1. Chapter 20 Unit 4 Oral Pathology
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

2. Biological Agents Actinomycosis is an infection caused by bacterium.
Painful swelling, pus, and yellow-granule discharge.
Poor oral hygiene or microorganisms obtaining access to the bone through the dental socket after a tooth removal are thought to be contributing factors.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

3. Biological Agents Herpes simplex Type I (above the waist)
Usually in the form of a cold sore; called herpes labialis
Type II (below the waist)
Commonly called genital herpes
Herpetic whitlow: a crusting ulceration on the fingers or hands that is extremely painful
Dental assistants must exert extreme care while working with patients who have herpes
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

4. Herpetic Whitlow
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

5. Herpes
Oral lesions
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

6. Biological Agents
Aphthous ulcers are common ulcerations that recur in the oral cavity.
Appear circular with yellow centers and erythematous (red) halos surrounding lesions.
Patients refer to them as canker sores.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

7. Biological Agents
Herpes zoster appears as unilateral, painful lesions that can last up to five weeks.
Causes varicella in children; may lie latent and then activate at a time when the person is immunodeficient.
Human immunodeficient virus (HIV) and advanced cancer patients are predisposed to herpes zoster.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

8. Herpes Zoster
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

9. Biological Agents
Syphilis, the venereal disease caused by bacteria that may be treated with antibiotics, has three primary stages.
First stage shows with a primary lesion about one-half inch in diameter that is hard and raised.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

10. Biological Agents Syphilis
Second stage begins with flu-like symptoms, followed by one of two types of lesions that are extremely infectious.
Third stage: a gummy or localized lesion appears (may occur many years after nontreatment).
Destroys bone and cartilage
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

11. Biological Agents Syphilis
Children who are born to mothers with syphilis
Hutchinson’s incisors and mulberry molars
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

12. syphillis
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

13. Biological Agents
Thrush is the common name for the fungal infection of candidiasis in children. It appears as a white, thick covering over the oral mucous membranes.
Often originates as the newborn travels through the birth canal.
Treatment is to wipe the involved area and apply topical antifungal drugs to the area.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

14. Thrush/ Candidiasis
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

15. Physical Agents Denture irritation causing hyperplasia
An ill-fitting denture can cause small ulcers that, after continued irritation, become folds of excess tissue called hyperplasia.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

16. Physical Agents
Amalgam tattoo can occur when amalgam particles become trapped in the tissue, either during oral surgery, an amalgam application, or crown preparation procedure.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

17. Physical Agents
Radiation injury is when a patient receives too much radiation.
Teeth may be malformed, dwarfed, or without roots, depending on the stage of development.
Tissue within the area may appear pigmented.
Spiderlike vessels may appear in skin that appears to be atrophied.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

18. Chemical Agents
Aspirin burns occur when people place an aspirin over the root area of the tooth to alleviate pain prior to seeking dental care.
Nicotine stomatitis is where chemicals from tobacco and heat affect tissues inside the mouth (usually pipe smokers).
Hyperkeratinized tissue
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

19. Aspirin Burns
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

20. Nicotone
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

21. Chemical Agents
Chewing tobacco (snuff) lesion appears in the oral vestibule (normally the lower anterior area between lip and teeth).
Appears as wrinkled, white, thickened tissue
Hairy tongue is a condition where the filiform papillae of the tongue become elongated and appear like hairs.
Gingival hyperplasia occurs when the connective tissue grows over the teeth.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

22. Hairy Tongue
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

23. Epilepsy
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

24. Hormonal Disturbances
Pregnancy gingivitis is where the gingival tissues appear enlarged and inflamed (occurs 5 percent of the time).
Some pregnant women also develop tumors.
Both of these clear up after hormonal balance returns to normal.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

25. Hormonal Disturbances
Pyogenic granuloma is the overgrowth of granulation tissue.
Puberty gingival enlargement is where adolescents may develop swollen gingival tissues (like pregnancy gingivitis) that will disappear after normal hormone balance returns.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

26. Disturbances in Tooth Development
Amelogenesis imperfecta is a genetic condition of the teeth in which the enamel is discolored, partially missing, or very thin.
Ankylosis is a condition in which the tooth, cementum, or dentin fuses with the alveolar bone, restricting movement of the tooth, as well as eruption.
Dentists may have to use a handpiece and a bur to separate the tooth from the bone to remove it from the socket.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

27. Amelogenisis
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

28. Disturbances in Tooth Development
Anodontia occurs when teeth are congenitally missing.
Dentinogenesis imperfecta is a condition in which the enamel appears to be opalescent and chips away from the dentin soon after eruption of the tooth.
Fusion is a condition in which the enamel and dentin of two or more individual teeth join together.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

