Overview of Oral Medicine Flashcards

(39 cards)

1
Q

Linea Albea

A

Elevation of buccal mucosa
Level of occlusal plane
Bilateral
White
Bruxism

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2
Q

Morsicatio

A

Buccal/labial mucosa
Lateral/labial tongue
Roughened/ragged/thickened surface plaque; may also see ulceration and erosion intermixed

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3
Q

Leukoedema

A

White-gray translucent appearance of the buccal mucosa
Superficial intra-epithelial oedema and retention of superficial keratin
Bilateral, soft to palpate
Disappears when mucosa stretched

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4
Q

Fordyce spots

A

Developmental anomaly
Sebaceous glands
Buccal/labial mucosa and vermillion borders of the lips
Numbers increase with advancing age
They do not require treatment unless for cosmetic concerns

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5
Q

Fissured tongue

A

5% of the population and increases with advancing age
M:F
Sometimes seen in combination with erythema migrans
Asymptomatic

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6
Q

Varix

A

Red/blue/purple elevations of oral mucosa
<5mm
Buccal mucosa/lip/lateral and ventral tongue and floor of mouth
Asymptomatic and blanch on diascopy

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7
Q

Circumvallate papillae

A

8-12 mushroom shaped swellings
Junction of the anterior 2/3 and posterior 1/3 of the dorsal aspect of the tongue
Supplied with taste buds responsive to bitter flavours

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8
Q

Foliate papillae

A

Folds, grooves on the posterior lateral aspect of the tongue
Lingual tonsils found immediately below

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9
Q

Torus Palatinus

A

Developmental malformation
Firm swelling midline of palate
20% of population
Can occur at any stage
Variable shape and size
Bony tissue covered by normal mucosa
Ulceration if traumatised

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10
Q

Torus Mandibularis

A

Firm bony swelling
Normal overlying epithelium
Torus mandibularis - 6%
Ulceration

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11
Q

Fibrous developmental malformation

A

Rare developmental swelling
Fibrous overgrowth
Maxillary tuberosity
Asymptomatic
Normal tissue appearance

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12
Q

Erythema Migrans

A

2% population
Irregular depapillated erythematous areas
Fissured tongue
Appears and regresses
Usually asymptomatic

Symptomatic:
Zinc mouthwash
Corticosteroid mouth rinses

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13
Q

Traumatic ulceration

A

Not site specific
Variable size and margins
Fibrinous base
Induration

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14
Q

Recurrent Aphthous Stomatitis

A

Recurrent episodes of ulceration in otherwise healthy individual
Common (80% population)
Aetiology - stress/trauma
Three sub-types: minor/major/herpetiform

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15
Q

Recurrent aphthous stomatitis minor

A

Most common
Crops of ulcers
<1cm in diameter
Oval in shape
Non-keratinised mucosa
Heal within 14 days

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16
Q

Recurrent aphthous stomatitis major

A

Uncommon (10%)
1-5 ulcers
Affect keratinised and non-keratinised mucosa
Large
Persist for weeks
Heal with scarring

17
Q

Recurrent aphthous stomatitis - Herpetiform

A

Uncommon
Recurrent crops of multiple small ulcers
Often coalesce to form irregular areas of ulceration
Can affect any mucosal site
Heal within 14 days
No scarring

18
Q

Management of RAS

A

SLS free tp
Mucosal protectants
Topical analgesics
Topical antimicrobials - corsydl mouthrinse
Topical steroid preparations - reducing healing time

19
Q

Symptomatic management RAS

A

Orobase (reduces pain)
0.15% Benzydamine hydrochloride mouthrinse (reduces pain)
Chlorhexidine gluconate mouthwash 0.2% (aids healing)
Doxycycline 100mg soluble tablets as mouth rinse (anti-inflammatory)
Hydrocortisone oromucosal tablets 2.5mg (aids healing)

20
Q

When to refer RAS?

A

Single ulcers persisting for 3+ weeks
Speckling
Induration
Uncertain aetiology
Significant impact on quality of life
Recalcitrant ulceration

21
Q

Lichen Planus

A

Chronic inflammatory autoimmune disease
Affects SSE
Posterior buccal mucosa/tongue/gingivae/labial mucosa and vermilion of lower lip
Lesions on the palate, floor of the mouth and the upper lip
1-2% of population
2F:M
Risk of malignant transformation 1-3%

22
Q

Reticular lichen planus

A

Network of connecting and overlapping lines, papules or plaques
Rarely symptomatic
10% gingival involvement

23
Q

Erosive lichen planus

A

Ulceration within areas of hyperkeratosis, atrophy
Variable degrees of soreness

24
Q

Atrophic lichen planus

A

Erythematous lesions
Desquamative gingivitis
Most common type of gingival LP
Variable degrees of soreness

25
lichen planus E/O lesions
Skin - 15% pts Nails Scalp
26
Oral candidosis
50% of pts wearing removable dentures 65% of pts in acute and long term care facilities
27
Pseudomembranous candidosis
Creamy plaques Large areas of oral mucosa Wiped off Erythematous base
28
Acute erythematous candidosis
Antibiotic use Red areas Common sites Painful
29
Chronic erythematous candidosis
Denture stomatitis Chronic erythema of denture bearing area Hyperplasia
30
Median rhomboid glossitis
Rhomboid area Midline dorsum of tongue Asymptomatic Atrophic filliform papillae Predisposing factors - smoking and undiagnosed diabetes
31
Angular cheilitis
Erythematous fissuring at commissures 2% Mixed infection
32
Management of oral candidosis
Biguanide antiseptics Polyenes (nystatin suspension) Azoles e.g., miconazole (Daktarin)
33
Leukoplakia
A white patch of questionable risk Cannot be characterised clinically or histopathologically as any other disease Middle ages and elderly Smokers
34
Clinical presentation of leukoplakia
Asymptomatic - homogenous/thin/flat Symptomatic- non homogenous/ speckled/ nodular/ verrucous
35
Management of leukoplakia
Removal of aetiological factors Preventative measures Surveillance
36
Oral cancer
Malignant neoplasm of upper aerodigestive tract SCC Metastasise
37
Epidemiology of oral cancer
2% cancers >55 yrs NI - 329 cases per year 2M:F Stage 1 - 91% at one year follow up, 60% at 5 year follow up Stage 4 - 57% at one year follow up, 24% at 5 year follow up
38
How does oral cancer arise?
Mutation Oncogenes Tumour suppressor genes
39
What are risk factors for oral cancer?
Smoking/Alcohol/UV light/ Other e.g., potentially premalignant oral epithelial lesions (PPOEL)