Podcast
Questions and Answers
What is the primary reason for performing a biopsy in erosive lichen planus?
What is the primary reason for performing a biopsy in erosive lichen planus?
- To identify the underlying cause of the ulcer
- To rule out neoplasm (correct)
- To assess the effectiveness of treatment
- To confirm the diagnosis of erosive lichen planus
What is the typical timeframe for the development of chemotherapy-related ulceration?
What is the typical timeframe for the development of chemotherapy-related ulceration?
- Within 1-2 years
- Within 1-2 weeks (correct)
- Within 1-2 days
- Within 1-2 months
What is the primary goal of treatment for chronic oral ulcers?
What is the primary goal of treatment for chronic oral ulcers?
- To refer the patient to a specialist
- To perform a biopsy
- To eliminate the underlying cause
- To make the patient comfortable (correct)
Which of the following is a common feature of oral Crohn's disease?
Which of the following is a common feature of oral Crohn's disease?
What is the purpose of removing precipitating factors in erosive lichen planus?
What is the purpose of removing precipitating factors in erosive lichen planus?
What is the primary concern in managing chemotherapy-related ulceration?
What is the primary concern in managing chemotherapy-related ulceration?
What is the role of a dentist in managing oral Crohn's disease?
What is the role of a dentist in managing oral Crohn's disease?
What is the typical outcome of chemotherapy-related ulceration after chemotherapy is completed?
What is the typical outcome of chemotherapy-related ulceration after chemotherapy is completed?
What is the primary cause of Focal/Frictional Hyperkeratosis?
What is the primary cause of Focal/Frictional Hyperkeratosis?
In which individuals is Oral Hairy Leukoplakia commonly seen?
In which individuals is Oral Hairy Leukoplakia commonly seen?
What is the characteristic appearance of Nicotinic Stomatitis?
What is the characteristic appearance of Nicotinic Stomatitis?
What is a characteristic of a submucosal hemorrhage?
What is a characteristic of a submucosal hemorrhage?
What is a treatment option for Hemangioma and Vascular Malformation?
What is a treatment option for Hemangioma and Vascular Malformation?
What is the primary goal of the biopsy in Oral Hairy Leukoplakia?
What is the primary goal of the biopsy in Oral Hairy Leukoplakia?
What is a complication of Vascular Malformation of the Jaws?
What is a complication of Vascular Malformation of the Jaws?
What is the treatment for Nicotinic Stomatitis?
What is the treatment for Nicotinic Stomatitis?
What is the characteristic of Idiopathic Leukoplakia?
What is the characteristic of Idiopathic Leukoplakia?
What is the purpose of aspirating before incision in a Vascular Malformation of the Jaws?
What is the purpose of aspirating before incision in a Vascular Malformation of the Jaws?
What is used to image Vascular Malformations?
What is used to image Vascular Malformations?
What is the treatment for Focal/Frictional Hyperkeratosis?
What is the treatment for Focal/Frictional Hyperkeratosis?
What is a sclerosing agent used to treat Vascular Malformations?
What is a sclerosing agent used to treat Vascular Malformations?
What is the common location of Oral Hairy Leukoplakia?
What is the common location of Oral Hairy Leukoplakia?
What is the primary cause of Physiologic Pigmentation in darker skinned individuals?
What is the primary cause of Physiologic Pigmentation in darker skinned individuals?
Which of the following is a characteristic of Classic KS?
Which of the following is a characteristic of Classic KS?
What is the main treatment for Smoker's Melanosis?
What is the main treatment for Smoker's Melanosis?
Which of the following drugs is NOT associated with Drug-Induced Pigmentation?
Which of the following drugs is NOT associated with Drug-Induced Pigmentation?
What is the primary mechanism of Drug-Induced Pigmentation?
What is the primary mechanism of Drug-Induced Pigmentation?
What is the preferred type of retainer in prosthetic management for Sjögren's syndrome?
What is the preferred type of retainer in prosthetic management for Sjögren's syndrome?
Which of the following heavy metals is associated with Heavy Metal Staining?
Which of the following heavy metals is associated with Heavy Metal Staining?
What is the primary treatment for Post-Inflammatory/Reactive Pigmentation?
What is the primary treatment for Post-Inflammatory/Reactive Pigmentation?
What is a common oral complication associated with Sjögren's syndrome?
What is a common oral complication associated with Sjögren's syndrome?
