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110 Cards in this Set
- Front
- Back
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If you see a traumatic ulcer, what should you ask the Pt?
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If they recently injured themselves or if they've had this condition before.
**if there is an obvious irritant, remove it.** |
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What is the apperance of a traumatic ulcer?
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Can be "craterlike" or "ditched out".
Exudate or bleeding may be present |
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What are some DD's of traumatic ulcers?
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syphilis, gonorrhea, apthous ulcer.
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How could someone Tx an traumatic ulcer?
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Saline rinse, oragel.
It will usually resolve in 7-14 days…if not, then need to re-evaluate. |
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What is necrotizing sialometaplasia?
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minor salivary gland necrosis related to (R/T) trauma
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Where in the mouth is necrotizing sialometaplasia usually found?
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Around tooth 2 & 14 (the 2nd Mx molars)
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What are some DD's of necrotizing sialometaplasia?
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syphilitic gummas,
deep fungal infection, squamous cell carcinoma |
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What are the 3 stages of syphilis?
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Primary-Chancre
Secondary-Mucous patches Third-gumma-->can show up 10-20 years later. |
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During what stages is syphilis most contageous?
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Primary-Chancre &
Secondary-Mucous patches |
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Recognize image
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Primary Chancre
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Recognize image
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Secondary -mucous patches
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Recognize image
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Gumma
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Which populations is syphilis more promenent?
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African-American Men & AIDS Pt's
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How is syphilis transmitted?
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Usually via sexual contact.
Can be passed mother to child or in blood transfusions |
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If a Pt presents with stage 1 or 2 syphilis, how should I Tx them?
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They are highly infectious-->Don't Tx Pt.
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How long does the Primary-chancre stage last?
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Usually 1-3 months and then resolves
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How long does the Secondary-mucous patch stage last?
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Typically 4-12 weeks but can go latent for many years.
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In congential syphilis what makes up the Hutchinson's Triad?
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1) Inflammation of cornea
2) Deafness 3) dental abnormalities (notched incisors/mulberry molars) |
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What age group is gonorrha usually found in?
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15-29 year olds.
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What symptoms of gonorrhea are usually found in men?
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Men don't usually show symptoms
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How is gonorrhea usually transmitted?
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Sexually transmitted of via Mother to fetus
*Babies who don't get Tx can die from this.* |
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What type of lesions will someone with gonorrhea usually present with and where?
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Pustular lesions on the tonsils & oropharynx
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What does the affected area look like?
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Red an inflamed?
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What are some DD's Gonorrhea?
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Aphthous ulcers, cancer of the tonsil, Pemphigus
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What type of infection is actinomycosis?
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Bacterial
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Since a fistula is the primary characteristic of actinomycosis, what often accompanies the presence of a fistula?
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Smelly Stink!
The sulfur granules stink! |
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How is actinomycosis treated?
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Antibiotics
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What is another name for aphthous ulcers?
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Cancer sore
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What casuses apthous ulcers?
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Stress, food trauma
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Hos long do apthous ulcers usually take to heal?
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They are self limiting and usually heal with in 7-10+ days (14 days)
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Where in the mouth are apthous ulcers usually found?
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Nonkeratinized mucosa
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What is the most common ulcer seen in the oral cavity?
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Apthous Ulcers
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How would you treat cancer sores?
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With a saline rinse
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The apthous ulcers that appear on keratinized tissue are cause by _______ ________.
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primary herpes
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What is a herpetiform?
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A type of apthous ulcer.
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What is the size of a herpetiform?
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small would be 1-3mm but they can coalese into clusters of 10-100 ulcerations
(They are smaller and more numerous than minor Apthous Ulcers AU's) |
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What is the size of a large AU?
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1-3 cm (30mm)
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What is erythema multiforme?
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An acute inflammatory disease of the skin and mucous membranes/
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Target lesions on the skin are…..
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erythema multiforme….these lesions go" hand in hand" with this condition.
**Really know that target lesions are Erythema multiforme. Know these go together!** |
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Where are the target lesions found?
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On the hands, body and oral tissue may be involved.
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What does erythema multiforme look like?
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Blister, surrounded by red inflammed tissue with a lighter ring of edema surrounding it. (Give it a target look)
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Are you going to have dental Tx in a Pt presenting with this condition?
