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5th BDS - OD > Oral Mucosa: normal, ageing, hereditary conditions & response to trauma > Flashcards

Oral Mucosa: normal, ageing, hereditary conditions & response to trauma Flashcards

1
Q

What are the normal layers of lining mucosa?

A

Epithelium
Lamina Propria
Sub-mucosa
Skeletal muscle

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2
Q

give 2 examples of masticatory mucosa in the mouth

A

Hard palate
Gingivae

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3
Q

give 2 examples of lining mucosa in the mouth

A

soft palate
uvula
buccal mucosa
etc

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4
Q

what type of epithelium is the tongue?

A

specialised epithelium

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5
Q

what is the name for mucosa fixed to bone

A

Mucoperiosteum

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6
Q

what is the difference in epithelium between the masticatory and lining mucosa?

A

lining mucosa is non-keratinised
masticatory mucosa has orthokeratin on top of prickle cell layer

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7
Q

what are the 4 types of papillae on dorsum of tongue?

A

-filiform
-fungiform
-foliate
-circumvalate

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8
Q

what are the functions of the specialised mucosa of the tongue?

A

Multiple functions:
-taste buds-foliate,fungiform
-abrasion-filiform (outbursts of keratin)

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9
Q

what is leukoedema?

A

Leukoedema is an asymptomatic, whitish or. whitish-gray edematous lesion of the oral mucosa.

variation of normal mucosa

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10
Q

what could also be included in the differential diagnosis of leukoedema and how can you tell if it is or not?

A

Differential Diagnosis: (none of these will disappear on stretching)
* White sponge naevus
* Chronic cheek biting (frictional keratosis)
* Lichen planus

leukoedema will disappear on stretching

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11
Q

what is geographic tongue?

A
  • Islands of erythema with white borders

It is also called erythema migrans as the red patches migrate around the tongue

it is a variation of normal mucosa

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12
Q

what are the symptoms associated with geographic tongue?

A
  • Asymptomatic or mild soreness
  • Aggravating factors
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13
Q

what would be included in differential diagnosis of geographic tongue?

A

Differential diagnosis:
* If classic appearance, dx can be made clinically
* Lichen planus
* Frictional keratosis

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14
Q

what is a fordyce spot?

A
  • Ectopic sebaceous glands – no function in the oral cavity
  • can have White or yellow speckling
  • Asymptomatic

it is a variation of normal mucosa

  • Common & easily diagnosed – just record in the notes no tx
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15
Q

what are the genetic association of white spongey naevus?

A

Hereditary condition:
* Autosomal dominant
* Family history but may skip generations
* Point mutation in keratin 4/or 13 genes

life long

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16
Q

what are the clinical signs of white spongey naevus?

A
  • Bilateral
  • seen on cheeks and floor of mouth
  • Thick white folds, wrinkled, ‘ebbing tide’
  • Life long
  • May affect other mucosal sites
  • Wont rub away and won’t disappear with stretching – probably been there since birth
17
Q

explain the histological features of white spongey naevus?

A
  • has acanthosis - increased thickness of prickle cell layer
  • it is uninflamed
  • has parakeratin on surface
18
Q

what could be included in differential diagnosis of white spongey naevus?

A

Differential Diagnosis:
* Lichen planus – unlikely as tends to be painful
* Lichenoid drug reactions
* Chronic cheek biting
* Leukoedema

19
Q

Name 4 age related changes that happen to oral mucosa

A

Age Changes in Oral Mucosa:
* Mucosa may appear atrophic (thinner) & smoother
* Decrease in elasticity
* Prominence of Fordyce Spots
* Varicosities ventral surface tongue

20
Q

name epithelial and connective tissue changed to trauma

A

EPITHELIAL - ulceration
- keratosis
- hyperkeratosis
- hyperplasia
- atrophy - not common

CONNECTIVE TISSUE - hyperplasia eg polyps

21
Q

give 4 examples of reasons for trauma related ulcers

A
  • Trauma from dentures
  • Teeth
  • Chemical burns
  • Irradiation for malignancy
  • These are common ones there are many more – common exam Q – eg chrons disease (covered in other lectures)
22
Q

what is frictional keratosis?

A
  • White patch caused by continual trauma.
  • Usually along the occlusal line or opposite sharp cusps, orthodontic wires or dentures.
23
Q

give the features of frictional keratosis histologically?

A

hyperkeratosis
acanthosis of epithelium
unimflammed connective tissue

24
Q

how is frictional keratosis diagnosed?

A

Diagnosis:
* Must be able to demonstrate lesion caused by trauma.
* Remove cause and lesion should regress
* If not then must consider other white lesions in differential diagnosis

25
Q

what is leukoplakia and its management?

A

Leukoplakia- white patch of unknown cause.
Usually painless
Associated with alcohol and tobacco use
Increased risk of malignant change. - need to inform patient

Management:
Biopsy- incisional to establish diagnosis

26
Q

give the features and management of Papillary hyperplasia of the palate

A

Papillary hyperplasia of the palate:
* Caused by ill-fitting dentures – patient that doesn’t remove the denture at night usually
* Symptomless, erythematous overgrowth of mucosa
* Corresponds to outline of denture

Management:
* New dentures
* Excision of papillary projections for advanced cases
* NOT pre-malignant

27
Q

give the features and management of Stomatitis nicotina

A

Stomatitis nicotina:
* Palate in pipe and cigar smokers – very uncommon – in smoking products that cause a lot of heat in the mouth
* Not a pre-malignant lesion.
* Positive correlation between intensity of smoking and severity

Treatment:
* Stop or reduce smoking
* Lesions may disappear
* Regular review

28
Q

name a white patch in mouth associated with asprin

A

asprin burn - people commonly used to do this for toothache

can ask patient about this if suspected

29
Q

name the factors that can effect healing?

A
  • Primary or secondary intention: wounds closely opposed heal faster than those separated.
  • Foreign Body: acts as a focus of infection and delays healing
  • Vascular Supply: reduced blood supply reduces healing capacity
  • Nutritional deficiencies: vitamin C
  • Irradiation: reduces blood supply
  • Malignancy: failure to heal e.g. non healing tooth socket
  • Infection: reduces healing capacity
  • Poor immune response: leukaemia, diabetes, immunosuppression

5th BDS - OD (7 decks)

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