What is the primary goal of dietary counseling in managing Sjögren's syndrome?
What is the primary goal of dietary counseling in managing Sjögren's syndrome?
What is the mechanism of action of pilocarpine (Salagen®) in stimulating salivary flow?
What is the mechanism of action of pilocarpine (Salagen®) in stimulating salivary flow?
What is the characteristic of Post-Inflammatory/Reactive Pigmentation?
What is the characteristic of Post-Inflammatory/Reactive Pigmentation?
What is the common characteristic of symptoms experienced by patients with burning mouth syndrome?
What is the common characteristic of symptoms experienced by patients with burning mouth syndrome?
What is the primary component of oral lubricants used in managing Sjögren's syndrome?
What is the primary component of oral lubricants used in managing Sjögren's syndrome?
What is the purpose of fluoride trays in managing Sjögren's syndrome?
What is the purpose of fluoride trays in managing Sjögren's syndrome?
What is the common feature of oral hygiene products that can exacerbate Sjögren's syndrome?
What is the common feature of oral hygiene products that can exacerbate Sjögren's syndrome?
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Study Notes
Erosive Lichen Planus
- Biopsy is necessary to confirm diagnosis
- May transform into neoplasm if left untreated
- Removal of precipitating factors such as food, mouth care products, medications, and stresses is crucial
- Palliative care may be necessary for chronic lesions, and topical steroids may be considered
Oral Crohn's Disease
- Consult with MD, as it may be the first presentation
- Eliminate aggravating factors such as diet
- Treatment may be directed by the GI or rheumatology specialist, with support from DDS
Chemotherapy Related Ulceration
- Affects rapidly dividing cells in the mucosa, leading to ulceration within 1-2 weeks
- Superinfection may occur due to immune compromise
- Palliative care is necessary, including hydration, vitamin supplementation, and oral mouth rinse (Tantum)
- Ulcerations usually resolve after chemotherapy is complete
General Approach to Ulcers
- Duration and previous incidence should be considered
- Remove suspected causes and make patients comfortable
- Close monitoring and follow-up are necessary
- Biopsy and referral may be necessary
Chronic Oral Ulcers
- Categories of ulcers include acute (single or multiple) and chronic (single or multiple)
- Focal/Frictional Hyperkeratosis occurs due to trauma, leading to increased keratin production
- Treatment involves removing the underlying cause or irritation
Oral Hairy Leukoplakia
- Caused by Epstein-Barr Virus infection in immune-suppressed individuals
- Seen on the lateral border of the tongue
- Diagnosis involves biopsy, and treatment includes antiviral meds and excision for limited areas
Nicotinic Stomatitis
- Caused by tobacco smoking, particularly pipe smoking
- Characterized by red dots on the palate with surrounding white keratotic rings (halo)
- Treatment involves tobacco cessation, and biopsy if no resolution
Idiopathic Leukoplakia
- Characterized by white patches due to chronic irritation from substances like EtOH, tobacco, and HPV
- Treatment involves removing the source of irritation and close observation
Hemangioma vs. Vascular Malformation
- Vascular malformation is limited in extent and easier to manage
- Treatment options include laser, resection, and magnetic resonance angiogram (MRA)
- Hemangioma of the jaws can be life-threatening and requires high caution
Submucosal Hemorrhage
- Characterized by well-demarcated, red to red-brown to pale brown lesions
- Caused by trauma, pressure, surgery, and coughing
- Seen in anticoagulated patients and those with underlying medical conditions
Physiologic Pigmentation
- Seen in darker-skinned individuals
- Characterized by diffuse brownish epithelial pigmentation in the gingiva and buccal mucosa
- No treatment is necessary
Post-Inflammatory/Reactive Pigmentation
- Seen in susceptible individuals due to trauma or inflammation
- Characterized by increased melanin production and deposition
- Resolution occurs once the trigger is removed
Smoker's Melanosis
- Characterized by diffuse hyperpigmentation due to prolonged tobacco use
- Treatment involves smoking cessation, but may not guarantee resolution
Drug-Induced Pigmentation
- Characterized by diffuse mucosal and/or cutaneous pigmentation
- Caused by chronic drug use, stimulating melanin production
- Treatment involves stopping the causative drug
Heavy Metal Staining
- Characterized by deposition of heavy metals like lead, mercury, and gold
- Biopsy can show lymphocytic infiltrate in the case of Sjögren's
- Treatment involves removing the source of heavy metal exposure
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