Identifying and describing lesions

Steps for identifying and describing lesions

1. Patient interview

2. Examination

   • extraoral and intraoral

3. Documentation

   • record if soft/hard tissue is normal or not

4. Images

What are the steps of the patient interview

1. Reason for attendance

2. History of present condition

   • SOCRATES

   • Site, Onset, Character, Radiating, Associations, Time, Exacerbating, Severity

3. Medical history + Medication

4. Dental history

5. Oral Hygiene

6. Diet

7. Habits (smoking, drinking, drugs)

8. Social history

Steps of clinical examination

1. Extraoral

2. Intraoral

3. Special (diagnositic) tests

Steps of extraoral exam

• general considerations

• head and neck

• lymph nodes

• TMJ

• muscles of mastication

• mouth opening

Steps of intraoral exam

• soft and hard tissues, lips, buccal mucosa, sulcus, hard/soft palate, tongue, floor of mouth, lingual mucosa

• saliva

• occlusion

• periodontium

• dentition

Frequent sites of oral cancer

• commissure (corners of mouth)

• retromolar pads

• tonsillar pillars

• lateral and ventral tongue

• floor of mouth

5 main descriptions of soft tissue pathologies

1. Site

2. Morphology

3. Colour

4. Size

5. Consistency

Elevated lesion

Blisterforms and Non-blisterforms

Blisterforms

contain fluid, translucent in appearance, soft

• <5mm in diameter = Vesicle

• >5mm in diameter = Bulla

• Pustules = any size, yellow in colour, contain pus

What lesion is this?

Vesicle

What lesion is this?

Bulla

What lesion is this?

Pustule

Non-blisterforms

solid with no fluid, opaque, firm

• Papule = <5mm diameter

• Nodule = >5mm but <20mm diameter

• Tumor = >20mm diameter

• Plaque = very slightly elevated, and usually >5mm in diameter

What lesion is this?

Mix of papules of nodules

What lesion is this?

Tumor

What lesion is this?

Plaque

Types of depressed lesions

• ulcer

• atrophy and scarring

• pits

What lesion is this?

Ulcer

What lesion is this?

atrophy and scarring

Types of flat lesions

• Macule (<10mm)

• Patch (>10mm)

What lesion is this?

Macule

What lesion is this?

Patch