Oral Pathology

Oral Pathology

·        Same pathology in the mouth as with skin, mucosa, nerves, blood vessels, etc. But also specialised stuff

·        Teeth and Teeth forming tissue:

o  Genetic defects

o  Severe illness eg measles ® bands on teeth

o  Tetracycline ® discolouration 

o  Vomiting, regurgitation (eg bulimia) ® erosion

o  Cysts or tumours of teeth forming tissue (eg ameloblastoma)

o   Gums: loose more teeth through gum disease than caries. Immunosuppressive disease can lead to abnormal gums (eg leukaemia)

·        Salivary glands:

o   Calcification in duct of major gland ® blockage

o   Tumours/cysts

o   Recurrent infections: short/wide ducts ® retrograde flow ® infection with oral commensals

o   Post-radiotherapy to head and neck.  Salivary tissue very sensitive ® dry mouth

o   Drug induced dry month: made worse by anxiety, smoking, dehydration

o   Sjogern‟s Disease: autoimmune attack of salivary and lacrimal glands 

o   Dry mouth ® rapid tooth decay (no buffering from saliva)

·        Oral Mucosa:

o   Hyperkeratosis with hyperplasia or atrophy: looks white

o   Upsets to normal flora. Eg candida overgrowth. Can lead to loss of papilla (atrophic candidiasis), hyperkeratosis

o   Ulceration: lots of causes: eg trauma (new dentures, burns), herpes, Aphthous ulcers (if recurrent then check ¯serum ferritin, hormonal cycle, stress, food allergy [eg benzoic acid in Coca Cola], heredity)

o   White lesions (due to thickened keratin layer):

o   Lichen Planus: white patches surround by red erosions

o   Lichenoid drug reactions 

o   Malignant and premalignant (eg leukoplakia - white, erythroplakia – red). Eg squamous cell carcinoma. Related to smoking – 60 – 75% of white lesions go away if they stop