29. Anodontia & Fusion
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

30. Disturbances in Tooth Development
Gemination may appear much like a fusion, but in this case a single tooth bud attempts to divide.
Macrodontia teeth are abnormally large.
Microdontia teeth are abnormally small.
Neonatal teeth are present at the time of birth or within the first month after birth.
Sheds quickly (roots have not yet formed)
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

31. Gemination, Microdontia
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

32. Disturbances in Tooth Development
Supernumerary teeth are extra teeth that appear dwarfed in size and shape but normal in all other aspects.
Twinning is a condition in which the gemination process has been successful and two separate teeth are made from one tooth bud (appears as a clone of the original tooth in both shape and size).
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

33. Supernumerary
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

34. Developmental Disturbances
Oral tori are boney outgrowths of tissue in the oral cavity that are benign in nature.
Exostoses is an enlargement or a nodular outgrowth of dense lamella bone that appears on the facial surfaces of the mandibular and maxillary palates.
Fordyce spots (granules) are numerous light-yellow spots in the oral cavity.
80 percent of population have them.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

35. Tori
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

36. Fordyce
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

37. Developmental Disturbances
Fissured tongue has a wrinkled, deeply grooved surface.
Bifid tongue is where the two lateral halves of the anterior two-thirds of the tongue fail to fuse completely (extra tag of muscle at the end of the tongue).
Ankyloglossia, or “tongue-tied”
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

38. Bifid & Fissured
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

39. Nutritional Disturbances
Glossitis is the inflammation of the tongue.
Angular cheilitis is caused by a deficiency of vitamin B, which causes lesions in the corners of mouth.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

40. Neoplasms This is the medical term for tumor.
These groups of lesions have great potential for becoming malignant.
Dental assistants should be knowledgeable and act on recognition; could save a patient’s life if detected early.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

41. Oral Cancer Warning Signs
Sore inside mouth that does not heal in a month
Lumps/swelling in the mouth, on lips, or at neck
White or rough lesions in the mouth or lips
Dryness in the mouth for no apparent reason
Numbness in or around the mouth
Soreness or burning sensation in/on mouth
Difficulty speaking, chewing, or swallowing
Repeated bleeding in a specific area of the mouth for no apparent reason
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

42. Examples of Neoplasms
Leukoplakia is a white, leathery patch that cannot be identified as any other white lesion.
A biopsy is required for further identification.
Usually, results show hyperkeratinization.
Could also show dysplasic cells.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

43. Examples of Neoplasms
Lichen planus appear normally on the lower leg or ankle (lesion is flat and dark violet).
Oral lesions begin as small, white papules that group and form interlacing white lines known as Wickham’s striae.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

44. Examples of Neoplasms
Erythroplakia is any red patch of tissue in the oral cavity that cannot be associated with inflammation; very dangerous lesion.
Squamous cell carcinoma is a cancer of the squamous epithelium.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

45. Examples of Neoplasms
Basal cell carcinoma is the most common form of skin cancer; normally appears on the neck, ear, face, lip, and head due to exposure to sun rays.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

46. Examples of Neoplasms
Papilloma is a lesion of squamous epithelium tissue that is benign in nature.
Fibroma is a benign tumor of connective tissue cells. It is a reactive hyperplasia rather than a true neoplasm.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

47. Oral Lesions Related to AIDS and HIV
Hairy leukoplakia are raised, white-patch lesions identified in patients with HIV.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

48. Oral Lesions Related to AIDS and HIV
Candida albicans is an infection found in patients with AIDS, patients who have had cancer treatments, or patients who are immunodepressed.
Kaposi’s sarcoma is an unusual malignant vascular tumor.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

49. Miscellaneous Disorders
Acute necrotizing ulcerative gingivitis (ANUG) is a condition where tissues present with bleeding, infection, pain, and foul odor.
Seen in young adults and teens
Mucocele is when a trauma occurs to a minor salivary gland.
Usually found on the mandibular anterior lip
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

50. Mucocele
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

51. Miscellaneous Disorders
Varix is a condition primarily seen in the elderly. The normal blood vessels become weakened and extended.
Geographical tongue is an
inflammatory condition where
patches on tongue resemble a
map of the world.
Bell’s palsy is a temporary paralysis of the muscles on one side of the face.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

52. Miscellaneous Disorders
Anorexia nervosa is a disease where loss of 15 percent of body weight occurs, and there is an intense fear of being fat.
Bulimia is out-of-control eating followed by vomiting.
Lingual surfaces of anterior teeth become decalcified, and enamel is eroded, causing existing restorations to deteriorate.
Rampant caries and enlargement of parotid glands are also present.
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.

53. Trick or Treat
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.