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BDS4 Oral Medicine > Oral Mucosal Diseases > Flashcards

Oral Mucosal Diseases Flashcards

1
Q

What are the different strata in the epithelium

A

stratum basale (deep)
stratum spinosum
stratum granulosum
stratum corneum (superficial)

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2
Q

What is atrophy

A
  • reduction in viable layers
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3
Q

What is erosion

A
  • partial thickness loss
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4
Q

What is ulceration

A

fibrin on surface
complete epithelial loss

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5
Q

How can haematinic deficiencies effect oral mucosa

A

can cause glossitis
can present with linear/patchy red lesions
burning mouth syndrome
ulceration
angular stomatitis

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6
Q

What are causes of anaemia other than nutrition

A

malabsorption
pernicious anaemia
chronic bleeding

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7
Q

What are benign mucosal conditions effecting the tongue

A

geographic tongue
black hairty tongue
fissured tongue

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8
Q

What conditions are linked to geographic tongue

A
  • family history
  • down syndrome
  • fissured tongue
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9
Q

How does geographic tongue present

A
  • irregular pink/red depapillated maplike areas
  • may be surrounded by thicker yellow border
  • increased thickness of intervening filiform papillae
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10
Q

How does black hairy tongue occur

A

filiform papillae undergo hyperplasia
become discoloured as papillae pick up pigment

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11
Q

What causes black hairy tongue

A
  • accumulation of epithelial squames
  • proliferation of bacteria
  • linked to smokers, soft diet and bad OH
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12
Q

What is the management of black hairy tongue

A
  • improve OH
  • remove elongations with tongue scraper
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13
Q

What is fissured tongue

A

aka scrotal tongue
usually asymptomatic but may become inflamed if enough food get trapped in fissure
discomfort may warrant investigations for additional disease e.g candida/LP

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14
Q

What are causes of swelling in the oral mucosa

A
  • papillary hyperplasia
  • epulides
  • fibroepithelial polyp
  • mucocele
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15
Q

What is papillary hyperplasia caused by

A
  • minor trauma e.g rocking of ill fititng denture
  • can also be associated with candida
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16
Q

How does papillary hyperplasia present

A
  • numerous tightly packed papillary projections
  • seen on denture bearing area
  • pebbled appearance
  • mucosa is red and oedematous
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17
Q

What are the histological features seen in papillary hyperplasia

A
  • papillary projections
  • hyperplastic, inflamed granulation and fibrous tissue
  • hyperplastic stratified squamous epithelium
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18
Q

What are epulides

A

localised tumour like gingival enlargement

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19
Q

How do epulides present

A
  • they are hyperplastic
  • tend to arise from interdentla tissues
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20
Q

What are the main aetiological factors for epulides

A
  • trauma/chronic irritation
    *common causes are subgingival calculus & overhands
21
Q

What are the types of epulides

A
  • fibrous epulis
  • pyogenic granuloma (vascular epulis/pregnancy epulis)
  • peripheral giant cell granuloma (giant cell epulis)
22
Q

What is the presentation of fibrous epulis

A

pedunculated/sessile
firm consistency
same colour as adjacent gingiva
surface may be ulcerated and may be covered with yellow fibrous exudate

23
Q

How does a fibrous epulis present histologically

A
  • granulation tissue present
  • inflammatory cell infiltration, mostly plasma cells
  • calcifications/metastatic bone within fibroblastic tissue may be seen especially if there is ulceration of the covering stratified squamous epithelium
24
Q

What is a pyogenic granuloma

A

contains granulation tissue
can occur on any mucosal sites

25
What is the cause of pyogenic granuloma
trauma
26
What is a pyogenic granuloma called on the gingiva
vascular epulis or pregnancy epulis (if pregnant)
27
What is the presentation of vascular/pregnancy epulis
soft, deep reddish-purplish swelling often extensively ulcerated haemorrhage may occur spontaneously or to minor trauma
28
What can be seen histologically in vascular/pregnancy epulis
granulation tissue vascular proliferation - vesseles appear dilated and thin walled ulcerated
29
Why is it important to remove trauma for epulis
it will recur otherwise
30
What is the difference between granulation tissue and granulamatous inflammation
Granulation tissue = healing tissue. Present in the proliferative phase of healing Granuloma = aggregation of macrophages in chronic inflammation as they try to remove foreign substances that it is otherwise unable to remove | Phases of healing: haemostasis, inflammatory, proliferative, remodelling
31
Where do peripheral giant cell granuloma occur
can occur anywhere but on the gingiva its called **giant cell epulis**
32
Where is the most common site for giant cell epulis
anterior to molars interdentally (buccal-lingual - indentate px)
33
What is the presentation of giant cell epulis
* pedunculated/sessile swelling * varying size * typically dark/red * commonly ulcerated * often interdental
34
How does giant cell epulis appear histologically
* focal collections of multinucleated giant cells * large no. of vascular channels * extravasated red blood cells and deposits of haemosiderin are present | haemosiderin is caused by breakdown of haemoglobin producing brown stain
35
Why should you always radiograph a giant cell epulis
* it is possible for a central giant cell granuloma to perforate the cortex and present as a peripheral lesion
36
Why can a vascular epulis mature to a fibrous epulis
due to granulation tissue first phase of granulation tissue formation is vascular followed by fibrous
37
Where are fibroepithelial polyps usually seen
cheek lip tongue
38
How do fibroepithelial polyps usually present
painless pedunculated/sessile polypoid swelling ulceration not a feature
39
What are mucoceles
* cysts arising in connection with minor salivary glands
40
What are the two types of mucoceles
extravasation cyst mucous retention ranula
41
When should you refer oral mucosal diseases
* symptomatic * abnormal overlying/surrounding mucosa * increase in size * rubber consistency * trauma from teeth * unsightly
42
Why is it important to refer symptomatic lesions
pain is a sign of salivary gland malignancy
43
When would you tend not to refer oral mucosal diseases
tori small polyp mucoceles unless they become fixed in size
44
Signs of iron deficiency
mouth ulcers glossitis angular cheilitis
45
Signs of B12 deficiency
beefy tongue
46
If the MCV shows the cells are microcytic, what type of anaemia may this be
fe deficiency thalassaemia
47
If the MCV shows the cells are macrocytic, what type of anaemia may this be
B12/folate deficiency relics
48
If the MCV shows the cells are normocytic, what type of anaemia may this be
bleed renal chronic disease

BDS4 Oral Medicine (17 decks)

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