Intro to Oral Med

Question 1

What is this condition?

Answer 1

amalgam tattoo

Question 2

Describe what can be seen histologically in an amalgam tattoo?

Answer 2

black material being taken up by phagocytic cells within tissues

Question 3

What is an amalgam tattoo?

Answer 3

Blue pigmentation of the gingivae due to amalgam used as a filling material getting into soft tissues + presenting as a pigment

Question 4

What is this condition?

Answer 4

Geographic tongue

Question 5

What is this swelling?

Answer 5

Fibroepithelial Polyp

Question 6

What type of ulcer is this?

Answer 6

apthous ulcer

Question 7

What is this condition?

Answer 7

Recurrent Herpes Simplex Virus (HSV)

Question 8

How does recurrent HSV present orally?

Answer 8

Lesions occurring inside the mouth
Leads to viral vesicles then ulcers forming in the muosa

Question 9

What has caused this oral ulceration?

Answer 9

Medication

Question 10

What is this condition?

Answer 10

Lichen planus

Question 11

What is lichen planus?

Answer 11

Immunological damage to the oral mucosa caused by lymphocytes in the connective tissue

The damage can cause thickening + thinning of the mucosal surface

Question 12

What are the red patches?
What are the white patches?

Answer 12

Red patches = thinning
White patches = thickening

Question 13

What is this condition?

Answer 13

Lichen Planus
(extreme case with areas of ulceration)

Question 14

Why are conditions of the skin seen in dermatology also sometimes seen within the mouth?

Answer 14

Because the oral mucosa is derived from the same embryological tissue as the skin

Question 15

name a condition that can appear as itchy areas of skin, hair loss + changes to the nails, that can also be seen affecting the oral mucosa?

Answer 15

Lichen planus

Question 16

What is this condition?
What causes the redness?

Answer 16

Lichen planus affecting the gingivae
Redness due to thinning of the surface

Question 17

What is causing the redness of the gingivae?

Answer 17

Redness due to thinning of the surface of the gingivae due to lichen planus

(not due to inflammation!!)

Question 18

Patient has allergy to foodstuff. What is the condition?

Answer 18

Angio-Oedema

Question 19

What reaction causes this Angio-Oedema?
How long does the reaction usually last?

Answer 19

Type 1 Hypersensitivity reaction
(usually due to foodstuffs)
Usually lasts around 1 hour

Question 20

What is causing this reaction?

Answer 20

Orofacial Granulomatosis

Question 21

What causes Orofacial Granulomatosis?

Answer 21

Blockage of the lymphatics due to unknown pathogen

Question 22

What happens to the fluids within tissues in Orofacial Granulomatosis?

How long can the condition last?

Answer 22

fluids unable to drain from tissues
Lymph nodes become swollen

Can last for weeks / months

Question 23

What condition is associated with Orofacial Granulomatosis?

Answer 23

Crohn’s disease

Question 24

What condition can patients with Orofacial Granulomatosis go on to develop?

Answer 24

Crohn’s disease

Question 25

Name 6 common dietary allergens

Answer 25

1. Beznoate + Sorbate 2. Cinnamon aldehyde 3. Chocolate 4. Citrus fruits 5. Cheese 6. Nickel

Question 26

After allergy testing, what should you advise patients?

Answer 26

If allergen reactive to certain foodstuffs, advice patients to avoid these to prevent / settle their oral condition

Question 27

What is this condition?

Answer 27

Erythema Multiforme

Question 28

What is this condition and what is it an example of

Answer 28

Condition = pemphigoid Example of a vesiculobullous problem

Question 29

Describe a pemphiod

Answer 29

Blisters filled with fluid, will rupture to form ulcers in the mouth Can be very painful

Question 30

Vesiculobullous problems result in....

Answer 30

formation of large blisters in mouth + on skin

Question 31

How are vesivulobullous problems (e.g. pemphigoid) treated?

Answer 31

systemic medication

Question 32

Name 3 medical problems you would liase with rheumatology colleagues for?

Answer 32

1. Rheumatoid Arthritis 2. Systemic Lupus Erythematosus 3. Systemic Sclerosis

Question 33

How does Systemic Sclerosis affect the body?

Answer 33

Gradual loss of elastic tissue

Question 34

What issues result from Systemic Scelorosis and how might this be a problem within dentistry?

Answer 34

Problems swallowing due to loss of elasticity making oesophagus unable to stretch around food Problems opening mouth (elastic tissue of face lost) - affects dental access - therefore tx planned in advance

Question 35

Why does oral candidiasis occur, what type of treatment / infections may it occur alongside?

Answer 35

Due to a reduced immune system Can occur during bone marrow transplantation, chemotherapy, HIV

Question 36

What condition is this patient displaying?

Answer 36

systemic sclerosis

Question 37

What is this condition?

Answer 37

Oral Candidiasis

Question 38

Name this neurological condition

Answer 38

Acoustic Neuroma

Question 39

What is an Acoustic Neuroma?

Answer 39

Cancer which forms on the 8th Cranial Nerve (vestibulocochlear)

Question 40

What other nerves may experience changes due to an Acoustic Neuroma?

Answer 40

Due to positioning of nerves in the brainstem - the 8th nerve lesion may not present, but changes to the trigeminal or facial nerves may present

Question 41

what might you expect a patient with Acoustic Neuroma to present with and why?

Answer 41

numbness / weakness of face due to changes to the trigeminal or facial nerves (because positioning of nerves in the brainstem - 8th lesion affected by the tumour may not present)

Question 42

What factors influence how you would assess pain in a patient?

Answer 42

age + communication of patient

Question 43

Name a condition which causes inflammatory changes within arteries

Answer 43

Temporal Arteritis

Question 44

What is temporal arteritis

Answer 44

Inflammation within the artery leading to limitation of blood flow to facial tissues

Question 45

Name two conditions cause changes to the trigeminal autonomic nerves within the face

Answer 45

Trigeminal Neuralgia Cluster Headaches

Question 46

What type of pain is associated with trigeminal neuralgia + cluster headaches

Answer 46

severe but short lasting

Question 47

Name 6 high risk sites for oral cancer

Answer 47

1. Floor of mouth 2. Lateral border of the tongue 3. Retormolar regions 4. Soft + hard palate 5. Gingivae 6. Buccal mucosa