Oral Mucosal Disease

Question 1

Epithelium type in oral mucosa/palate

Answer 1

Stratified squamous epithelium

Question 2

Epithelium type in cheek

Answer 2

Non keratinised stratified

Question 3

Reactive changes of epithelium (in response to triggers like trauma)

Answer 3

Keratosis

Acanthosis (thickening of stratum spinosum)

Elongated rete ridges
(hyperplasia of basal cells)

Question 4

Mucosal reactions in epithelium

Answer 4

• Atrophy
• Erosion
• Ulceration
• Oedema
• Blister

Question 5

Term for the opposite of atrophy

Answer 5

Acanthosis

Question 6

Relavent nutritional deficiencies for mucosal reactions

Answer 6

Iron
Vit B

Question 7

Name examples of benign mucosal tongue lesions (3)

Answer 7

Geographic tongue

Black hairy tongue (hyperplasia of papillae bacterial pigment)

Fissured tongue (often asymptomatic)

Question 8

Fibrin on surface is a indicator of ____

Answer 8

Ulceration

Question 9

What causes geographic tongue patchy appearance? (3)

Answer 9

Disease of maturation

Whole areas of epithelial surface replaced in single occasion

Reproduction of epithelial cells starts again after few days

Question 10

Symptoms of geographic tongue

Answer 10

• Sensitivity to spicy/flavoured foods
• Intermittent
• Worse in young children

Question 11

Possible causes for patient complaining of geographic tongue symptoms

Answer 11

• Assess haematinics (B12, Folate, Ferritin)
• Parafunctional trauma (to tongue tip/edge)
• Dysaesthesia

Question 12

Tx for black hairy tongue

Answer 12

Removing elongated surface papillae with tongue scraper

Question 13

Possible complications with a fissured tongue

Answer 13

Can become deeply fissured and trap food/debrid

Aided with soft brush to clean into the fissures of the tongue

Question 14

Define glossitis

Answer 14

Inflammation of the tongue

Question 15

Investigations for glossitis

Answer 15

Iron deficiency

May be caused by LP

Biopsy (study mucosa + fungal cultures)

Question 16

Why are mandibular tori a risk factor for patients on bisphosphonates?

Answer 16

Likely to get avascular necrosis of the mucosa over the tori than other areas in mandible

Question 17

Name for pregnancy epulis

Answer 17

Pyogenic granuloma

Question 18

When to refer swellings

Answer 18

• Symptomatic
• Abnormal overlying and surrounding mucosa
• Increasing in size
• Rubbery consistency
• Trauma from teeth

Question 19

When to avoid refer swellings

Answer 19

• Tori
• Small polyps
• Mucoceles (unless they become fixed in size)