Oral Injuries (3)

Question 1

Attrition

Answer 1

Tooth on tooth wear; primary or permanent dentition. Mouth breathers often have attrition. Rate of attrition influenced by diet.

Question 2

Bruxism

Answer 2

A type of attrition. Grinding and clenching for nonfunctional purposes. Signs and symptoms of intensity: Wear facets, muscle tenderness, hypertrophy of masenter, increased cheek biting, tooth mobility, and excessive attrition.

Treatment: Acrylic splints (anterior splint) or occlusal adjustments

Question 3

Abrasion

Answer 3

Wearing away of tooth structure as a result of repetitive mechanical habit. Commonly seen in exposed root surfaces because cementum and dentin are not as hard as enamel. Slow process. Presents as notching on root surface. Ex: tooth brush abrasion at gumline.

Question 4

Abfraction

Answer 4

Wedge shaped lesion at cervical area of tooth. Lesions occur in adults. Cause related to fatigue, fracture, deformation of tooth structure. A weakened tooth more susceptible to abrasion. Increases size with time.

Question 5

Erosion

Answer 5

Loss of tooth structure as result of chemical action. Area of erosion appears smooth and polished. Usually involves multiple teeth. Can be occupational: breathing acid in workplace, sucking lemons, bulimia, methamphetamine, drugs, decreased saliva, lack of hygiene, high sugar beverages.
Management: rinsing with water after purging, fluoride rinse and toothpaste

Question 6

Aspirin Burn

Answer 6

Placing aspirin on painful tooth rather than swallowing it. Tissue becomes necrotic and white. Sloughs off and ulcerates. Heals in 7 to 21 days.

Question 7

Electric Burn

Answer 7

Seen in children and infants who have bitten or chewed a live electric cord. Electric current causes a great deal of damage.

Question 8

Other Burns: “soup burn” or hot food burns

Answer 8

Burn seen on palate

Question 9

Hematoma

Answer 9

A bruise on the inside of the mouth. There is an accumulation of blood within the tissue due to trauma.

Question 10

Traumatic Ulcer

Answer 10

Occurs as a result of trauma. Identified by patient history

Question 11

Frictional Keratosis

Answer 11

Chronic rubbing or friction against oral mucosa resulting in thickening of keratin on surface. Appearance is opaquely white and is a protective response. NOT malignant.

Question 12

Nicotine Stomatitis

Answer 12

Occurs in smokers; Keratinization occurs, making palate pale. Raised red dots at openings of minor salivary glands on palate. Increased risk of malignancy.

Question 13

Tobacco pouch keratosis

Answer 13

White lesion tobacco where tobacco habitually placed. Usually in mucobuccal fold; opaquely white corrugated lesion. Increased risk of SCC.

Question 14

Amalgam tatoo

Answer 14

A flat blueish gray lesion; usually in area of large filling or missing tooth. Amalgam became impacted into tissue and tissue heals and appears blue.

Question 15

Solar Cheilitis

Answer 15

Degeneration of tissue of lip due to sun exposure. Vermillion border undefined, color is pale pink and mottled. Lips dry and cracked. Strong relationship between solar cheilitis and basal cell and sq. cell carcinoma.

Question 16

Mucocele

Answer 16

Forms when the salivary gland duct is severed and saliva spills in adjacent connective tissue. Waxes and wanes over time. Lower lip most common site.

Question 17

Ranula

Answer 17

Forms unilaterally on floor of mouth. Associated with ducts of sublingual and submandibular glands. Treated with surgery.

Question 18

Sialolith

Answer 18

Salivary gland stone. Form by precipitation of calcium salts around central core. Can often be seen on radiograph. They are painful.

Question 19

Phenol Burn

Answer 19

Used in dentistry as a cavity sterilizing agent and a cauterizing agent. Will cause whitening and sloughing of the area as a result of tissue destruction.

Question 20

Factitious injury

Answer 20

Due to a habit (Ex: biting fingernails)

Ask questions to determine cause.

Question 21

Reactive connective tissue hyperplasia

Answer 21

Proliferating, exuberant granulation tissue and dense fibrous connective tissue.

Question 22

Granuloma (Same as preg. tumor)

Answer 22

Occurs in response to injury. Proliferation of connective tissue with an abundance of blood vessels and inflammatory cells. Deep red, usually ulcerated, soft to palpation, bleeds easily. Usually develop rapidly and then remain static. Most seen in teenagers and young adults. If it cannot be regulated with better oral habits, it must be surgically treated.

Question 23

Peripheral Giant Cell Granuloma

Answer 23

Occurs only in the jaws, seems to orig. from periodontal ligament or periosteum in response to injury.

Question 24

Irritation Fibroma

Answer 24

Most common mass on the gingiva. Usually small lesion, less than 1cm in diameter. Usually lighter than surrounding tissue (stratified sq. epithelium). Response to chronic injury.

Question 25

Denture Induced Fibrous Hyperplasia

Answer 25

Also called Epulis Fissuratum or Inflammatory hyperplasia. Caused by ill-fitted denture. Requires surgery and remake of CD. Also seen with patients that rarely take out denture.

Question 26

Papillary Hyperplasia of the Palate

Answer 26

Irritation inflammatory response due to dentures not being removed regularly. Palatal vault has multiple erythematous papillary projections, surgery and remake of appliance needed.

Question 27

Gingival Hyperplasia

Answer 27

Gingival enlargement; can be caused by certain drugs (Ex: dilantin, phenytoin, CA channel blockers). Increase in bulk of free and attached gingiva, esp. interdental papilla. may be generalized or localized, mild or severe. Always find cause of enlargement. Treatment: Gingivoplasty (reshaping of gingiva), gingivectomy (removing gingival tissue). Tissue may need to undergo a biopsy to rule out gingival enlargement seen in individuals with leukemia.

Question 28

Chronic Hyperplastic Pulpitis

Answer 28

Excessive proliferation of chronically inflamed dental pulp. Occurs in teeth with large carious lesions. Appears as a pink mushroom growing out of occlusal surface. Usually asymptomatic and painless. Treatment is EXTRACTION.