Oral Mucosal Disease

Question 1

what three oral mucosal lesions should be referred to oral medicine

Answer 1

anything the dentist thinks is cancer or dysplasia
any symptomatic lesion that has not responded to standard treatment
any benign lesions that the patient cannot be persuaded is not cancer

Question 2

what is the oral mucosa made up of

Answer 2

stratified squamous epithelium

Question 3

what are the gross types of oral mucosa

Answer 3

lining
masticatory
gustatory

Question 4

what is atrophy

Answer 4

reduction in viable layers

Question 5

what is erosion

Answer 5

partial thickness loss

Question 6

what is ulceration

Answer 6

fibrin on the surface

Question 7

what is oedema

Answer 7

can be intracellular or intracellular swelling

Question 8

what is a blister

Answer 8

vesicle or bulla

Question 9

what is geographic tongue

Answer 9

condition where there is an alteration of maturation and replacement of normal mucosal surface - whole areas replaced at one time so the tongue appears redder

Question 10

what are people with geographical tongues more sensitive to

Answer 10

spicy or flavoured food

Question 11

symptoms of geographic tongue

Answer 11

sensitivity to acid/ spicy foods
intermittent
semi-circular red/ white patches

Question 12

what is brown/ black hairy tongue

Answer 12

can be due to bacterial colonisation and elongation of tongue papillae that stains with pigments from food

Question 13

management of geographical tongue

Answer 13

dont eat spicy foods during a flare up

Question 14

management of black/brown hairy tongue

Answer 14

tongue scraper
or suck on a peach stone

Question 15

what is fissured tongue

Answer 15

can occur spontaneously and is asymptomatic to patient
deep fissures that then food can get trapped in and can cause bacteria and local inflammation

Question 16

what is glossitis

Answer 16

inflammation of the tongue - red and smooth appearance of the tongue
seen in iron deficient patients

Question 17

when should you refer swellings

Answer 17

if theyre symptomatic
abnormal overlying and surrounding mucosa
increasing in size
rubbery consistency
trauma from teeth
unsightly

Question 18

when should you not refer sweallings

Answer 18

tori
small polyps
mucoceles

Question 19

what are tori

Answer 19

bony swellings

Question 20

what are mucoceles

Answer 20

migration of saliva into mucosal tissue from minor salivary glands

Question 21

what is a fibrous polyp

Answer 21

very thin and elongated lesion
manage by removing before new denture is constructed

Question 22

what are palatine/ mandibular tori associated with

Answer 22

parafunctional clenching habots

Question 23

what is the link between tori and bisphosphonates

Answer 23

tori are a risk factor for patients starting bisphosphonates as they are more likely to get avascular necrosis of mucosa over the tori

Question 24

what is a pyogenic granuloma

Answer 24

swelling with no epithelial surface
granulation tissue - mixed inflammatory infiltrate on fibro-vascular background
has either a fibrous yellow look to it or just plain red