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No!
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What is the more sever form of erythema multiforme called?
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Stevens-Johnson syndrome
Its self limiting but can be fatal. |
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What causes oral lesions associated with hypersensitivity?
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A product or medication that gives a tissue response.
**Talk with your Pt to see what "new" things have been added to their oral cavity lately. Toothpaste, mouthwash, gum.** |
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What type of disease is Lupus erythematosus?
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Autoimmune (The body attacks itself)
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Who is more likely to experience lupus erythematosus?
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Women in the 30 year old range.
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What is the classic distribution of lupus erythematosus?
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Butterfly distribution
**Know this term is synomous with Lupus Erythematosus** |
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Skin involvement of Lupus Erythematosus is most common in areas with _____ ________.
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Sun Exposure.
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How do oral lesions appear with Lupus Erythematosus?
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Eroded lesions, gingiva may be sluffing and erosive. Erythematous (red)
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What type of disease is Crohn's disease?
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GI disease
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What do the oral lesions of Crohn's disease look like?
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Ulcer looking, have the "cobble stone effect"
They are Extremely painful and slow to heal! |
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Keratin Pearls is synomous with what condition?
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Squamous cell carcinoma--Cancer of the stratified squamous epithelium
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Which population is squamous cell carcinoma most common?
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Males 45+
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Which cancer accounts for 90% of all oral cancers?
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Squamous cell carcinoma
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What are risk factors in squamous cell carcinoma?
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Tobacco, betel nut, alcohol and sunlight
(diet and stress also contribute) |
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What are the primary areas for developing oral cancer?
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Later border of Tongue, Floor of mouth, gingiva. (salivary glands and areas of drainage are frequent sites)
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Outside of the oral cavity where is a popular site for squamous cell carcinoma?
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The LIPS!
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What is another name for Oral squamous papilloma?
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Oral WART!
Its very common |
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What virus causes oral squamous papilloma?
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HPV…which means its sexually transmitted.
Be aware when discussing with juvenilles under 18 |
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What is the look of oral squamous papilloma?
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Cauliflower look and texture…usually white to pink in color.
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What is the TX for oral warts?
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Excise them
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Verruca Vulgaris is a common ______ _______.
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skin wart.
Caused by HPV |
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What is the Tx for verruca vulgaris?
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Excise the wart.
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Condyloma Acuminatum is a ________ wart cause the the ________ virus.
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venereal wart
HPV |
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What does Codondyloma acuminatum look like?
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Cauliflower-like growth similar to papilloma.
It is white-pink in color |
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Where is condyloma acuminatum usually found?
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Lips, tongue, palate, labial & lingual frenum
There can be multiple and coalesce. |
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What is the Tx for Condyloma Acuminatum?
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Excise the wart.
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Which conditions are related to HPV?
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Oral Squamous Papilloma,
Verruca Vulgaris, Condyloma Acuminatum |
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What are some possible DD's for "wart lesions"?
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Oral Squamous Papilloma,
Verruca Vulgaris, Condyloma Acuminatum |
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Focal epithelial hyperplasia is more common in which population?
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Native Americans (first noted in Navajo Indians)
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What is another hame for focal epithelial hyperplasia?
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Hecks Disease
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What does Focal Epithelial Hyperplasia look like?
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Multiple nodules on lower lip, buccal mucosa and tongue, cauliflower like and pink-white.
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What is the DD for Focal Epithelial Hyperplasia?
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Crohn's disease?
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How is Focal Epithelial Hyperplasia transmitted?
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Genetics and HPV
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What is papillary hyperplasia associated with?
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Wearing dentures 24 hours a day or ill fitting dentures
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What should you advise the Pt to do if presenting with papillary hyperplasia?
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Remove the dentures and let the tissue rest.
Dentures may need to be "re-lined" |
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Verrucous Carcinoma is related to what habit?
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Chewing tobaco (comes from the carcinogens)
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Who is more likely to encounter verrucous carcinoma?
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Men 55+
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How does Verrucous Carcinoma present?
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White patches early and then cauliflower like larger areas as the cancer grows. Ulcerations may be present.
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What are the 3 major forms of skin cancer?
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Basal Cell Carcinoma
Squamous Sell Carcinoma & Melanoma |
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Who might be the first to detect skin cancer lesions?
