Chapter 17: oral pathology

Disturbances in Tooth Development and Eruption

Ameloblastoma- A tumor composed of remnants of the dental lamina that failed to disintegrate after the tooth buds were formed Anodontia- is the congenital absence of teeth Supernumerary teeth-are any teeth in excess of the 32 normal permanent teeth Macrodontia- abnormally large teeth Microdontia- abnormally small teeth Dens in dente- a tooth within a tooth

Disturbances in lip, palate, and tongue development

Ankyloglossia: also known as tongue tie, results in a short lingual friend them that extends to the Apex of the tongue this limits the movement of the tongue

ankylosis

Ankylosis are deciduous teeth in which the bone has fused to the cementum and Dentin

Role of the Dental Assistant

Be able to recognize the differences between normal and abnormal conditions that appear in the mouth for example while taking radiographs or impressions the dental assistant might notice a lesion in the patient's mouth that appears abnormal the dental assistant would then inform the dentist so that a diagnosis could be made

Laboratory Diagnosis

Blood chemistries and other laboratory tests including urinalysis can provide information that leads to a diagnosis

Dental Implications of chemotherapy

Chemotherapeutic agents are powerful drugs that destroy or deactivate rapidly dividing cancer cells. The significant adverse effects of these drugs frequently involve the oral tissues

developmental disorders

Congenital disorders are present at birth

Lesions extending below mucosal surface

EROSION of the soft tissue is a shallow injury in the mucosa caused by mechanical trauma, such as chewing. ABSCESS is a collection of pus in a specific area. CYST Is a fluid or semi solid, fluid filled sac.

Lesions even with mucosal surface

Ecchymosis, which is a medical term for bruising

Environmental factors

Environmental factors that have a negative effect on development are called Teratogens

Leukoplakia

General term that means "white patch"

Lesions extending above mucosal surface

Hematoma : similar to a blister but contains blood

Disturbances in Enamel Formation

Hypocalcification- Is the incomplete calcification or hardening of the enamel of a tooth

lesion

Is a broad term for abnormal tissues in the oral cavity lesions of the oral mucosa are classified as to whether they extend below or extend above the mucosal surface, and whether they lie flat or even with the mucosal surface

glossitis

Is a general term that is used to describe inflammation and changes to the tongue. A condition called black hairy tongue may be caused by an oral flora imbalance after antibiotics are administered These elongated papillae become stained by food and tobacco, producing the name black hairy tongue

Candidiasis

Is a superficial infection caused by the yeastlike fungus Candida albicans

Bruxism

Is an oral habit that is characterized by involuntary gnashing grinding and clenching of the teeth often associated with stress or tension

oral cancer

Is one of the 10 most frequently occurring cancers in the world. In the United States the site most often affected is the Vermilion border of the lip

Oral pathology

Is the study of disease is in the oral cavity

smokless tobacco

It is a major concern because of the high rates of pre-cancerous leukoplakia and oral cancer that occur among the users of smokeless tobacco

disturbances in jaw development

Macrognathia: A condition that is characterized by abnormally large jaws Micrognathia: A condition that is characterized by abnormally small jaws Exostosis: is a benign bony growth that projects outward from the surface of a bone a.k.a. Torus Torus palatinus: is a bony overgrowth at the midline of the hard palate Torus mandibularis is a bony overgrowth on the lingual surface of the mandible near the premolar and molar areas

Genetic factors

Malformations are often caused by genetic factors such as abnormalities in the chromosomes

acute inflammation

Minimal and short-lasting injury to tissue

Who can diagnose pathological disease conditions

Only a dentist or physician

Dental Implications of radiation therapy

Osteoradionecrosis radiation also causes a decreased blood supply to the bones of the jaw. this can result in osteonecrosis death of the bone

Historical Diagnosis

Personal history, family history, medical and dental histories, and history of the lesion are often useful in making a diagnosis

Radiographic diagnosis

Radiographs are excellent in providing information about Periapical pathology, internal resorption, and impacted teeth

Abrasion

The abnormal wearing away of tooth structure

orofacial piercings

The dental complications of the practice can include chipped teeth, broken teeth, and serious infection at the sites of piercings

To be classified as Leukoplakia

The lesion should be firmly attached to the underlying tissue, and rubbing or scraping with an instrument should not remove it Leukoplakia often appears before a malignant lesion develops, so early diagnosis and treatment are important

Attrition

The normal wearing away of tooth structure during chewing

geographic tongue

The surface of the tongue loses areas of the Filiform papillae in irregularly shaped patterns. The smooth areas resemble a map thus the name geographic tongue

Therapeutic diagnosis

Therapeutic diagnosis is made by providing a treatment (therapy) and seeing how the condition responds for example: angular cheilitis

Raised or flat lesions

Tumors aka neoplasms A tumor may be benign (not life threatening) or malignant (life threatening)

Microscopic diagnosis

When a suspicious lesion is present, tissue is removed from the lesion and is sent to a pathology laboratory, where it is evaluated microscopically called biopsy.

differential diagnosis

When two or more possible causes of a condition or identified, a differential diagnosis must be made. The dentist will determine which test or procedure should be done to rule out the incorrect cause and make a final diagnosis.

Bulimia

an eating disorder characterized by food binging followed by self induced vomiting. Generalized erosion of the lingual surfaces of the teeth is common in results from the acid produced by frequent vomiting

chronic inflammation

continuous injury or irritation to tissue

Oral cancer warning signs

*Any sore in the mouth that does not heal *Any lump or swelling on the neck, lips, or oral cavity *White or rough-textured lesions on the lips or oral cavity *Numbness in or around the oral cavity *Dryness in the mouth for no apparent reason *Burning sensation or soreness in the oral cavity for no apparent reason *Repeated bleeding in a specific area of the oral cavity for no apparent reason *Difficulty speaking, chewing, or swallowing

clinical diagnosis

A clinical diagnosis is based on the clinical appearance of the lesion, including the color, size, shape, and location. Examples of conditions diagnosed on the basis of clinical appearance are fissured tongue

surgical diagnosis

A diagnosis is made on the basis of findings from a surgical procedure

Pseudomembranous Candidiasis

A white curdlike material is present on the mucosal surface Aka THRUSH

aphthous ulcers

AKA canker sores occur as a common form of oral mucosal ulceration