Quiz 1 LOs: Diagnosis of Oral Lesions

LO1: List the diagnostic categories that contribute to the diagnostic process

Medical / Dental History

Intraoral Exam / Extraoral Exam

Radiographs

Confirmatory tests: biopsy/referral to specialists --> Laboratory/Microscopic/Surgical

Therapeutic

Differential findings

What do we include in a description of oral lesions?

clinical appearance, consistency, color, size, texture

What are the terms we use to describe the appearance soft tissue lesions?

Macule

Papule/nodule

Vesicle/bulla

Pedunculated/sessile

Macule

flat lesion, pigmented

Papule/nodule

raised lesion

nodule > 1 cm

papule < 1 cm

Vesicle/bulla

fluid filled raised area

bulla > 5 mm

vesicle < 1 cm

Pedunculated/sessile

sessile has a raised surface

pedunculate needs to the probe to raise it (mushroom shape)

What are the terms we used to describe soft tissue consistency?

soft

firm

fluid-filled

What are the terms we used to describe the color of the lesion?

Normal/white/red/pigmented (black/blue)

Leukoplakia - White patch

Erythroplakia – Red patch

Erythema – red surface

What units do we use for size of the lesion?

cm or mm

What are the terms we used to describe the surface texture of the lesion?

Smooth

Papillary/verrucous --> irregular

Ulcerated --> grey center

How do you describe a jaw lesion?

location, growth pattern, symptoms, others

What terms do you use to describe location of a jaw lesion?

Maxilla/Mandible

Anterior/Posterior

What terms do you use to describe growth pattern of a jaw lesion?

Swelling (expansile/non-expansile)

Slow/fast

growing

Breaking through bone

Ulceration/inflammation

What terms do you use to describe symptoms of a jaw lesion?

pain, paresthesia, exudate

What other terms do you use to describe a jaw lesion?

systemic signs and symptoms --> fever, fatigue, pigmentation, malignancy, endocrine dysfunction etc

LO2: What is periapical cemento-osseous dysplasia? (cementoma)

form of COD that is confined to the bone around the roots of the md anterior teeth

LO2: What is the relationship between race, sex, and age and periapical cemento-osseous dysplasia? (cementoma)

black women in their 30s

LO2: What is the radiographic appearance of periapical cemento-osseous dysplasia? (cementoma)

a radiolucent area at the apex of a tooth on a radiograph

LO3/4: Define leukoplakia

white lesion that cannot be rubbed off and cannot be diagnosed through clinical characteristics alone

LO3: Define erythroplakia

red lesion that cannot be diagnosed on the basis of clinical features alone.

LO4: Describe tori

excessive growth of normal bone

common in ADULTS

What race and sex is torus palatinus most common in?

native american females

LO4: Describe squamous cell carcinoma

malignant transformation

of the squamous epithelium lining of the oral cavity

carcinomas: malignant tumors arising from cells that originated

from embryonic ectoderm

LO4: Describe linea alba

appears as a white line along the plane of occlusion

unilateral or bilateral

tissue becomes keratinized

LO4: Describe erythema migrans

usually asymptomatic, etiology unknown

abundance of both acute and chronic inflammatory cells

LESIONS ON MUCOSAL SURFACES --> red, irritated

lesions develop and then spontaneously regress, then appear again later

LO4: Describe nutritional deficiencies

varied --> can include glossitis, pallor, etc.

LO4: Describe a Vitamin D deficiency

result in bone loss and increased inflammation

LO4: Describe a protein deficiency

cell-mediated immunity, complement system, phagocyte activity and production of cytokines

LO4: Describe an antioxidant and Omega-3 defiency

increases risk for perio

LO4: Describe angular cheilitis

describe redness and cracking at the corners of the mouth

LO4: Describe necrotizing ulcerative gingivitis

Punched out papilla

Profuse bleeding

Fever

Fatigue

Swollen lymph nodes

Rapid onset

LO4: Describe fordyce granules

oil glands of skin that appear as yellow nodules along buccal and labial mucosa

LO4: Describe leukoedema

generalized translucent or

opalescent covering, located over the buccal mu-

cosa

lesion initially appears

translucent white or opalescent and then disappears when the tissue is stretched

most common in BLACK individuals

LO4: Describe melanin pigmentation

diffuse or localized brown pigmentation of the mucosa

LO4: Describe erythema migrans --> geographic tongue

usually asymptomatic, etiology unknown

abundance of both acute and chronic inflammatory cells

LESIONS ON TONGUE--> red, irritated

asymmetrical, bordered areas of ery-

thematous mucosal atrophy, surrounded by white or

yellowish circinate (circular or ring-shaped), slightly

elevated borders

LO4: Describe fissured tongue

deep grooves present on the dorsum on the tongue

LO4: Describe hairy tongue

elongated filiform papillae that

produce a hair-like appearance

can pick up

yellow or brown stain and present an aesthetic problem for the patient

LO4: Describe median rhomboid glossitis (central papillary atrophy)

localized loss of the filiform papillae creating a smooth, red, rhomboid-shape at the midline on the dorsal surface of tongue

more common in ADULTS

LO5: Define variant of normal

Anatomical structures or conditions that deviate from the common presentation BUT are considered within the range of normal variation and are not pathological

LO5: What are some examples of the tongue that are variants of normal?

fordyce granules, tori, melanin pigmentation, linea alba, leukoedema

LO6: Define lingual thyroid

normal thyroid tissue

remains on the dorsum of the tongue --> it is ectopic, meaning out of place

most commonly a mucosal-colored round nodule, reaching up to 4 cm in diameter

affects WOMEN more than men

LO6: What are the 3 clinical symptoms associated with lingual thyroid?

1. Dysphasia--> language disorder that affects how you speak and understand language

2. Dysphonia --> difficulty speaking

3. Dyspnea --> shortness of breath