ORAL PATHOLOGY

Cassandra Ligor

MEDICAL HISTORY

46 year old Caucasian male

No medications

Regular dental visits

No systemic diseases

No contraindications to treatment

INTRA ORAL EXAM

During examination of the tongue and ventral surface of the tongue irregular shaped, flat, red patches were found.

DESCRIPTION OF LESION

Most predominate lesion was found on the ventral surface this was 4mm by

3mm , flat, red, with a white boarder around lesion (ring like) . Lesions on the dorsal surface were similar . Flat

with a more red appearance.

SYMPTOMSNo reported pain Patient has never had a problem with the lesion or condition. Voice WNLSalivary glands and Lymph nodes WNLPatient presented with slight fissured tongue and

ankyloglossia of the tongue. All other intra and extra oral examinations were WNL

NEXT STEP??

Instructor was consulted.

Measurements taken.

Intraoral photo graphs were taken.

Patient was informed.

Follow up questions asked to patient.

•Patient is aware of lesions,

noticed them since he was young ,

never had problem with them , “not always seen in mouth”

Routine care was provided.

DIFFERENTIAL DIAGNOSIS

#1. -GEOGRAPHIC TONGUE (benign migratory glossitis) Benign lesion that typically is found on the tongueUsually effects females more than malesEtiology is unknown can be found on other surfaces of oral cavity but usually is found on the tongueThese lesions present as multiple, well demarcated erythematous areas. This appearance is because of the atrophy(decrease in size) of the filiform papillae.

GEOGRAPHIC TONGUE

DIFFERENTIAL DIAGNOSIS

#2- Geographic Stomatitis (Areata Erythema Migrans)

Inflammation of the mucous lining of soft tissues of the oral cavity. Often associated with fissured tongue.Red angular patches of the labial and buccal mucosa, soft palate and occasional floor of the mouth. The patches are mild erosion of mucosa. Require no treatment Can respond well to topical steroids Occurs at different areas other than tongue, usually.

GEOGRAPHIC STOMATITIS

DIFFERENTIAL DIAGNOSIS

#3- Primary Herpetic Gingivostomatitis

Painful, erythematous and swollen gingiva.

Multiple tiny vesicles.

Systemic symptoms :fever, lymphadenopathy.

Disease most likely in children but can occur at any age.

Lesions heal spontaneously.

P R I M A RY H E R P E T I C G I N G I VO S T O M AT I T I S

PRELIMINARY DIAGNOSIS

GEOGRAPHIC TONGUE

Confirmed by instructor.

Patient reports no pain.

Patches are not always in same areas.

Patient does have some sensitivity to spicy foods, but rare.

Lesions are not severe red in color.

BIBLIOGRAPHYIsben and Phelan: Oral Pathology for the Dental Hygienist 5th edition pg. 8,9 and 130

Langlais and Miller: Color Atlas of Common Oral Diseases 3rd edition pg. 106 and 107

Geographic Tongue: Clinical Characteristics of 188 Cases, estrip.org

Benign migratory glossitis with fissured tongue. Full Text Available By: Goswami, M.; Verma, A.; Verma, M. Journal of the Indian Society of Pedodontics & Preventive Dentistry. Apr-Jun2012, Vol. 30 Issue 2, p173-175. 3p. DOI: 10.4103/0970-4388.100008. Subjects: PEDODONTICS; ULCERS; TONGUE -- Diseases; ASTHMA; TONGUE -- Diseases -- DiagnosisDatabase: Dentistry & Oral Sciences Source

ORAL PATHOLOGY. Full Text Available By: Houston, Glen D. Oklahoma Dental Association Journal. Jul2010, Vol. 101 Issue 5, p28-28. 1p. 3 Color Photographs. Subjects: CASE studies; TONGUE -- Diseases; DISEASES -- Causes & theories of causation; ANTISEPTICS; STEROID drugsDatabase: Dentistry & Oral Sciences Source

THANK-YOU

THE END