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Dental Hygienists!
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What is the most common cancer among women ages 20-29?
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Melanoma!
Its also the #1 cancer in men over 50! |
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What is the most common form of skin cancer?
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Basal Cell Carcinoma
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What are risks for Basal Cell Carcinoma?
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Ultaviolet light, genetics & arsenic ingestion
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What is it about basal cell carcinoma that makes it look different from other skin cancers?
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The Pearly Border!
**Don't forget basal cell carcinoma is very slow growing.** |
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What is the TX for basal cell carcinoma?
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Excise the lesion.
*If you catch the lesion before it metastasizes there is a 99% 5 yr survival rate. If the lesion has matastasized there is only a 10% survival rate.* |
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What are some risks for Squamous cell carcinoma?
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Sun exposure, tobacco use, burned skin & genetics
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What is a key factor for squamous cell carcinoma?
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It develops in pre-existing actinic keratosis.
**Any lesion that is non-healing NEEDS to be evaluated.** |
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Melanoma makes up ____% of skin cancers?
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4%
Looks like a nevi **But if it metastasizes…it can be deadly!** |
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What is the Tx for Melanoma?
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Excise the lesion Possibly chemo or radiation.
**5 Year survival rate is 90-97%** |
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What are the ABCD's of skin cancer?
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A-->Asymmetry is there a lack of uniformity to the lesion?
B--> Border Irregularity are the edges of thelesion blurred, notched or ragged C-->Color Variation Does the lesion vary in shades of tan, brown, black w/red white or blue pigments D--> Diameter Noted when lesions ismore than 6mm or larger (size of pencil eraser) |
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What is the most common type of precancerous lesion? (Know This!)
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Actinic Keratosis!
(Often seen in the lips where someone is chronically burning them.) |
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Actin Keratosis is an early marker for ________ _________ ___________.
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Squamous Cell Carcinoma.
(Check the back of hands, ears, forehead and lower lip!) |
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What does actin Keratosis look like?
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Scaly or crusty patches
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_________ _________ is a form of actinic keratosis. (Apparently we will see this all the time in practice)
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Actinic Cheilitis
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Where is Actinic Cheilitis usually found?
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Lip mucosa (exposed to sunlight)
**Has a blothcy apperance and smokers are more at risk!** |
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Neoplasms can be either __________ or ____________.
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Benign or Malignant
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Describe the traits of a benign neoplasm.
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Encapsulated
Grow Slowly Don't Spread Can be Fatal (A benign tumor in the brain for example) |
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Describe traits of a Malignant neoplasm
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Not Encapsulated,
Grow Quickly Spreads Metastasizes to other sites Can't tell where normal tissue starts and malignant tissue ends, Fatal if undetected. (Terms used Carcinoma & Sarcoma) |
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Dysplasia
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Creation of abnormal cells from normal cells
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Carcinoma in Situ
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Early stage of cancer/carcinoma…when dysplastic cells are separated from the surrounding tissues by the basement membrane.
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Invasive carcinoma
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A malignant neoplasm composed of epithelial cells that infiltrate & destroy surrounding tissues and may metastasize!
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Metastasis
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The spread of cancer to distant parts of the body from where it orginated.
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What is cancer staging? (In general)
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In general, it describes the extent or severity of an individuals cancer based on:
Location of primary tumor Size & number Lymph node involvement Cancer type & grade (how closely the cancer cells resemble normal tissue) Presence or absence of metastases |
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What does TNM refer to?
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T= based on extent of Tumor
N=extent of spread to lymph Nodes M= presence of Metastasis **A number is added to each letter to indicate the size or extent of tumor and extend to the spread of the disease.** |
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Localized
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limited to the area it begain w/o spreading
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Regional
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spread beyond orginal primary site to nearby lymph tissues/nodes
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Distant
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Cancer has pread from primary site
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What are the biggest causes of cancer?
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Tobacco 30% & Diet/Obesity 30%
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What are 3 BIG oral side effects of cancer Tx? (KNOW THIS!)
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1) Xerostomia--loss of function of salivary glands
2) Mucositis--painful oral ulcers on any mucocal tissues 3) Radiation caries--happens VERY FAST Seen at cervial 1/3, destruction of salivary glands and inadequate OHI **4) Candidiasis may be present due to compromised immune system.** |
