Podcast
Questions and Answers
What should be done if a traumatic keratosis lesion does not heal within 2 weeks?
What should be done if a traumatic keratosis lesion does not heal within 2 weeks?
Which of the following factors is most commonly associated with cheek chewing?
Which of the following factors is most commonly associated with cheek chewing?
Which of the following describes the lesions caused by chemical injuries to the oral mucosa?
Which of the following describes the lesions caused by chemical injuries to the oral mucosa?
What is the most effective approach to prevent chemical injuries of the oral mucosa during dental procedures?
What is the most effective approach to prevent chemical injuries of the oral mucosa during dental procedures?
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Which demographic group is most likely to engage in cheek chewing habits?
Which demographic group is most likely to engage in cheek chewing habits?
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What is the typical healing time for superficial burns in the oral cavity following chemical injuries?
What is the typical healing time for superficial burns in the oral cavity following chemical injuries?
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What is a common characteristic of lesions resulting from cheek chewing?
What is a common characteristic of lesions resulting from cheek chewing?
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Which substance is NOT commonly associated with chemical injuries to the oral mucosa?
Which substance is NOT commonly associated with chemical injuries to the oral mucosa?
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What is the primary causative agent of candidiasis?
What is the primary causative agent of candidiasis?
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Which of the following is considered a predisposing factor for oral candidiasis?
Which of the following is considered a predisposing factor for oral candidiasis?
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How does the use of antibiotics contribute to candidiasis?
How does the use of antibiotics contribute to candidiasis?
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Which condition is characterized by fissured lesions at the commissural angles and is often associated with Candida?
Which condition is characterized by fissured lesions at the commissural angles and is often associated with Candida?
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What factors are contributing to the development of Angular Cheilitis?
What factors are contributing to the development of Angular Cheilitis?
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Which demographic group is most susceptible to oral candidiasis due to an underdeveloped immune system?
Which demographic group is most susceptible to oral candidiasis due to an underdeveloped immune system?
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What role do corticosteroids play in the development of candidiasis?
What role do corticosteroids play in the development of candidiasis?
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Which condition is described as erythematous patches of atrophic papillae on the dorsum of the tongue?
Which condition is described as erythematous patches of atrophic papillae on the dorsum of the tongue?
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What physiological changes during pregnancy might lead to an increased risk of candidiasis?
What physiological changes during pregnancy might lead to an increased risk of candidiasis?
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What is a key clinical feature of Candidal Leukoplakia?
What is a key clinical feature of Candidal Leukoplakia?
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What is a primary risk factor for the development of Candida infections in denture wearers?
What is a primary risk factor for the development of Candida infections in denture wearers?
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Which condition is a common risk factor for candidiasis in diabetics?
Which condition is a common risk factor for candidiasis in diabetics?
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Which stage of chronic atrophic candidiasis is characterized by diffuse erythema involving most of the denture-covered mucosa?
Which stage of chronic atrophic candidiasis is characterized by diffuse erythema involving most of the denture-covered mucosa?
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Which statement is true regarding immunocompromised patients and oral candidiasis?
Which statement is true regarding immunocompromised patients and oral candidiasis?
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What is the primary action of acidophilus in relation to Candida?
What is the primary action of acidophilus in relation to Candida?
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What distinguishes denture sore mouth from contact stomatitis?
What distinguishes denture sore mouth from contact stomatitis?
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What is a significant contributing factor to xerostomia that facilitates candidal invasion?
What is a significant contributing factor to xerostomia that facilitates candidal invasion?
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Which management strategy is advised when predisposing factors for oral candidiasis cannot be eliminated?
Which management strategy is advised when predisposing factors for oral candidiasis cannot be eliminated?
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Which medication is typically used for topical treatment of oral candidiasis?
Which medication is typically used for topical treatment of oral candidiasis?
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What type of immune response is indicated as important to the immunity against Candida?
What type of immune response is indicated as important to the immunity against Candida?
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What treatment is recommended to address the appearance of denture sore mouth?
What treatment is recommended to address the appearance of denture sore mouth?
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Which of the following is NOT an option for systemic therapy in treating oral candidiasis?
Which of the following is NOT an option for systemic therapy in treating oral candidiasis?
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Which is a therapeutic intervention suggested to enhance oral candidiasis management?
