Intro To Oral Med Flashcards

(41 cards)

1
Q

Describe fordyce spots and where it’s usually located in the oral mucosa

A

Sebaceous glands, yellowish bumps, no associated pathology

Buccal mucosa and lips

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2
Q

Percentage of adults experiencing fordyce spots

A

60-75%

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3
Q

Describe linea alba, it’s histological features and where it usually occurs in the oral mucosa

A

Horizontal, asymptomatic, white lesion

Histologically: hyperkeratosis, prominent or reduced granular layer, Acanthosis

Occurs along the occlusal plane

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4
Q

Geographic tongue is also known as __________or___________

A

Benign migratory glossitis or Erythema migrans

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5
Q

Percentage of population affected with geographic tongue

A

3%

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6
Q

What is geographic tongue? Symptoms if any

A

Loss of filiform papillae, areas of tongue atrophy and hyperkeratinisation

Comes and goes, changes appearance

Can affect other areas of oral mucosa

Asymptomatic: sometimes sensitive to hot and spicy foods and toothpaste

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7
Q

What should a person with geographic tongue do when they experience sensitivity to hot and spicy foods and toothpaste?

A

Avoid trigger foods and use SLS free toothpaste

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8
Q

Describe fissured tongue

A

Variation of normal anatomy, canoccur later in life, commonly presents with geographic tongue

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9
Q

Treatments/ advice for fissured tongue individuals

A

No treatment necessary
Encourage good oral hygiene, light tongue brushing

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10
Q

Describe black hairy tongue

A

Asymptomatic
Hyperplasia of filiform papillae
Buildup of commensal bacteria and food debris
Pigment inducing fungi and bacteria

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11
Q

Treatment/ Management of black hairy tongue

A

Reassure
Stop smoking
Stay hydrated
Light tongue brushing/ exfoliating tongue surface
Eating fresh pineapple

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12
Q

Causes of black hairy tongue

A

Specific cause is unknown, associated with smoking, antibiotics, chlorhexidine mouthwash, poor oral hygiene

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13
Q

Describe desquamative gingivitis

A

Full thickness erythema of Gingiva
Not a diagnosis
Associated with lots of conditions

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14
Q

_______ can exacerbate desquamative gingivitis but not cause it

A

Plaque

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15
Q

Describe bony exostosis, common association, and different names depending on their locations

A

Benign overgrowth of calcified bone associated with parafunction
Can interfere with denture placement, typically painless, may be more prone to ulceration

Palate: Torus palatinus
Mandible: torus mandibularis (linguals typically)
Buccal alveoulus

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16
Q

Describe physiological pigmentation and what conditions to consider

A

Normal, more common in non white ethnicities, due to increased melanin pigmentation, can make diagnosis musical disease more challenging

Consider: Addisons disease, smokers Melanosis, drug related pigmentation

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17
Q

What is pain and what are the 3 types of pain

A

Pain are signals to the brain
Nociceptive pain, inflammatory pain and pathological pain

18
Q

Describe nociceptive pain

A

High threshold pain, putting hand on hot pan, producing a withdrawal reflex

19
Q

Describe inflammatory pain

A

One of the cardinal features of inflammation , for example pain in irreversible pulpties

20
Q

Describe pathological pain

A

Maladaptive due to abnormal functioning nervous system, seem in oral dysarsthesia, often.no cure

21
Q

Approach to pain in oral medicine

A

Taking history (pain, medical, social)
exclude dental pathology ( do examination, radiographs, pulp vitality, joint clinic with restorative dentistry)
Do further investigations ( blood investigations, cranial nerve exam, MRI)

22
Q

Examples of non odontogenic intra oral pain

A

Mucosal:
Ulcers
Lichen planus
Vesiculobullous disorders
Salivary gland pain

Neuropathic pain
Trigemincal neuropathic pain
Persistent idiopathic dentoalveolar pain
Burning mouth syndrome- oral dysaesthesia

23
Q

Describe burning mouth syndrome

A

Pain/ burning sensation
Altered sensation
Perception of dry or excess saliva
Common on tongue
Normal muscosa
Discompfort as apposed to pain
Doesn’t follow anatomical boundaries

24
Q

Describe trigeminal neuralgia

A

Electric shock like/ shooting/ stabbing pain
Unilateral
Severe 10/10
Short lasting
Episodic
Rarely has concominatpain
May or may not have triggers

25
Management to trigeminal neuralgia
Medication: tricyclic antidepressants, anti epileptics Coping stategies: distraction, meditation, exercise
26
What is an ulcer
Breach in mucosa
27
Define oral ulceration
Localised defect, where there is destruction of epithelium exposing underlying connective tissue
28
Common causes of oral ulceration
Trauma Metabolic/ nutritional Allergy/hypersensitivity Infective Inflammatory Immunological Drug induced Neoplastic Idiopathic
29
Describe this lesion
Traumatic ulcer White keratitis borders Surrounding mucosa normal and ulcer soft
30
Describe apthlous ulcers
Most common ulcerative conditions Painful Red border, yellow white centre Affects 20%
31
Types of recurrent aphthous stomatitis
Major- > 1cm, long time to heal Minor: < 1cm, takes 2-3 weeks to heal herpetiform -multiple small ulcers that may coalesce
32
Similarities and differences between causes of metabolic/ nutritional ulcers in children/ teenagers and adults
Children/Teenagers: associated with growth Adults: GI/ GU pathology Both may be caused by malnourishment, anemia
33
Blood tests to investigate anaemia
FBC, VitB12, Folate, ferritin, coeliac screen
34
Types of inflammatory/ immunological ulcers
Behcet’s : Apthous appearance, mouth, skin, genitals, eyes Necrotising sialometaplasia lichen planus Vesicobullous disease Connective tissue disease: systemic lupus erythematous, rheumatoid arthritis, scleroderma
35
Primary herpes simplex virus infection generally affects children between ______ Years old
2 to 5
36
What is primary herpes simplex virus infection associated with?
Fever, headache, malaise, dysphagia, cervical lymphadenopathy
37
Describe primary heroes simplex virus infection
Short lasting vesicle effective tongue. Lips, buccal, palatial, ginigival mucosa then forming ulceration
38
What causes reactivation of primary varicella zoster infection ( shingles)
Immunocompromisation or other acute infection
39
Examples of iatrogenic cause of oral ulcers
Chemotherapy, radiotherapy, graft versus host disease, drug induced ulceration ( potassium channel blockers, bisphosphonates.NSAIDs, DMARDs
40
Symptoms of neoplastic ulceration
Exophytic, rolled borders, raised, hard to touch, non moveable, not always painful, sensory disturbance
41
Local management of oral ulceration
Mouthwashes: Simple Antiseptic - CHX,hydrogen peroxide, doxycycline LOCAL ANESTHETIC -Benzydamine Steroid- betamethasone Steroid inhaler: beclomethasone Onward referral