Physical and chemical injuries Flashcards
Common alteration on the buccal mucosa; most likely associated with pressure or frictional irritation:
linea alba
Clinical features:
- Bilateral white line at level of occlusal plane
- May appear scalloped
- Common
Linea alba
What is the treatment for lines alba?
None
Morsicatio buccaraum, morsicato labiorum:
Chronic mucosal chewing
Chronic mucosal chewing is often observed in:
stress/psychological situations
Clinical features:
- thickened, shredded white areas
- MC on buccal mucosa
- may have areas of erythema or ulceration
chronic mucosal chewing
What is the treatment for chronic mucosal chewing?
Treatment not indicated
- Often caused by acute or chronic injury such as a sharp cusp on a tooth
traumatic ulceration
_____ ulcers are caused by medication intervention (trauma from dental instrument or anesthesia)
Iatrogenic ulcers
Iatrogenic ulcers are an example of:
traumatic ulceration
What form of traumatic ulceration is considered histologically unique?
traumatic ulceration with strom eosinophilia (TUGSE)
Clinical features:
- MC on tongue, lips, buccal mucosa
- area of erythema and fibrinous exudate
- often appears greater like
- may have hyperkeratotic collar
Traumatic ulceration
Differential diagnosis for traumatic ulcerations: (3)
- deep fungal infection
- syphilitic ulcer
- squamous cell carcinoma
Treatment for traumatic ulceration:
- remove source of irritation if present
- biopsy for longstanding lesions
Accounts for 5% of all burn admissions:
oral cavity electric burns
Clinical features:
- MC site in adults: Hands
- MC site in children: oral cavity- lips more frequent
- charred area, that becomes necrotic
electrical burns
Most common area for electrical burns in adults:
Hands
Most common area for electrical burns in children:
mouth
- often occur from hot foods and beverages:
thermal burns
Clinical features:
- MC on palate or posterior buccal mucosa
- zone of erythema and ulceration
- necrotic epithelium
thermal burns
linea alba
chronic mucosal chewing
chronic mucosal chewing
traumatic ulceration
electrical burns (child)
thermal burn
Treatment for thermal and electrical burns include:
- prophylactic antibiotic for severe cases
- appliances to prevent microstomia
- surgical intervention
- chemicals and drugs placed in the oral cavity that causes caustic injuries:
Chemical injuries
Dental related chemical injuries can be due to: (4)
- silver nitrate
- formocresol
- sodium hypochlorite
- acid etch materials
What common drug can induce a chemical burn?
aspirin
Aspirin may cause:
mucosal necrosis
Clinical features:
- white areas of epithelial necrosis
- may slough off (tissue)
- mucosal necrosis
Chemical burn - aspirin
Treatment for aspirin chemical burn:
prevent exposure, limit use
What type of sexual activity may cause trauma to the oral mucosa?
orogenital
Clinical features:
- palatal petechia
- fibrous hyperplasia
oral trauma from sexual acts
Differential diagnosis for oral trauma caused by sexual acts:
- trauma
- violent coughing
- platelet abnormalites
- viral infections
Treatment for oral trauma from sexual acts:
no treatment indicated
implantation of dental amalgam in oral mucosa:
amalgam tattoo
Amalgam tattoos may be incorporated into the oral mucosa in several ways including: (4)
- after restorative procedure
- fractured amalgam restorations
- contaminated dental floss
- endodontic treatment
Differential diagnosis for amalgam tattoo: (4)
- melanotic macule
- melanoma
- tattoos
- graphite (pencil)
Treatment for amalgam tattoo:
None if diagnosis is confirmed (biopsy if not)
Anticancer therapy may result in damage to:
normal tissue
A common site for cancer complications:
oral cavity
Oral complications of cancer therapy are related to:
chemotherapy and radiation
Clinical features:
- mucosistis
-hemmorhage
- xerostomia
Oral complications of cancer therapy
Occurs in 80% of patients treatment with H&N radiation:
mucositis
Mucositis may present as:
- atrophic mucosa
- edema
- erythema
Describe the atrophic mucosa seen with mucositis:
ulcerations and epithelial necrosis
Usually secondary to thrombocytopenia; develops from bone marrow suppression:
hemmorhage
Salivary glands are sensitive to radiation therapy; this can cause caries:
xerostomia
Treatment for oral complications of cancer therapy (mucositis):
- topical anesthetics
- pain meds
- coating agents
treatment for oral complications of cancer therapy (xerostomia):
- sugarless candy
- fluoride trays
- medications
chemical injury
chemical injury
chemical burn- aspirin
oral trauma from sex
oral trauma from sex
amalgam tattoo
amalgam tattoo
oral complication of cancer treatment
oral complications from cancer treatement
Abnormal growth of gingival tissues secondary to use of systemic medication
drug-related gingival hyperplasia
Drug related gingival hyperplasia is strongly associated with what drugs?
- phenytoin
- nifedipine
- cyclosporine
Clinical features:
- gingival enlargement that originates in the interdental papilla
- spreads across tooth surface
- edentulous area usually not affected
Drug-related gingival hyperplasia
Treatment for drug-related gingival hyperplasia:
- discontinuation of offending medication
- oral hygeine
- surgery
T/F: Drug-induced gingival hyperplasia greatly effects edentulous areas
false- usually does not affect edentulous areas
Dentur Epulis may also be called:
- epulis fissuratum
- inflammatory fibrous hyperplasia
Hyperplasia of fibrous connective tissue due to ill-fitting denture/partial
Denture epulis
Clinical features:
- folds of hyperplastic tissue in alveolar vestibule
- firm and fibrous
- may be erythmateous
Denture Epulis
Treatment for denture epulis:
- surgical removal
- denture should be remade or relined
Often arises from traumatic event resulting in hemorrhage within tissues:
Submucosal hemorrhage
Non-traumatic causes of submucosal hemorrhage:
- anticoagulant therapy
- thrombocytopenia
- viral infections
- hemorrhagic disease
Clinical features:
- petechia
- purpura
- ecchymosis
- hematoma
submucosal hemorrhage
Minute hemorrhage on skin or mucosa:
Petechia
Slightly larger area of hemorrhage 4-10 mm
Purpura
Hemorrhage greater than 1cm:
ecchymosis
Hemorrhage that produces a large mass:
hematoma
Treatment for a submucosal hemorrhage:
- may resolve spontaneously
- directed at treating the underlying cause
- several medications may be implicated such as Minocycline, AIDS meds, estrogen, and ketoconazole:
drug-related discolorations
Clinical features:
- diffuse melanosis of mucosal surfaces
- MC in females
Drug-related discolorations
Treatment of drug-related discolorations:
discontinuing medication usually results in regression over time
What are some medications that may cause drug-related discolorations? (4)
- Minocycline
- AIDS meds
- Estrogen
- Ketoconazole
Topical antibiotic in petroleum base produces a foreign-body reaction:
myospherulosis
Myospherulosis may occur at:
Surgical extraction site
Clinical features:
- extraction surgical site (mandibular molars)
- occasional facial swelling
- radiograph (circumscribed radiolucency)
myospherulosis
Treatment for myospherulosis includes:
surgical removal
drug-related gingival hyperplasia
denture epulis
denture epulis
submucosal hemorrhage
submucosal hemorrhage
hemorrhage
drug-related discoloration
drug-related discoloration
myospherulosis
myospherulosis
drug-induced gingival hyperplasia