Which is a therapeutic intervention suggested to enhance oral candidiasis management?
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Why are soft liners in dentures considered a hazard for patients susceptible to oral candidiasis?
Why are soft liners in dentures considered a hazard for patients susceptible to oral candidiasis?
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What indicates the need for surgical excision in cases of chronic atrophic candidiasis?
What indicates the need for surgical excision in cases of chronic atrophic candidiasis?
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What is a defining characteristic of leukoplakia?
What is a defining characteristic of leukoplakia?
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Which systemic treatment for oral candidiasis is administered once daily?
Which systemic treatment for oral candidiasis is administered once daily?
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Which is a key indicator of angular cheilitis?
Which is a key indicator of angular cheilitis?
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What intervention is often recommended before surgical excision of lesions in denture-related candidiasis?
What intervention is often recommended before surgical excision of lesions in denture-related candidiasis?
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Which of the following conditions is characterized as hereditary?
Which of the following conditions is characterized as hereditary?
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What common side effects can occur from short-term use of systemic antifungals?
What common side effects can occur from short-term use of systemic antifungals?
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What is the primary classification of oral lichen planus?
What is the primary classification of oral lichen planus?
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Which type of lesions can be associated with reactive/inflammatory conditions?
Which type of lesions can be associated with reactive/inflammatory conditions?
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Which of the following is NOT a typical etiology of oral lichen planus?
Which of the following is NOT a typical etiology of oral lichen planus?
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What percentage of patients with oral lichen planus also experience skin lesions?
What percentage of patients with oral lichen planus also experience skin lesions?
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How long do skin lesions associated with oral lichen planus typically last?
How long do skin lesions associated with oral lichen planus typically last?
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What is a common form of non-hereditary leukoplakia?
What is a common form of non-hereditary leukoplakia?
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Which of the following is categorized under reactive/inflammatory lesions of the oral cavity?
Which of the following is categorized under reactive/inflammatory lesions of the oral cavity?
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What type of response is linked to idiopathic lichen planus?
What type of response is linked to idiopathic lichen planus?
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Which factor is NOT indicated as a potential trigger for oral lichen planus?
Which factor is NOT indicated as a potential trigger for oral lichen planus?
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Study Notes
Oral Mucosa Lesions
- Red and white lesions of the oral mucosa are a variety of conditions.
- Macules are flat, discolored lesions, not palpable and caused by vascular or inflammatory changes or pigment.
- Papules are solid bumps <1cm in diameter.
- Plaques are solid bumps >1cm in diameter.
- Nodules are solid raised lesions that are palpable in the dermis.
- Vesicles are fluid-filled blisters <1 cm in diameter.
- Bullae are fluid-filled blisters >1 cm in diameter.
- Pustules are raised lesions containing pus.
- Erosions are moist red lesions often due to blister rupture or trauma.
- Ulcers are defects in the epithelium, commonly a well-circumscribed, depressed area where the epidermal layer is lost.
- The normal color of oral mucosa is pink due to light passing through translucent superficial tissue and reflecting from capillaries.
- Four factors contributing to oral mucosa’s color are blood quantity and quality, thickness of the mucosa, presence of melanin, and keratinization degree.
- White lesions are caused by changes in the epithelium, within the epithelium, or under the epithelium like pseudomembranous candidiasis, oral keratosis, and oral submucous fibrosis.
- Clinical classifications of white and red lesions include variation in structure/appearance of normal oral mucosa, such as linea alba buccalis, leukoedema, and Fordyce's granules; non-keratotic lesions that can be rubbed off, such as aspirin burns or thrush; and keratotic lesions that cannot be rubbed off, including those with and without potential precancerous changes.
- Hereditary white lesions include: leukoedema, white sponge nevus, hereditary benign intraepithelial dyskeratosis, and dyskeratosis congenita.
- Infectious white lesions include Oral hairy leukoplakia, Koplik's spots, Candidiasis, Mucous patches and Parulis. Oral submucous fibrosis is characterized by a progressive inability to open the mouth, swallow, or speak.
Classification of Red and White Lesions
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This is a complex classification of different types of lesions, both hereditary, infectious, autoimmune-related, and miscellaneous, with examples provided for each.
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The section further classifies the lesions into types based on their causes (hereditary, infectious, autoimmune, or reactive).
