Oral Medicine Flashcards
What do we need to know
- History taking
- Red patches
- Ulcers
- White patches
- managing suspicious lesion
- when to refer your patient
Pain history ? SOCRATES
Site- where is pain?
Onset- when/how did pain start ( sudden/gradual)
Character- describe the pain? Dull/sharpe
Radiation- Does pain move anywhere?
Associations- Any symtoms/ signs associated with pain?
Timing- How has pain changed over time?
Exacerbating/Relieving factors- does anything worsen/ relieve the pain?
Severity- How bad is the pain in scale 1-10 ?
History of lesion?
- when did you notice it?
- were they any predisposing events?
- has it changed?
- does it bother you?
- are there any other lumps?
Past medical history ?
- Current and previous illness
- Previous operation
- Previous investigation
- Allergies
- other
Drug History
- Current and previous medication
- Dosage and durations
- Any allergies
Family history
- Note any relevant conditions in immediate family members
- Systemic illnesses, neoplasms etc
Social History
- Smoking no. Per day and how long for
- vaping
- Alcohol intake in unit / single spirit 1 unit
- Occupation
Red patches/ Erythema
- Red patches appear red due to thinning/ ulceration / erosion of oral mucosa and increased
- Most will cause a degree of discomfort (occasionally painless)
- Some are pre- malignant
- can be widespread in oral cavity.
Erythema
- Trauma
- Infection e.g Candida
- Immune related disease
- Idiopathic tongue - swelling of tongue
- Neoplasia - uncontrolled , abnormal growth of cells or tissue in body
Type of Erythema
1- Painful and May ulceration-
Post radiotherapy mucositis
Hypersensitivity reaction
Erosive lichen planus
2- painful with no ulceration.
Acute candidosis
Geographic Tongue
Anemia ( iron , folate)
3- Painless with no ulceration
Erythroplakia
Chronic Candidosis
4- Painless with ulceration
Squamous cell carcinoma
Infectious mononucleosis
Contact hypersensitivity reaction
Cause by dental material/chemical I.e
Nickel , orthodontic wires
Acute Erythematous Candiosis
-May be painful
- steroid inhaler
- immunosuppression / HIV
Median Rhomboid glossitis
Caused by CANDIDA
Chronic Erythematous Candidosis
- Seen under fitting surface of URA and nance buttons
- caused by Candida albicas
- management- OHI , appliance cleaning adv, soaking and leaving out at night
- some cases - Tropical anti fungal paste-Miconazole 6hrs for 4 Weeks
Geographic tongue ( Erythema migrants)
- Idiopathic condition
- Typically involves tongue
- increased sensitivity to certain foodstuffs
- management- reassurance and symptomatic relief
Erythroplakia
- Aetiology Tobacco, Alcohol, deficiency, Candida infection, chronic Trauma
- Malignant 5-10 %
- Require biopsy