Extraoral and Intraoral Deviations

What are the intraoral deviations on the floor of the mouth?

Exostoses: mandibular tori

Trauma (eating?)

Enlarged salivary gland

What is the classification of Exostoses: mandibular tori? (floor of the mouth)

atypical

What is the classification of Trauma (eating?) (floor of the mouth)

atypical

What is the classification of Enlarged salivary gland? (floor of the mouth)

abnormal

What are the intraoral deviations of the hard palate?

exostosis, trauma, nicotine stomatitis, petechiae

What is the classification of exostoses? (hard palate)

maxillary/palatal tori

atypical

What is the classification of trauma? (hard palate)

burns, atypical

What is the classification of nicotine stomatitis? (hard palate) Other descriptors?

atypical related to smoking

small papules (raised areas) with a background of grey or white tissue

treatment is to quit smoking

What is the classification of petechiae? (hard palate) Other descriptors?

atypical in general, but if concerned about connection to systemic condition, then refer

Tiny red spots caused by escape of small amount of blood

Trauma

Anemia

Leukemia

What are the intraoral deviations on the soft palate, pharynx, uvula?

Redness = Infection

Enlarged Tonsil

Infected Tonsil

Bifed uvula

What is the classification of Redness = Infection? (soft palate, pharynx, uvula)

atypical

What is the classification of enlarged and infected tonsils? (soft palate, pharynx, uvula)

usually atypical, but may require removal

cryptic tonsils are filled with debris, bacteria, hard stones

What is the classification bifid uvula? (soft palate, pharynx, uvula)

atypical

What is the classification of all tongue deviations?

normal or atypical

Intraoral deviation on the tongue: scalloped

Intraoral deviation on the tongue: geographic

Intraoral deviation on the tongue: black hairy tongue

Intraoral deviation on the tongue: white hairy tongue

Intraoral deviation on the tongue: lingual variocosities (ventral surface)

Intraoral deviation on the tongue: ankyloglossia

Intraoral deviation on the tongue: traumatic ulcer

Intraoral deviation on the tongue: hairy leukoplakia

**diff classification

abnormal - needs referral because of medical condition if not already diagnosed

Intraoral deviation on the tongue: cancer

**diff classification

if still there after 2 week, need to investigate

abnormal

What are the effects of tongue piercings?

cracked molar, fractured edge of tooth, self inflicted trauma

What is the intraoral buccal mucosa deviation?

fordyce granules

atypical

What should you record when you find something atypical/abnormal?

Description: location, size, color, texture/ consistency, symptoms

Need for referral?

Follow-up at later appts.

Patient to monitor

What is the purpose of self-examination for patients?

Promotes prevention

Early identification

Follow-up for lesions present

Similar observation and palpations

What should you inform patients to be aware of?

sores that do not heal within 2 weeks

white, red, dark patches

swelling, lump, bump, growth

repeated bleeding

pain or loss of feeling

How does early detection of oral cancer save lives?

5 year survival for localized disease is 76%

5 year survival for metastatic disease is 19%

80-90% survival rate when detected early!

What are the warning signs of oral cancer?

lesions with leukoplakia and erythroplakia

other:

1. Lump or thickening of oral soft tissue

2. Soreness or "lump" in throat

3. Difficulty chewing or swallowing

4. Ear pain

5. Difficulty moving jaw or tongue

7. Hoarseness

8. Numbness of tongue or mouth

9. Swelling of the jaw

Leukoplakia

thickened, white, leathery-looking spots on the inside of the mouth that can develop into oral cancer

can be from smoking

Erythroplakia

any red patch of tissue in the oral cavity that can signify oral cancer

What are some risk factors for oral cancer?

Tobacco use

Alcohol use

Exposure to sunlight (lips)

Age (40 and up)

Gender (males more common, white)

Race