Opath1 - Block 0 - Intraoral Exam

Front 1

Unstimulated salivary flow

Back 1

- Normal = 0.2-0.3 mL/min
- Hyposalivation = less than 0.1 mL/min

Front 2

Stimulated salivary flow

Back 2

- Normal = 1.5-2.0 mL/min
- Hyposalivation = less than 0.7 mL/min

Front 3

Causes of xerostomia

Back 3

- Medication
- Autoimmune disease
- Systemic disease
- Stress/anxiety/depression
- Radiation therapy to head and neck
- Gender (70% female, usually post menopause)

Front 4

Radiation to head and neck

Back 4

30 Gy = glandular fibrosis
60-70 Gy = glandular destruction

Front 5

Complications of dry mouth

Back 5

- dental caries
- candidiasis (and angular cheilitis)
- halitosis (bad breath)
- ascending suppurative sialadentitis (infection of salivary gland)

Front 6

Lingual varices

Back 6

- veins on ventral surface of tongue
- prominent in old people
- because of the vascularity, cancer can spread quickly around this area

Front 7

Desquamative gingivitis

Back 7

If you put gauze here, the gingiva will peel off. Sloughing off. Any small pressure will cause it to peel off.

Front 8

Meth mouth

Back 8

Generalized broken teeth and root caries

Front 9

Physiological pigmentation

Back 9

Increased melanin accumulation, more common in darker skin pts

Front 10

Leukoedema

Back 10

- gray-white, diffuse, filmy surface
- lesion disappears when tisssue is stretched
- Parakeratosis and acanthosis in the epithelium
- Marked intracellular edema of the spinous cells
- common in dark skin pts

Front 11

Fordyce granules

Back 11

- ectopic sebaceous glands on buccal mucosa

Front 12

Amalgam tattoo

Back 12

- most common pigmented lesion in the mouth
- implantation of amalgam particles forms a pigmented macule

Front 13

Chemical burn

Back 13

- aspirin, garlic, mouthwash

Front 14

Traumatic ulcer

Back 14

Traumatic ulcer due to sharp instruments, broken teeth or biting especially common at the lateral borders of the tongue.

Front 15

Nonhealing ulcers on the tongue

Back 15

- can be inflammatory or dysplastic

Front 16

Black hairy tongue

Back 16

- hyperplasia of the filiform papillae with retardation of the normal rate of desquamation
- thick matted surface that serves to trap bacteria and food debris
- in smokers there is brownish discoloration due to nicotine stain

Front 17

Atrophic tongue

Back 17

- bald tongue
- all the papillae are lost, leaving a smooth reddened dorsal surface
- most commonly found in Pernicious Anemia and Fe deficiency anemia

Front 18

Geographic tongue

Back 18

- localized (not generalized) loss of filiform papillae, and outlined
- fissured tongue pts will develop these geographic tongues
- most of the time is asymptomatic

Front 19

Traumatic fibroma

Back 19

- a scar frequently on tongue and on the cheek due to cheek biting

Front 20

Leukoplakia

Back 20

Any white lesion in the oral cavity, can include several conditions

Front 21

Actinic cheilitis

Back 21

- Lips are very white-ish and dry. There are vertical lines which can be peeled off.
- from sitting in the sun a lot
- need biopsy to test for cancer

Front 22

Angular cheilitis

Back 22

- Infection at the corners of the mouth, lip commisures
- Due to fungal infection

Front 23

Lip mucocele

Back 23

- gland gets clogged, and mucous doesn't get secreted
- benign

Front 24

Herpes Labialis

Back 24

- cold sores
- caused by HSV
- recurrent infections seen on keratinized mucosa, such as hard palate, gingival and vermilion borders of the lip (herpes labialis)

Front 25

Aphthous ulcer

Back 25

- canker sore
- 10-14 days to heal
- on non-keratinized mucosa, such as ventral surface of tongue and buccal mucosa. Well demarcated, pseudo-membrane on the surface with surrounding erythmatous halo

Front 26

Nicotinic stomatitis

Back 26

- in the palate of smokers
- ulcers and thickening of epithelium

Front 27

Oral cancer

Back 27

- Red and white areas at the ventral/floor of the mouth, most common area for developing oral cancer.