Podcast
Questions and Answers
Which of the following is a GDC learning outcome related to oral diseases?
Which of the following is a GDC learning outcome related to oral diseases?
Early detection of oral diseases is not preventable.
Early detection of oral diseases is not preventable.
False (B)
Which of these is a common condition of the mouth?
Which of these is a common condition of the mouth?
What is the most common type of cancer found in the mouth?
What is the most common type of cancer found in the mouth?
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In Lichen Planus, the painless white lines are called ______.
In Lichen Planus, the painless white lines are called ______.
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Which of these is a classic descriptor of cancer in the mouth?
Which of these is a classic descriptor of cancer in the mouth?
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Malignant transformation of Lichen planus is not possible.
Malignant transformation of Lichen planus is not possible.
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What does USC stand for in reference to cancer referrals?
What does USC stand for in reference to cancer referrals?
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Which of the following is a factor that exacerbates soft tissue disease?
Which of the following is a factor that exacerbates soft tissue disease?
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Why is clear and accurate record keeping important for soft tissue diseases?
Why is clear and accurate record keeping important for soft tissue diseases?
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Which of the following factors can influence the patient's response to pathology?
Which of the following factors can influence the patient's response to pathology?
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A DH/DT can never organize a referral.
A DH/DT can never organize a referral.
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What is the significance of a soft tissue examination?
What is the significance of a soft tissue examination?
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Host response is crucial in the ______ and influenced by several factors such as systemic diseases.
Host response is crucial in the ______ and influenced by several factors such as systemic diseases.
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Which of these are benefits of early detection of oral problems?
Which of these are benefits of early detection of oral problems?
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Self-screening for oral cancer is not important.
Self-screening for oral cancer is not important.
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Describe why the oral environment is so important?
Describe why the oral environment is so important?
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Flashcards
Oral Diseases
Oral Diseases
Conditions affecting the mouth that require prevention, diagnosis, and treatment.
Aetiology
Aetiology
The study of the cause or origin of a disease.
Pathogenesis
Pathogenesis
The development and progression of a disease.
Systematic Examination
Systematic Examination
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Patient History
Patient History
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Comprehensive Examination
Comprehensive Examination
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Soft Tissue Examination
Soft Tissue Examination
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Signs of Disease
Signs of Disease
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Factors Exacerbating Conditions
Factors Exacerbating Conditions
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Supportive Care
Supportive Care
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Follow-up Care
Follow-up Care
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Awkward Conversations
Awkward Conversations
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Self-doubt
Self-doubt
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Competency
Competency
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Oral Cancer
Oral Cancer
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Lichen Planus
Lichen Planus
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Pemphigoid
Pemphigoid
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Candida
Candida
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Pemphigus
Pemphigus
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Leukoplakia
Leukoplakia
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Oral Examination Prep
Oral Examination Prep
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Signs of Soft Tissue Disease
Signs of Soft Tissue Disease
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Importance of Early Detection
Importance of Early Detection
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Factors Hindering Screening
Factors Hindering Screening
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Intraoral Examination
Intraoral Examination
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Extraoral Examination
Extraoral Examination
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Chronic Conditions
Chronic Conditions
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Clinical Knowledge and Skills
Clinical Knowledge and Skills
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Interpersonal Skills
Interpersonal Skills
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Self-management Skills
Self-management Skills
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Study Notes
Introduction to Soft Tissue Diseases
- Module: Oral & Dental Sciences
- Lecturer: Mariya Mahmood
GDC Learning Outcomes
- Describe oral diseases and their relevance to prevention, diagnosis, and treatment
- Explain the etiology and pathogenesis of oral diseases
- Recognise the importance of and carry out an appropriate systematic intra- and extra-oral clinical examination
- Recognise the importance of and record a comprehensive and contemporaneous patient history
- Recognise abnormalities of the oral cavity and the rest of the patient and raise concerns where appropriate
- Recognise the need for and make arrangements for appropriate follow-up care
SPF Learning Outcomes
- Clinical Knowledge and Skills: C1.1, C1.2, C1.17, C1.25, C1.31, C1.38, C2.1.1, C2.1.11
- Interpersonal Skills: I(B)1, I 1.6
- Self-management: S(B)2
Intended Learning Outcomes
- Outline the significance of a soft tissue examination and linked history taking in identifying signs of disease
- Describe influencing factors that may exacerbate soft tissue conditions
- Demonstrate accurate history taking and recording of soft tissues conditions
- Identify the first considerations of supporting/managing and treating patients with soft tissue conditions
- Reflect on experience of learning
Scope of a DH/DT
- What is your remit?
- What manifests in the mouth?
- What is your level of responsibility?
Examining Soft Tissues and Their Diseases
- What is the purpose of intraoral and extraoral examination?
- Preparation for Year 2 Oral Medicine – conditions explained in more depth
What are the Soft Tissues?
- When does the examination begin?
- Who holds responsibility?
