Oral Med

• What is the location of the ulcer in the patient?

  Lateral border of the tongue
• What is the initial approach to assess the lesion?

  • Use the listen, look, feel approach
  • Gather medical, social, diet, and family history
  • Identify potential risks/causes of the lesion
• Why should the word 'cancer' be used carefully during assessment?

  To avoid worrying the patient prematurely
• What should be reviewed in the patient's medication list?

  Potential effects on the lesion
• What habits should be assessed regarding tobacco use?

  Smoking or chewing tobacco history
• What is the risk factor increase for cancer due to smoking?

  3-fold increase
• What is the combined risk factor increase for cancer with smoking and alcohol?

  38-fold increase
• What conditions can cause ulceration?

  Diabetes, xerostomia, Sjögren's syndrome
• What is the purpose of a full intraoral examination?

  To check for other signs of infection
• What characteristics of the lesion should be noted?

  Size, shape, color, and texture
• What should be assessed regarding the ulcer's pain?

  Type of pain and aggravating/relieving factors
• What sensation disturbances should be inquired about?

  Taste or sensation disturbances
• What should be palpated during the examination?

  The texture of the ulcer
• What signs of discharge should be looked for?

  Blood, pus, or clear fluid
• What should be done for documentation of the lesion?

  Take clinical photographs and radiographs
• When should a patient be referred to oral medicine?

  For a biopsy of the lesion
• What are the characteristics of a malignant lesion?

  • Large or rapidly growing ulcers
  • Persistent ulcers not healing in 2-3 weeks
  • Multiple ulcers present
  • Severe pain or discomfort
  • Bleeding easily or excessively
  • Unusual locations for ulcers
  • Isolated persistent lesions with no known cause
  • Altered taste or sensation
  • Pigmented surfaces
  • Crater-like ulceration
  • Presence of bleeding, pus, or leakage
  • Hard and lumpy texture
• What are the signs and symptoms of mouth cancer?

  • Non-healing lip or mouth sore
  • White or reddish patch in the mouth
  • Loose teeth
  • Growth or lump inside the mouth
  • Mouth pain
  • Ear pain
  • Difficult or painful swallowing
  • Weight loss
  • Change in appetite
• What is Candida albicans?

  A harmless fungus in the oral cavity
• What factors can lead to opportunistic Candida infections?

  Local and systemic factors
• What are local factors influencing Candida?

  Dentures, smoking, xerostomia, inhalers, antibiotics
• What are systemic factors influencing Candida?

  Immunosuppression and diabetes
• What is the most common form of oral candidiasis?

  Acute pseudomembranous candidiasis
• What does acute erythematous candidiasis appear as?

  Soreness and redness, especially on the tongue
• What does chronic hyperplastic candidiasis appear as?

  White lesions in the mouth
• What is the difference between primary and secondary oral candidiasis?


  Primary is limited to the mouth; secondary affects other body parts
• What are the clinical presentations of acute candidal conditions?

  • Denture stomatitis: red, swollen palate
  • Thrush: white buildup on oral surfaces
  • Angular cheilitis: cracking and soreness at mouth corners
  • Candidal leukoplakia: white speckled markings
  • Median rhomboid glossitis: depapillated red patch on tongue
• What is the management for denture stomatitis?

  Good denture hygiene and antifungal treatment
• What is the management for angular cheilitis?

  Xerostomia management and antifungal treatment
• What is the appearance of candidal leukoplakia?

  White speckled markings on buccal mucosa
• What is the appearance of median rhomboid glossitis?

  Depapillated red patch on the center of the tongue
• What should be done when a mucocoele is suspected?

  Take a full patient history
• What steps should be taken to describe a mucocoele?

  • Full patient history
  • Assess risk factors
  • Use listen, look, feel approach
  • Measure size with dental ruler/probe
  • Note oral tissues bordering the lesion
  • Palpate the lesion for texture
  • Document all findings
• What should be done for follow-up of a mucocoele?

  Consult with the dentist and take clinical photographs
• What is the purpose of taking a swab of the lesion?

  To test it in a lab for diagnosis
• Why is informed consent important during the process?

  To ensure the patient understands procedures
• What should be done to reassure the patient?

  Keep them informed and calm