Oral Medicine

Question 1

give an example of an oro-facial infection

Answer 1

angular cheilitis

Question 2

what can present in the mouth in patients with anaemia or haematinic deficiency

Answer 2

recurrent aphthous stomatitis- minor or major, or herpetiform,

Question 3

how does crohns affect the mouth

Answer 3

direct involvement of the oral mucosa, blood loss, malabsorption

Question 4

how does coeliac disease affect the mouth

Answer 4

malabsorption

Question 5

what are the oral manifestations of direct involvement of crohns disease

Answer 5

oral ulceration, mucosal tags, cobblestone mucosa, swollen, angular cheilitis

Question 6

what type of diabetes affects the mouth the most

Answer 6

type 2

Question 7

what can type 2 diabetes cause in the mouth

Answer 7

thrush (acute psuedomembranous candidosis)

Question 8

what does nicorandil do and what is it used to treat

Answer 8

increases blood flow through vessels, used for angina and as a potassium channel activator

Question 9

what is an oral side effect of nicorandil

Answer 9

oral ulceration

Question 10

what is a dermatological problem commonly associated with the mouth

Answer 10

lichen planus (non erosive and erosive (ulcersative))

Question 11

what is an apthamology condition commonly associated with the mouth

Answer 11

mucous membrane pemphigoid

Question 12

what is a rheumatological disease associated with the mouth

Answer 12

sjogrens syndrome- dry mouth and or dry eyes

Question 13

what infectious diseases can manifest in the mouth

Answer 13

HIV/AIDS (hairy leukoplakia, kapsoi’s sarcoma, candidosis)

Question 14

what is the most common oral cancer

Answer 14

squamous cell carcinoma

Question 15

what are the characteristics of asymptomatic invasive oral cancers

Answer 15

surface texture; granular or smooth
elevated
usually no ulceration, bleeding or indurated (hardened)
colour change- white and red

Question 16

how common is oral cancer

Answer 16

more than testicular and cervical cancer combined

Question 17

what is happening to the incidence of oral cancer

Answer 17

increase in men and women

Question 18

what worsens the prognosis of oral cancer

Answer 18

how far back it is in the mouth

Question 19

is the incidence of oral cancer higher in england/scotland and men/women?

Answer 19

higher in scotland and in men

Question 20

how is prevalence of oral cancer affected by age

Answer 20

increases with age

Question 21

when should you refer someone on suspsicion of oral cancer

Answer 21

if something doesnt heal in 2 weeks or doesnt respond to treatment

Question 22

what are the causes of oral cancer

Answer 22

tobacco, alcohol, (tobacco + alcohol), diet, HPV, UV light (lips), candida, syphilis, dental factors

Question 23

why is cannibis potentially more harmful that tobacco

Answer 23

as smoke has more tar

Question 24

what can chewing tobacco cause in the mouth

Answer 24

submucous fibrosis, pre malignant condition

Question 25

what is the weekly alcohol limit

Answer 25

14 units

Question 26

what is the units of binge drinking

Answer 26

8 in one session in men, 6 in women

Question 27

what aspect of nutrition could mean an increased risk of oral cancer

Answer 27

low in Vit A (used to treat leukoplakia), C and iron

Question 28

what is leukoplakia

Answer 28

atrophy of oral mucosa

Question 29

what oral cancer is associated with HPV

Answer 29

oropharyngeal- oral sex

Question 30

what else can cause red and white patches in the mouth

Answer 30

infection

Question 31

what is erosive L.planus

Answer 31

skin condition in the mouth- redness can give rise to cancer

Question 32

what are the high risk sites of mouth cancer

Answer 32

Soft (non keratinizing) sites Eg ventral tongue/floor of mouth Lateral tongue

Question 33

what does non heamogenous mean

Answer 33

not smooth

Question 34

what can submucous fibrosis affect

Answer 34

opening of the mouth

Question 35

how does dyskeratosis present

Answer 35

Leukoplakia Nail Dystrophy Increased Skin Pigmentation

Question 36

what can d.congenita cause

Answer 36

nail/skin changes

Question 37

what is erythroleukoplasia

Answer 37

red patch on oral mucosa

Question 38

what are the warning signs of oral cancer

Answer 38

``` Red / White/ Red & White lesion Ulcer (exclude trauma,drug,systemic etc ) Numb feeling eg lip,face Unexplained pain in mouth or neck Change in voice Dysphagia ```

Question 39

what are the rarer orofacial manifestations of cancer

Answer 39

``` Drooping eye lid or facial palsy Fracture of mandible Double vision Blocked or bleeding from nose Facial swelling ```

Question 40

what 4 key questions should you ask a patient who presents with a suspicious lesion

Answer 40

How long has lesion been present ? Is it painful ?(pain is usually late manifestation of OC but would be expected if benign ulcer) Does patient Smoke? & Drink?..how much? What colour is the lesion?

Question 41

why is distinguishing between painful and non painful legions important

Answer 41

as traumatic and infectious ulcers are painful, cancerous can be painless

Question 42

what are the main oral diseases that have a significant affect on public health

Answer 42

tooth decay (dental caries), gum disease (periodontal disease), oral cancer

Question 43

what aspects of a patients life does oral health impact

Answer 43

``` physcial health (diet, dentition) social, psychological health ```

Question 44

what are causes of dental caries

Answer 44

acids produced by bacteria in the presence of sugar

Question 45

how are dental caries measured

Answer 45

decayed (present), missing (past treatment), filled (past treatment)

Question 46

what public heath factor are caries associated with

Answer 46

socio-economic staus

Question 47

what are periodontal diseases

Answer 47

Group of related conditions, both acute and chronic, characterised by inflammation of the periodontal tissues in response to the presence of dental plaque

Question 48

give examples of periodontal diseases

Answer 48

``` Gingivitis Chronic periodontitis Aggressive periodontitis Necrotising ulcerative gingivitis (NUG) Periodontal abscess Perio-endo lesion Gingival enlargement ```

Question 49

what diseases have periodontal diseases been associated with

Answer 49

``` Atherosclerosis, stroke, MI Adverse pregnancy outcomes Diabetes Respiratory infections Rheumatoid arthritis, osteoporosis Obesity ```

Question 50

how are periodontal diseases treated

Answer 50

``` Oral Hygiene Stop smoking Scaling and root planing Surgery Long term maintenance Extraction ```