Benefits of Early Detection
- Preventable
- Easily treated
- Slow down progression
- Fatality prevented
- Early identification improves prognosis
Factors Hindering Screening
- Awkward conversations
- Self-doubt
- Assumption of providing diagnosis
- Competency
- Assumption another will identify
Most Common Conditions
- Cancer
- Lichen Planus
- Pemphygoid
- Candida
- Pemphigus
- Leukoplakia
- Ulcers
- Herpes
Common Conditions Continued
- Oral Cancer: Cancerous lesions of 3 distinct sites: oral cavity (mouth), oropharynx (throat), and lip (outer)
- Lichen planus: Chronic, cell-mediated inflammatory disease affecting the oral mucosa (<3% turns cancerous)
- Ulcers: Loss or erosion of the delicate mucous membrane; repeat ulcers can be a manifestation of other diseases
Individual Disease Susceptibility
- Predisposed to developing a certain disease
- Individual's disease susceptibility influenced by a combination of genetic and environmental factors
- Host factors
- Acquired immune response
- Environmental influences
Influencing Factors With Soft Tissue Diseases
- Immuno-compromised (e.g., Lupus, HIV, Diabetes)
- Stressed?
- Tired?
- Nutritionally deficient (e.g., Vit D risk factor for oral cancer)
- These issues impact patient response to pathology
Exacerbating Factors
- Alcohol
- Smoking
- Beta nut
- Vaping
- Human papillomavirus (HPV 16)
- Nutritional deficiency
- Spicy food
- Poor oral hygiene
How would you describe the oral environment?
- Plaque: Exacerbates most oral conditions
Dental Diversity
- Physiological/racial pigmentation of gingivae
- Soft tissue size
- Differing anatomy
- Gingival biotypes
Is self-screening important?
- Self-screening can be important, though professional screening is necessary
Screening for oral cancer
- Self-examination guide available
- 8-step oral cancer screening process
Clinician Considerations for Soft Tissue Diseases
- Clear and accurate record keeping
- Clinical photos
- History taking
- Referral to Oral Medicine Specialist for diagnosis confirmation
- Maintaining optimum health for the whole mouth
- Dietary/lifestyle advice
- Specific and tailored oral hygiene advice
- Specific adjunct requirements if needed
Descriptive Language
- Size (mm x mm)
- Location
- Raised/elevated lesion
- Blister/vesicle/bulla
- Crusty edges
- Borders (poorly/well defined)
- Shallow/deep crater
- Color (white/red/speckled, etc)
- Painful/not painful
Communicating with the patient
- Avoid "C" word
- Remain calm, composed
- Avoid subjectiveness
- Inform patient of urgent referral pathway
- Remember you have not diagnosed a patient
- You are not trained to counsel patients with a cancer diagnosis
Suspected Pathway
- Urgent Suspected Cancer (USC) referral forms
- NHS fast-track two-week referral policy
- Can a DH/DT refer?
Activity – How would you describe this?
- Describe the clinical presentation of the lesion
- Questions to ask the patient for a history
- Are you concerned? Why/why not?
Holistic Approach
- Identify abnormality
- Consider relevant histories
- Predisposing/host factors
- Communication and documentation
- Referral/support/maintenance
Case Study Examples
- Condition
- Definition
- Photograph
- Descriptors
- Patient management
Cancer (Squamous Cell Carcinoma)
- Classic descriptors
- Most common location (floor of mouth/lateral side of tongue)
- Ragged ulcer (slow to heal)
- Raised, poorly defined borders
- Classically not painful
- Malodor/halitosis
- Stiffness of the tongue
- Lymphadenopathy
- Change in color
Cancer Management
- Urgent Suspected Cancer (USC) referral forms
- Diagnosis and patient impact determine care
- DH/DT involvement pre- and post-surgery to ensure optimal dental health
- Oral health advice
- Debridement
- Dietary advice
- Adjunct suggestions as needed
Lichen Planus
- Classic descriptors (painless white lines)
- Red painful erosions or ulcers on attached gingivae
- Appearance of mucosa loss (desquamative gingivitis)
- Skin lesions tend to appear purple, raised, and sometimes itchy
Lichen Planus Management
- Regular supportive periodontal therapy
- Dietary support
- Guidance on mouthwash/toothpaste adjuncts if needed
- Possible medications (e.g., Betamethasone)
- Malignant transformation possible (reported as 1%)
Importance of Thorough Examination
- Describe soft tissues in image B
- Compare soft tissues in B and C
- How could this be missed?
Activity – Soft Tissue Lesions
- Select a condition
- Describe its appearance
- Management
- Present
Reflect
- 3 things learned
- 3 things known
- 3 things you would like to know
References (Images and Studies)
- List of referenced image sources
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Description
This quiz focuses on the study of oral diseases and their implications in prevention, diagnosis, and treatment. Participants will explore the etiology and pathogenesis of these diseases while learning to recognize and manage abnormalities through systematic examination. It is essential for students in the field of Oral & Dental Sciences.
