Fordyce Granules

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Fordyce Granules

• A common condition in which small yellow dots are
  observed in the oral mucous membrane these
  represent misplaced sebaceous glands once
  properly diagnosed, no treatment is necessary

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Fissured Tongue

• A condition of probable developmental etiology in
  which cracks are observed in the tongue dorsum
  food debris and Candida albicans colonies may
  form in the fissures once properly diagnosed, no
  treatment is necessary.

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Varix

• A fairly-common condition of older people in
  which distended blood vessels are observed on the
  lingual tongue surface once properly diagnosed,
  no treatment is necessary.

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Torus Palatinus

• A hamartomatous overgrowth of bone from the
  midline of the maxilla.

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Torus Mandibularis

• A hamartomatous overgrowth of bone bilaterally
  from the lingual surface of the mandible.

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Exostosis

• Overgrowth of bone (like tori) from a site other
  than the maxillary midline or bilateral lingual
  mandible commonly occur in the buccal maxilla
  adjacent to the bicuspid teeth.

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Nasopalatine duct cyst

• A common true jaw cyst appearing as a
  radiolucency in the maxilla midline just lingual
  to the central incisor teeth (in the incisive
  canal) surgical removal will cure this cyst.

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Oral Lymphoepithelial Cyst

• Uncommon lesion that develops in lymphoid tissue
  in the oral pharynx including the palatine
  tonsils, lingual tonsils, and pharyngeal
  adenoids. They may also arise within accessory
  lymphoid tissue on the floor of the mouth,
  ventral surface of the tongue, and soft palate.
  These small (rarely exceed 1cm) submucosal cysts
  have a yellow or white appearance and feel firm
  on palpation. They contain creamy or cheesy
  keratinous material and are usually asymptomatic
  except when they are traumatized of become
  infected. They may occur at any age but are most
  prevalent in young adults. Cysts rarely recur
  after surgical excision.

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Amelogenesis Imperfecta

• The designation "amelogenesis imperfecta" refers
  to inherited defects in enamel formation. Several
  forms are recognized based on their pathogenesis
  and severity.
• Clinically, affected enamel may be thinner than
  normal (generalized hypoplastic form), may be of
  normal thickness but lacks strength
  (hypocalcified form), or may be pitted
  (hypoplastic pitted form).

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Periapical Cyst

• This cyst is a direct sequela of inflammation of
  the pulp which has extended into the adjacent
  periapical tissues.
• Treatment consists of endodontic therapy or
  extraction of the associated tooth with curettage
  of the cyst.

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Acute Necrotizing Ulcerative Gingivitis

• Poor oral hygiene combined with serious life
  stress and possibly nutritional deficiencies.
  Aka trench mouth. It can be painful, and it is
  characterized by areas where the gum tissue has
  become so inflamed that it has become necrotic.
  These areas will be small ulcers, and will be
  grayish in color, and will tend to slough off.
  The tissue will be generally swollen, and where
  it isn't dead, it will bleed very easily.

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Wipes Off
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Pseudomembranous Candidiasis

• A common fungal infestation of the oral cavity in
  the immunocompromised or antibiotic-treated
  patient. Appears as milky white areas on the oral
  mucosa lesions wipe-off leaving red
  (erythematous) base. Responds well to antifungal
  agents.

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Angular Cheilitis

• Erythema, fissuring, and scaling at the angles of
  the mouth.
• Often in an older person with reduced vertical
  dimension of occlusion
• Caused by C. albicans, S. aureus (in kids Rx
  OTC triple antibiotic ointment), often both.

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Primary Herpetic Stomatitis

• Effected mucosa develops numerous pinhead
  vesicles which collapse to form small, red
  lesions which enlarge and develop central areas
  of ulceration covered in yellow fibrin.
• Adjacent ulcerations may coalesce to form larger,
  shallow, irregular-shaped ulcerations.
• Distinctive punched-out erosions along the
  midfacial free gingival margins

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Recurrent Herpes Labialis

• cold sore or fever blister
• Most common site for recurrence vermillion
  boarder and adjacent skin of the lips
• Small, erythematous papules clusters of fluid
  filled vesicles rupture and crust within 2
  days.

