Oral Swelling

• What do we consider when assessing an oral swelling?


  • site
  • persitent/recurrent
  • single/multiple
  • ulcerations
  • colour, temperature
  • texture
  • lymphadenopathy
  • duration
  • static/enlarging
  • symmetry
  • dischaarge/bleeding
  • surface
  • margins
  • fluctuation
  • transillumintation?
• further assessment of oral swelling?

  • adjacent teeth for caries/vitality
  • bone
  • possible aetiology
  • systemic symptoms eg weight loss, malaise, pyrexia, lymphadenopathy
  • habits eg smoking/drinking
• types of swelling?


  • bony
  • mucosal
  • vascular
  • lymphatic
  • cystic
• torus palatinus

  
• torus palatinus with burn

  
• tori mandibularis

  
• multiple exostoses

  
• squamous papilloma

  
• fibroepthilelial polp

  
• haemangioma/vascular malformation

  
• traumatic swellings?


  • fibrous overgrowth/polyps
  • denture granuloma
  • epulis
  • mucocoele
  • haematoma
• chronic traumatic swelling

  
• traumatised fibroepithelial polp

  
• denture hyperplasia and maxillary cyst

  
• mucocoele

  
• mucocoele on ventrum of tongue

  
• inflammatory swelling?

  • infection
  • pyogenic granuloma
  • pregnancy epulis
  • allergic swelling
  • orofacial granulomatosis/Crohns disease
• dental abscess with sinus onto skin

  
• denture stomatitis and hyperplasia

  
• viral papillomas

  
• pyogenic granuloma

  
• pregnancy epulis

  
• allergy to tin

  
• orofacial granulomatosis/crohns disease

  
• drug induced swelling?

  • calcium channel blockers
  • ciclosporin
  • phenytoin
• drug-induced hyperplasia - nifedipine

  
• lipoma benign tumour of fat cells

  
• fibroma benign tumour

  
• benign salivary gland tumours

  
• when to refer?

  • isolated persistent lesion of unknown cause and no other aetiology
  • rapid increase in size
  • altered sensation
  • pigmented lesions
  • ulcerated surface
  • bleeding
  • induration
  • fixation to overlying structure
  • lymphadenopathy
• SCC

  
• SCC

  
• SCC