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Various types of infections, predisposing factors causing oral issues, and other possible causes are listed for each classification.
Specific Lesions
- Oral Hairy Leukoplakia is a corrugated white lesion, often on the lateral or ventral tongue surfaces in immunocompromised patients and linked to HIV and EBV.
- Koplik's spots are small, bluish-white spots in the oral mucosa, preceding measles.
- Candidiasis (thrush) is a common fungal infection causing white plaques or patches on the oral mucosa, possibly acute or chronic. Predisposing factors include antibiotics use, smoking, xerostomia (dry mouth), corticosteroid therapy, and certain medical conditions like diabetes.
- Angular Cheilitis is an infection at the corners of the mouth associated with Candida and other factors like reduced vertical dimension or nutritional deficiencies.
- Median Rhomboid Glossitis is an erythematous patch on the tongue's dorsal surface, often associated with chronic atrophic candidiasis.
- Chronic Hyperplastic Candidiasis—This is a chronic oral candidiasis characterized by the presence of leathery white plaques.
- Denture Stomatitis/Denture Sore Mouth—This is a chronic inflammation of the denture-bearing mucosa often caused by poor hygiene, ill-fitting dentures, and/or candida overgrowth.
- Actinic Keratosis (cheilitis) is a precancerous lesion linked to sun exposure.
- Smokeless Tobacco-Induced Keratosis is a white lesion in contact areas with tobacco, often in the mouth's vestibule.
- Nicotine Stomatitis is a white lesion on the palate linked to tobacco smoking and habits; it's generally not precancerous.
- Leukoplakia is a white patch or plaque that cannot be characterized as any other disease; usually on tongue and buccal mucosa.
- Erythroplakia is a bright red velvety lesion of the oral cavity, frequently associated with premalignant and malignant changes.
- Oral Submucous Fibrosis (OSF) is a chronic fibrotic disease marked by inflammation, fibrosis, and reduced mouth opening, often linked to betel quid chewing.
- Fordyce's Granules are ectopic sebaceous glands typically on the buccal mucosa, harmless, and common.
- Geographic Tongue– Red patches of dekeratinized and desquamated filiform papillae on the tongue's dorsal surface are seen in an initially benign condition.
- Hairy Tongue (Black Hairy Tongue): This is an abnormal coating on the dorsal surface of the tongue due to the buildup of keratin on filiform papillae.
Diagnosis and Management
- Diagnosis is made after clinical and histological examination fails to reveal an alternative condition.
- Various methods for managing lesions are outlined in detail but vary based on type, severity, and presence of dysplasia, including topical antifungal medications, surgical excision, and/or the removal of irritants.
- Specific features of each lesion, such as size, location, and response to treatment, help guide management decisions.
- Important techniques like toluidine blue staining and cytobrush techniques for diagnosis and biopsy are discussed.
- Immunological studies and tests (such as the LE cell test) for diagnosis and classification of systemic diseases.
Lupus Erythematosus
- It's a chronic inflammatory disorder.
- Can be systemic (SLE) or confined to the skin (DLE).
- Subacute cutaneous lupus is intermediate in severity between these two.
- It can affect various body systems and organs.
- Oral manifestations of the disease like erythematous patches are seen or may be in the absence of skin lesions. Different types of disease forms of oral SLE and DLE are described, including reticular or erosive types.
- Several factors, immunological, infectious, environmental, and endocrine factors, are implicated in the development of SLE.
- Specific characteristics, such as skin lesions occurring on the face (butterfly rash) and a possible link with arthritis and other systemic symptoms, and diagnostic methods, including auto-antibody detection and cellular tests.
Lichenoid Reactions and Associated Drugs
- Lichenoid reactions are characterized by some oral manifestations that can appear in various forms.
- These reactions are often a result of an allergic response to certain medications.
- Lichenoid reactions can exhibit a variety of presentations that are identified as a form of skin and oral manifestation of the disorder.
- Various drug types triggering lichenoid reactions are provided.
Additional Information
- Different aspects of various oral lesions are included. They include their common locations, appearance, causes, predisposing factors, diagnosis, and management.
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Description
Test your knowledge on oral pathology, including traumatic keratosis, chemical injuries, and candidiasis. This quiz covers critical factors related to oral mucosa conditions and healing times. Perfect for dental students and professionals looking to refresh their understanding.