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Recurrent Intraoral Herpes Simplex

• Multiple coalescing ulcerations on FIXED MUCOSA

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Herpes Zoster

• Recurrent infection, often after several decades
• Virus was latent in the dorsal spinal ganglia
• Recurrent intraoral
• Unilateral, severe pain
• Looks like recurrent herpes simplex

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Linea Alba

• Normal variation in the buccal mucosa that
  appears as a white line beginning at the corners
  of the oral cavity and extending posteriorly at
  the level of the occlusal plane. It is composed
  of keratinized oral mucosa.

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Cheek Chewing

• Hyperkeratosis caused by habitual chewing on the
  cheek

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Amalgam Tattoo

• A bluish-black or gray macular lesion of the oral
  mucous membrane caused by accidental implantation
  of silver amalgam into the tissue during tooth
  restoration or extraction.

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Antral Pseudocyst

• The antral pseudocyst is a common and
  well-documented finding on a panoramic
  radiograph. Most are discovered during routine
  radiographic examination and have little clinical
  significance. The antral pseudocyst should not be
  confused with the mucocele of the sinus. The
  antral pseudocyst is believed to be caused by an
  inflammatory exudate that accumulates under the
  maxillary sinus mucosa and results in a sessile
  elevation.

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Aphthous Lesion

• A very common self-limiting, episodic disease of
  unknown origin manifesting as one or several
  painful ulcers on the lining mucosa the ulcers
  heal in 7-10 days with or without treatment.

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Major Aphthous Stomatitis

• Major aphthae are more serious ulcerative disease
  of unknown etiology manifesting as large, deep,
  painful ulcers that leave scars they recur more
  often and persist longer than minor aphthae
  treatment consists of promoting healing and
  alleviating pain.

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Cinnamon Stomatitis

• Contact stomatitis from artificial cinnamon
  flavoring (concentrations of the artificial
  flavoring are up to 100 times that in the natural
  spice). Most common in chewing gum, candy,
  toothpaste.

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Dentifrice Stomatitis

• Superficial epithelial sloughing, no pain or
  bleeding, a reaction to detergent in toothpaste

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Squamous Papilloma

• A common benign neoplasm arising from mucosal
  epithelium appearing as a raised, soft, pink
  lesion with a papillary surface texture some are
  caused by viruses (HPV) surgical excision will
  cure squamous papillomas

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Seborrheic Keratosis

• Extremely common skin lesion of older people and
  represents an acquired, benign proliferation of
  epidermal basal cells. There is a positive
  correlation with chronic sun exposure. Does NOT
  occur in the mouth.

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Does NOT wipe off.
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Idiopathic Leukoplakia

• a clinical white lesion that does NOT rub off
  and cannot be determined to be a specific
  disease.

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Oral Melanotic Macule

• Flat, brown mucosal discoloration produced by an
  increase in melanin deposition. The cause is
  unclear, but is not dependant on sun exposure. A
  solitary, well demarcated, uniformly colored,
  asymptomatic, round or oval macule. Vermillion
  zone of lower lip is the most common site. Can
  occur at any age.

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Stafne Defect

• Asymptomatic radiolucency below the mandibular
  canal in the posterior mandible, between the
  molar teeth and the angle of the mandible.
  Typically well circumscribed and has a sclerotic
  border.
• Developmental in nature, although not present at
  birth.

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Speckled Erythroplakia

• Red and white, or reddish with white spots
• Almost always carcinoma in situ or squamous cell
  carcinoma (not good)

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Smokeless Tobacco Keratosis

• Characteristic white plaque produced on the
  mucosa in direct contact with the snuff or
  chewing tobacco. Typically thin, gray or
  gray-white, almost translucent plaque with a
  border that blends gradually into the surrounding
  mucosa. The usually stretched mucosa appears
  fissured or rippled.

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Actinic Cheilitis

• A common condition caused by excessive exposure
  to sunlight manifesting as a crusting lesion of
  the lower lip it may show evidence of dysplasia
  and superficial invasion however, simple
  excision of actinic cheilosis usually cures this
  condition.

