Oral Pathology

Question 1

What is the most common kind of oral cancer?

Answer 1

Squamous cell carcinoma

Question 2

How does squamous cell carcinoma present/look like?

Answer 2

Variable - white, red, speckled, ulcer, lump

Question 3

Where are “high risk sites”for SCC?

Answer 3

floor of he mouth
lateral border and ventral surface of tongue
soft palate
tonsillar pilars

Question 4

Where is it rare to find SCC?

Answer 4

Hard palate

dorsum of tongue

Question 5

Give some causes of SCC

Answer 5

tobacco
alcohol
smoking and alcohol (risk is 40x greater)
Ultra-violet light
HPV
Nutritional deficiencies (low in Vit A, C and Iron)
Pt with history of primary oral SCC

Question 6

How are SCC graded?

Answer 6

by degree of differentiation

Question 7

What are the degrees of differentiation of SCC?

Answer 7

Well-differentiated - very obviously squamous with ‘prickles’ and keratinization

Moderately differentiated

Poorly differentiated - difficult to identify tumour cells as epithelial

Question 8

What is the 5 year survival rate for oral SCC?

Answer 8

40-50%

Question 9

How does iron deficiency present in the oral cavity?

Answer 9

recurrent oral ulceration
oral dysaesthesia
oral candida
angular cheilitis/stomatitis
smooth tongue

Question 10

Causes of iron deficiency

Answer 10

GI bleeding 
excess menstrual loss
poor diet 
malabsorption 
malignancy

Question 11

Why could the mouth be involved in Crohn’s disease?

Answer 11

direct involvement of oral mucosa
blood loss
malabsorption

Question 12

In coeliac disease, what may lead to oral manifestation of the disease?

Answer 12

malabsorption (recurrent oral ulceration is 2y to malabsorption)

Question 13

What is orofacial gramuoatosis?

Answer 13

Swelling of lips and cheeks with angular cheilitis usually due to an allergy.
Can also be caused by Crohn’s disease and sarcoidosis

Question 14

What are the oral manifestations of Crohn’s disease?

Answer 14

Oral ulceration
mucosal tags 
cobblestone mucosa 
swollen lips 
angular cheilitis

Question 15

How may GORD present in the oral cavity?

Answer 15

dental enamel erosion

mucosal irritation and fibrosis

Question 16

How may UC present in the oral cavity?

Answer 16

Recurrent oral ulceration

Oral side effects of drug therapy (sulphasalazine steroids)

Question 17

Which cardio drugs have adverse reactions in the oral cavity?

Answer 17

nicorandil

potassium channel activator

Question 18

What are potentially malignant lesions?

Answer 18

Erythroplakia 
Erythroleukoplakia (speckled)
Leukoplakia 
Erosive lichen planus 
submucous fibrosis

Question 19

Give some warning signs of oral cancer

Answer 19

• Red/ white/ red&white lesion
• ulcer (exclude trauma, drugs, systemic disease etc)
• numb feeling
• unexplained pain in mouth or neck
• change in voice
• dysphagia

Question 20

4 key questions to ask with suspicious lesion presents?

Answer 20

How long has it been there?
Is it painful?
Smoke and drink?
What colour is the lesion?