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Oral Pathology

2

Introduction• Antigenic

– Capable of causing antibody production

• Palpate– Feel with fingers

3

Introduction• Biopsy

– Surgical removal of tissue

• Etiology– Cause of the disease

4

Inflammation

• Redness

• Heat

• Swelling

• Pain

5

Diagnosing Oral Pathology

• Radiographs

• Examination

• Genetic history

• Surgical procedures

• Microscopic examinations (biopsy)

• Lab, differential, and therapeutic diagnoses

6

Oral Lesions

• Four classifications– Above surface of oral mucosa– Below surface of oral mucosa– Even or flat with surface of oral mucosa– Flat or above surface of oral mucosa

7

Lesions Above the Surface

• Blister• Bulla• Hematoma • Papule

• Plaque • Pustule • Vesicles

8

Lesions Below the Surface

• Abscess

• Cyst

• Erosion

• Ulcer

9

Lesions Even or Flat with the Surface

• Ecchymosis

• Macule

• Patch

• Petechiae

• Purpura

10

Lesions Flat with or Above the Surface

• Granuloma

• Neoplasm

• Nodule

11

Biological Agents• Actinomycosis

– Infection caused by bacterium– Painful swelling, pus, and discharge– Poor oral hygiene

12

Biological Agents

• Herpes Simplex– Cold sores– Genital herpes– Herpetic whitlow

13

Biological Agents• Aphthous ulcers

– Canker sores

• Herpes Zoster

• Syphilis– Three stages

• Thrush

14

Physical Agents

• Denture irritation causing hyperplasia

• Amalgam tattoo

• Radiation overdose– Under-developed teeth – Pigmented tissue – Spider-like vessels

• Oral piercing and tongue splitting

15

Chemical Agents

• Aspirin burns

• Nicotine stomatitis

• Hyperkeratinized tissue – Appears as wrinkled, white, thickened tissue

• Hairy tongue

• Gingival hyperplasia

• “Meth” Mouth

16

Hormonal Disturbances

• Pregnancy Gingivitis– Inflamed gum tissues

• Pyogenic Granuloma– Pregnancy tumor– Found in others as well

• Puberty Gingival Enlargement– Inflamed gum tissues

17

Tooth Development Disturbances

• Amelogenesis Imperfecta– Discolored enamel, thin or partially missing

• Ankylosis– Tooth, cementum, dentin fuses with bone

18

Tooth Development Disturbances

• Anodontia– Congenitally missing teeth

• Dentinogenesis Imperfecta– Opalescent enamel and chips away

19

Tooth Development Disturbances

• Fusion– Teeth joined together

• Gemination– Tooth bud attempts to divide

20

Tooth Development Disturbances

• Macrodontia– Abnormally large teeth

• Microdontia– Abnormally small teeth

21

Tooth Development Disturbances

• Neonatal Teeth– Present at time of birth

• Supernumerary Teeth– Extra teeth

• Twinning– Two separate teeth from one bud

22

Developmental Disturbances• Oral Tori

– Boney outgrowths of tissue– 20 percent of population

• Exostoses – Enlargement or nodular outgrowth

23

Developmental Disturbances

• Fordyce spots– Granules in the oral cavity– 80 percent of population

24

Developmental Disturbances

• Fissured tongue

• Bifid tongue – Extra tag of muscle

• Ankyloglossia, or “tongue-tied”

25

Nutritional Disturbances

• Angular Cheilitis – Deficiency of vitamin B– Lesions in the corners of mouth

• Glossitis – Deficiency of vitamin B– Inflammation of the tongue

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Neoplasms• Neoplasms is the medical term for tumor

– Benign tumors– Malignant tumors

• Great potential to become malignant

• Inform dentist – Without alarming patient

27

Oral Cancer Warning Signs

• Sores

• Lumps and swelling

• White or rough lesions

• Dryness in the mouth

28

Oral Cancer Warning Signs

• Numbness

• Burning sensation

• Difficulty speaking, chewing, swallowing

• Repeated bleeding in the same area

29

Types of Neoplasms

• Leukoplakia – White, leathery patch that cannot be

identified as any other white lesion– Biopsy required for further identification

30

Types of Neoplasms• Lichen Planus

– Initially appear on lower leg or ankle– Oral lesions begin as small, white papules

that group and form interlacing white lines known as Wickham’s striae.

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Types of Neoplasms

• Erythroplakia – Red patch of tissue, very dangerous

• Squamous Cell Carcinoma– Cancer of the squamous epithelium– Benign form called Papilloma

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Types of Neoplasms

• Basal Cell Carcinoma – Most common form of skin cancer

• Papilloma – Benign lesion of the squamous epithelium

• Fibroma – Benign tumor of connective tissue cells

33

Oral Lesions Related to AIDS and HIV

• Hairy leukoplakia – Raised, white-patch lesion

• Candida Albicans– Fungal Infection

• Kaposi’s Sarcoma– Vascular tumor– Blue-purple lesions

34

Miscellaneous Disorders• Acute Necrotizing Ulcerative Gingivitis

– Tissues bleed, are infected, painful, foul odor

• Mucocele – Trauma occurs to a minor salivary gland

35

Miscellaneous Disorders• Varix

– Weakened blood vessels

• Geographical Tongue – Inflammatory patches on the tongue – Resembles a map of the world

36

Miscellaneous Disorders• Anorexia/Bulimia

– Decalcified teeth – Eroded enamel – Deterioration of existing restorations– Rampant caries

– Enlargement of parotid glands

• Bell’s Palsy – Temporary paralysis on one side of the face