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Squamous Cell Carcinoma

• A common epithelial malignancy of the oral mucosa
  appearing as a red, white, or ulcerated "sore"

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Basal Cell Carcinoma

• A common malignancy of skin, usually of the upper
  face, that invades locally but rarely
  metastasizes.
• Classic" appearance of basal cell carcinoma is a
  central depression and a rolled peripheral
  border. Most basal cell carcinomas are located
  above an imaginary line drawn between the lower
  and upper lips.

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Mucocele

• Easy diagnosis lesion in area of minor
  salivary glands, goes up and down in size
• Duct of salivary gland is severed, mucus leaks
  out into the tissue
• Fast inflammatory reaction, macrophages come in
  to clean it up - Replacement by granulation
  tissue fibroma

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Melanoma

• A very serious malignancy of melanin-producing
  cells in the skin and occasionally of the oral
  mucosa tends to invade and metastasize early

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Ranula

• Large mucocele on floor of mouth (major salivary
  gland, usually caused by blockage)

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Minor Salivary Gland Tumor

• Bump in the upper lip is NOT a mucocele it is
  probably a minor salivary gland tumor
• 50 are malignant!

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Fibroma

• Most common tumor of oral cavity
• Reactive hyperplasia of fibrous connective tissue
  in response to local irritation or trauma
• Most common location buccal mucosa along bite
  line (also labial mucosa, tongue, gingival)
• Smooth surfaced pink nodule, most sessile,
  asymptomatic, most lt1.5cm
• Rx conservative surgical excision

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Four Ps

• Pyogenic granuloma, peripheral giant cell
  granuloma, peripheral ossifying fibroma,
  peripheral fibroma

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Hemangioma

• A common benign neoplasm arising from blood
  vessels manifesting as flat or raised red-purple
  surface discoloration
• Most common tumor of infancy (strawberry
  hemangioma) - rapid growth, but most resolve by
  age 5, almost all by age 9.

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Langerhans Cell Disease

• Growing evidence indicates this is a neoplastic
  process of Langerhans cells. Intraosseous lesions
  may result in radiographic appearance of teeth
  with unsupported bone, often termed teeth
  floating in space.

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Florid Cemento-osseous Dysplasia

• Multiple mixed radiopaque and radiolucent lesions
  of the mandible and maxilla

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Simple Bone Cyst

• A benign, empty, or fluid containing cavity
  within bone that is devoid of an epithelial
  lining. Cause is uncertain, but one theory is a
  trauma-hemorrhage route that causes an
  intraosseous hematoma that may not undergo repair
  but instead may liquefy, resulting in a cystic
  defect.
• Can be a well-delineated radiolucent lesion with
  projections between the roots of vital premolar
  teeth producing a scalloped appearance

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Periapical Cemento-osseous Dysplasia

• It is a self-limiting fibro-osseous process where
  bone appears to react abnormally to some unknown
  stimulation.
• Typical example is multiple radiolucencies at the
  apices of lower anterior teeth - It may be
  mistaken for inflammatory periapical disease.
  Determining tooth vitality will settle the issue
  (teeth are vital)

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Lateral Periodontal Cyst

• An odontogenic cyst arising in the alveolar
  process appearing as a small radiolucency between
  the roots of the adjacent teeth (usually
  mandibular permanent bicuspids).
• Generally quite small and well demarcated.
  Usually adjacent to vital teeth.

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Ameloblastoma

• An uncommon benign jaw neoplasm of odontogenic
  epithelium appearing as an unilocular or
  multilocular radiolucency because of its
  locally-infiltrative growth pattern, this
  neoplasm may be difficult to eradicate.
• Should be suspected when ever a large
  multilocular radiolucent lesion is discovered.
  Most common in the posterior mandible.

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Lichen Planus

• A fairly-common non-neoplastic dermatologic
  condition manifesting as flat, lacy, white,
  intersecting lines on the oral mucosa. Presumed
  autoimmune reaction to basal cells of oral mucosa
  and skin.
• Intersecting white lines (Wickham's striae) may
  be irregular white plaques may be ulceration and
  sloughing in erosive form.

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Bells Palsy

• Facial nerve paralysis on one side of the face