Abnormal Oral

Pathologies

 Important things to understand about

abnormal oral pathologies:
 Lesions should never be in mouth longer
than 7-10 days. If it is there longer than that
go to the dentist.
 If you notice a lesion that is not healing and
is red and white go to the dentist
 The longer you wait to see the dentist the
worse the prognosis gets.
 If you notice an area in your mouth that
has changed, note when it happened, if
possible how it happened and monitor it for
7-10 days.
 Its better to be cautious about a lesion and
get a specialists opinion than ignore it and
allow it to get worse.
 Candidiasis
(Oral Thrush)

 Oral Candidiasis is a yeast or fungal infection that

occurs in white bumpy patches all throughout the
mouth and tongue.

 There is a healthy amount of fungus throughout the

body and mouth that is controlled by the bacteria in
your body. When that bacteria becomes disrupted the
fungus grows uncontrollably.

 Causes of Candidiasis:
 Antibiotic therapy
 Hormonal changes (pregnancy)
 Diabetes that is uncontrolled
 People who smoke
 Corticosteroids
 Cancer
 Medications that cause dry mouth

 Treatment may include taking antifungal medications

and mouthwash.
 Other methods are eating yogurt when you are prescribed
antibiotics and limiting the consumption of foods that
contain sugar and yeast.
 Verruca Vulgaris

 Verruca vulgaris, or what most people know as a common

wart is a benign contagious papillomavirus seen on the hands,
feet, lips tongue and roof of the mouth.

 The wart will have a white pointed look that resembles a

cauliflower. It is rough and hard to the touch.

 The lesions arises from the human papillomavirus, specifically

HPV-2, HPV-4 and HPV-40.

 The most common sites for warts to appear on are hands and
then the warts are spread to the lips and mouth from the
hands.

 Treatment for verruca vulgaris includes:

 Surgical excision, making sure to get to the very base to prevent regrowth
 Laser removal
 Topical salicylic acid on skin warts
 Liquid nitrogen cryotherapy on skin warts

 Removal is important when verruca vulgaris is in the oral cavity

because it could develop on the back of the throat and can
continue to spread.
 Solar Cheilitis
(Actinic Cheilitis)

 Solar cheilitis a precancerous lesion on the lips,

occurring mostly on the lower lip. The lip will become
dry, chapped, thin and white.

 Chronic exposure to sunlight is the main cause of

solar cheilitis.
 It arises mostly on fair skinned people.
 People that work outside or live in a tropical areas are at a higher risk of
developing solar cheilitis

 There isn’t one true treatment for solar cheilitis, but to

prevent it from developing into cancer you can:
 Wear chap stick with sunscreen
 Avoid being out in the sun for long periods of time
 Protect your face with a hat and stay in the shade

 Solar cheilitis can become cancerous if precautions

listed above are not followed and the lips and face
are frequently exposed to sunlight.
 Pyogenic Granuloma

 A pyogenic granuloma is a non cancerous skin growth

that develops quickly and bleeds easily. They are a
reddish purple and the sizes range from very small to
several centimeters.

 Pyogenic granulomas typically arise in teenagers and

young adults, but can develop at any age. It is also
very common to see them in pregnant women.
 When pyogenic granulomas arise in pregnant women they are called
pregnancy tumors.

 Causes of pyogenic granulomas:

 They often occur after an injury or constant irritation
 Hormonal fluctuations in teenagers and pregnant women
 Medications such as birth control , Indinavir and Accutane

 Treatment of a pyogenic granuloma can range from

surgically removing the growth to watching to see if the
growth with regress.
 If growth appears when pregnant, typically to protect the baby you will
wait to see if it goes away after the baby is born.
 Tobacco Pouch
Keratosis

 Tobacco pouch keratosis is a lesion on the lip and or

cheek folds resulting from excess tissue irritation.
Early signs of tobacco pouch keratosis will feel
grainy and have with small wrinkles. Areas that have
been exposed to tobacco for long periods of time
will look shiny white and corrugated (like
cardboard).

 Tobacco pouch keratosis arises from tobacco being

continuously placed in the lip or cheek fold.
 When tobacco chemicals are being habitually placed on the
tissue there is an increased risk of oral cancer or what we call
squamous cell carcinoma.

 Treatment includes:
 Biopsy to determine if lesion is cancerous
 Rubbing on the lesion to get blood flow to return to area
 Quitting chewing tobacco to help the lesion to heal and return to
normal
 If quitting is not an option moving the tobacco to other areas of
the mouth and not habitually placing it in one place
 Necrotizing Ulcerative
Gingivitis (NUG)

 Necrotizing ulcerative gingivitis is when the gums become red

and painful that easily bleeds. The gums in-between your
teeth will start to die and will have a craterd look that sloughs.
NUG can be generalized throughout the mouth or be in just
one spot, depending on the severity of the bacterial infection.

 A fever will arise and the patient will have swollen lymph
nodes with bad breath and a metallic taste in their mouth.

 NUG is a bacterial infection and associated with stress. When

the body is under stress it decreases the bodies immunity and
resistance to infection causing the bacteria to flourish.

 Other factors that may cause NUG consist of:

 Poor oral hygiene
 Deficient in nutrients from poor nutrition
 Additional illness that have lowered the bodies immunity
 Smoking of cigarettes

 Treatment of NUG includes:

 Removing the bacteria by debriding the gingiva, usually done with
anesthesia to lessen the pain
 Use of antibiotics to help clear up the harmful bacteria and fever
 Rinsing the mouth out with either chlorhexidine or salt water to help
remove the bacteria