Oral Pathology

Oral pathology

Study of diseases in the oral cavity

Historical data

Includes family, medical, and dental history 

Clinical data 

Based on appearance

• Color, size, shape, and location 

Radiographic data 

Used for bony lesions that are not visible clinically 

Laboratory data

Blood tests, saliva tests, cultures

Surgical vs Therapeutic Diagnosis

• Surgical = Exploratory

• Therapeutic = Response to treatment

Pulp vitality 

Determines whether tooth pulp is vital or non-vital 

Biopsy

• Removal of tissue for a microscopic exam

• Gold standard definitive diagnosis

• Two types: brush and surgical

Leukoplakia 

White lesion caused by irritation or cancer (requires biopsy)  

Melanin Pigmentation

Darker pigment caused by excess melanin

Ulcer

open sore

Pustule 

Small blister or pimple on the skin containing pulse 

Hematoma 

Collection of blood outside blood vessels 

Abscess 

Localized collection of pus 

• Usually from infection

Periapical Abcess 

Bacterial infection at the apex of the tooth 

• Caused by an infected nerve usually from decay 

Vestibular Abcess

Spread into surrounding tissues

• May involve face

Cellulitis

Infection spreading in soft tissues

• Severe inflammation, redness, fever

• Dangerous because it may spread to eye/ brain

Antibiotics 

Treat bacterial infections like Abcess or cellulitis 

• Penicillin, Clindmycin 

Herpes simplex

Multiple painful ulcers on palate or attached gingiva

• Triggered by sunlight, stress, menstruation

Herpes labialis

“Cold Sore/Fever Blister” On lips

Varicella vs Zoster 

• Varicella = chickenpox in children 

  • vesicles, fever, contagious

• Zoster = shingles in adults

  • Unilateral painful vesicles

Antiviral drugs 

Not very effective 

• Palliative drugs relive symptoms 

  • Corticosteroid drugs suppress inflammation 

Candidiasis (thrush)

White curd-like material that wipe off

• Red underneath

• Candida albicans

Opportunistic infection

Occurs when antibiotics kill off specific bacteria → fungal overgrowth

Angular cheilitis 

Fungal infection at commisure 

• Diagnosed via therapeutic evaluation 

Antifungal drugs

Nyastatin

Aphthous ulcers 

“ Canker Sore”

• Shallow, yellow centers that are painful 

• Moveable mucosa 

Minor vs Major Aphthous Ulcers

• Minor = shallow

  • Less than 6 episodes

  • Heal within 7-10 days

• Major = deep

  • Larger, deeper ulcers >1cm

  • Painful, inability to eat

Lichen planus 

Chronic autoimmune condition 

• Wickham’s Striae ( white lacy pattern) 

Nicotine stomatitis

Keratinized hard palate with red duct openings

• not cancerous

Glossitis

Inflammation of the tongue

Hairy tongue 

Elongated filiform papillae 

• Stained by food/tobacco 

• Often from antibiotics 

Geographic tongue

Migratory desquamation of filiform papillae

• Map like patches

Fissured tongue

Deep grooves with debris irritation

ANUG 

Painful, punched-out papilla 

• Bad taste, odor, fever

• Treated with debridement + peroxide 

Mandibular vs Palatal tori

• Mandibular = dense bone on lingual mandible

• Palatal = bone midline palate

  • Inherited, asymptomatic

What does a Periapical radiolucency indicate?

Bone loss at apex → nonvital tooth

• Needs pulp test