Pathology of the GI Tract- Oral Cavity and Salivary Glands (Part 1 of 4)

Question 1

most of the lymphatic drainage of the tongue occurs how?

Answer 1

it converges toward and follows the venous drainage

Question 2

what part of the tongue runs an independent course for lymphatic drainage?

Answer 2

tip of the tongue, frenulum, and central lower lip

Question 3

when it comes to oral cavity manifestations, what will patients present with complaints of? (5)

Answer 3

could be asymptomatic, pain, lesion/growth/mass (mouth or neck), weight loss, or other medical conditions/ systemic disease/ syndrome (diabetes)

Question 4

what radiology can be used when a patient presents with an oral cavity complaint?

Answer 4

conventional x-ray, panorex, CT scan, or ultrasound

Question 5

what are three examples of diseases of teeth and supporting structures?

Answer 5

caries, gingivitis, and periodontitis

Question 6

what is the most common disease worldwide?

Answer 6

dental caries (tooth decay); also a major cause of tooth loss before age 35

Question 7

what is significant about dental caries medically speaking?

Answer 7

it could cause pain to the extent that it affects activities of daily living; it could cause weight loss/ nutrition problems, it could cause loss of self confidence/ esteem, or it could cause potential life-threatening infections

Question 8

what causes dental caries?

Answer 8

focal demineralization of tooth structure (enamel and dentin) by acidic products of bacterial sugar fermentation

Question 9

early colonizers of the tooth are mainly health-associated what species? (2)

Answer 9

streptococcal species: S. sanguinis and S. gordonii

Question 10

what can poor oral hygiene, a high sugar diet, and other salivary immunological and microbial factors lead to?

Answer 10

development of pathogenic biofilms (dysbiosis); S. mutans produces a glucan matrix

Question 11

what does the glucan matrix that S. mutans produces lead to?

Answer 11

robust biofilm formation and colonization by taxa which could not have bound the tooth surface unassisted (late colonizers)

Question 12

what are some examples of acid-tolerant cariogenic organisms? (3)

Answer 12

s. mutans, lactobacillus spp., Veillonella spp.

Question 13

what selects for increasingly acid-tolerant cariogenic organisms?

Answer 13

production of acid within the biofilm

Question 14

what is gingivitis?

Answer 14

inflammation of the oral mucosa surrounding the teeth

Question 15

what causes gingivitis?

Answer 15

accumulation of dental plaque and calculus- the result of poor oral hygiene

Question 16

when is gingivitis the most prevalent and severe?

Answer 16

in adolescence (ranging from 40-60%)

Question 17

what is dental plaque?

Answer 17

a sticky, colorless biofilm that collects between and on the surface of the teeth because of poor oral hygiene

Question 18

when does a biofilm form?

Answer 18

when certain microorganisms adhere to the surface of some object in a moist environment and begin to reproduce

Question 19

if not removed, what can plaque become?

Answer 19

mineralized to form calculus (tartar)

Question 20

what is periodontitis?

Answer 20

an inflammatory process that affects the supporting structures of the teeth (periodontal ligaments), alveolar bone, and cementum

Question 21

what causes periodontitis?

Answer 21

poor oral hygiene with resultant change in oral flora

Question 22

periodontitis is associated with some systemic diseases such as what? (7)

Answer 22

AIDS, leukemia, chron disease, diabetes, down syndrome, sarcoidosis, and syndrome associated with defects in neutrophil function/ production

Question 23

what is the general description of an inflammatory lesion?

Answer 23

something that is inflammatory causes a local reaction that shows up by swelling, heat, pain, and redness

Question 24

what is the general description of a reactive lesion?

Answer 24

it is something that is showing response to a stimulus

Question 25

what are two causes of inflammation?

Answer 25

organisms or foreign bodies

Question 26

what are 3 examples of injurious stimuli?

Answer 26

physical agents, nutritional changes, genetic changes

Question 27

What is the medical term for a canker sore?

Answer 27

Aphthous ulcer

Question 28

how would you describe an aphthous ulcer?

Answer 28

often recurrent, exceedingly painful, superficial oral mucosal ulcerations of unknown etiology

Question 29

what are aphthous ulcers associated with?

Answer 29

familial clustering and associated with immunologic disorders such as celiac disease, inflammatory bowel disease, and Behcet disease

Question 30

what are three examples of fibrous proliferative lesions?

Answer 30

traumatic fibroma/irritation fibroma, pyogenic granuloma, peripheral ossifying fibroma

Question 31

where are traumatic fibroma/irritation fibromas primarily found?

Answer 31

on the buccal mucosa along the bite line or the gingiva

Question 32

how would you describe the histology of a traumatic/irritation fibroma?

Answer 32

circumscribed, well-defined borders, benign; submucosal

Question 33

what is a pyogenic granuloma?

Answer 33

an inflammatory lesion typically found on the gingiva of children, young adults, and pregnant women (pregnancy tumor)

Question 34

what does the histology of a pyogenic granuloma look like?

Answer 34

there is actually no pyogenic component; there are lobular capillary proliferations –> that’s why it looks like red vascularized tissue

Question 35

how do peripheral ossifying fibromas appear?

Answer 35

red, ulcerated, and/or nodular lesions of the gingiva

Question 36

when is the peak incidence for peripheral ossifying fibromas?

Answer 36

young and teenage females; NOT associated with pregnant females

Question 37

what happens if you let a pyogenic granuloma run its natural course?

Answer 37

it turns into a peripheral ossifying fibroma

Question 38

how do you treat a peripheral ossifying fibroma?

Answer 38

complete surgical excision down to the periosteum is the treatment of choice