

Question 6

What are the oral manifestations of diabetes?

Answer 6

Pt is more susceptible to candidosis

Question 7

What are one of the oral side effects of nicorandil?

Answer 7

Oral ulceration

Question 8

What is the most common dermatological condition to present orally?

Answer 8

Lichen planus

Question 9

What is the oral manifestations of mucous membrane pemphigoid?

Answer 9

Patients produce antibodies to specific components of the basement membrane of epithelium so blisters and vesicles breakdown to form ulcers

Question 10

What is the oral presentation of rheumatological disease Siogren’s Syndrome?

Answer 10

Oral dryness ( is a autoimmune connective tissue disorder)

Question 11

How can HIV/AIDs present orally?

Answer 11

• Hairy leukoplakia (caused by epstein barr virus) • Kaposi’s sarcoma (tumour of endothelial cells) • Candidosis (recurrent)

Question 12

What is meant by potentially malignant disorders?

Answer 12

An increased risk of malignancy which is present either at the time of diagnosis or at a future date

Question 13

What is leukoplakia?

Answer 13

Leukoplakia is a white patch that develops in the mouth, associated with risk of squamous cell cancer

Question 14

What are the risk factors for malignant transformation from leukoplakia?

Answer 14

• Female gender - Long duration - Non-homogenous appearance - Found on tongue/floor of mouth - >200 mm size - Presence of dysplasia - Non-smoker (Although smoking increases the risk of having it at all, if you are a non-smoker and have it then it shows that the only driving force is genetic instability)

Question 15

What is erythroplakia?

Answer 15

Fiery red patch that cannot be characterized either clinically or pathologically as any other definable lesion

Question 16

What is sub mucous fibrosis?

Answer 16

Characterized by juxta-epithelial inflammatory reaction and progressive fibrosis of the submucosal tissues

Question 17

What are the 3 main pre-malignant disorders of the mouth?

Answer 17

• Leukoplakia - Erythroplakia - Submucous fibrosis

Question 18

What are the 4 malignant neoplasms that can affect the mouth?

Answer 18

• Squamous cell carcinoma (95%) - Kaposi’s sarcoma - Salivary gland tumours e.g. adenoid cystic carcinoma - Lymphoma

Question 19

What are some of the risk factors for oral carcinoma?

Answer 19

• Cigarette smoking alone • Alcohol consumption alone (3 or > drinks per day) • Paan (betel quid) • Areca nut • Smokeless tobacco • Reverse smoking (smoking the lit end) • Poor diet • Viruses e.g. HPV

Question 20

How may oral carcinomas present?

Answer 20

• Granular surface which appears red and rough - Exophytic – growing out of the mouth - On palpation of the lesions • Indurated (hardened) • Fixed – don’t move freely

Question 21

What 3 oral conditions have significant public health impact?

Answer 21

• Tooth decay (dental caries) • Gum disease (periodontal disease) • Oral cancer

Question 22

What are dental caries?

Answer 22

Essentially tooth decay. Dental caries is a dynamic process involving the exchange of calcium and phosphate ions between tooth structure and saliva (plaque fluid), in the presence of acids produced by the fermentation of carbohydrates by oral micro – organisms

Question 23

What is the main risk for dental caries?

Answer 23

Excessive sugar consumption

Question 24

What is used to measure dental caries?

Answer 24

DMF index (decayed, missing for filled teeth/surfaces) - shows current or past treatment of caries

Question 25

Where are dental caries most commonly found within the mouth?

Answer 25

Back of the mouth in the molars

Question 26

What are periodontal diseases?

Answer 26

Group of related conditions, both acute and chronic, characterised by inflammation of the periodontal tissues in response to the presence of dental plaque

Question 27

What are some of the main periodontal diseases?

Answer 27

• Gingivitis • Chronic periodontitis • Aggressive periodontitis • Necrotising ulcerative gingivitis (NUG) • Periodontal abscess

Question 28

What are the stages of periodontal disease?

Answer 28

1) Inflammation develops around the gum. 2) Gum comes away from the tooth 3) More bugs get into the pocket that’s formed 4) Destruction of the tooth and gums causes the tooth to become extra-mobile and eventually fall out

Question 29

What are the treatments for periodontal disease?

Answer 29

• Oral Hygiene - Stop smoking - Scaling and root planing - Surgery - Extraction

Question 30

What screening programmes are in place for dental caries?

Answer 30

• National Dental Inspection Programme (NDIP) - Two levels: • Basic examination • Detailed examination • P1 or P7 children

Question 31

Where are the main high risk sites of carcinoma within the mouth?

Answer 31

Fl oor of mouth, lateral border of and ventral tongue, soft palate, retromolar pad/ tonsillar pillars