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Oral med OSCE, Human papilloma virus, Herpes simplex, Leukoplakia,…

- - - - Desquamative gingivitis
    - - Tx: corticosteroid for symptoms - spitting out excess is very important!!
    - - Pemphigoid
        Pemphigus
        acute gingivitis
        Nutritional deficiencies
- - - - Pseudomembranous Candidosis
        
        white pseudomembranous slough
        
        can be scraped off and RAW area underneath
    - - Erythematous Candidosis
        
        symptomatic/ maybe misdiagnosed as nutritional deficiency
    - - Angular Chelitis
        
        differ from cold sore - CS can be sore blisters that scab, AC is
        
        cause: wrinkling lead to moist environment
        
        vaseline
        
        can be associated with poorly fitting denture and loss of OVD
    - - Median Rhomboid Glossitis
        
        assoicated with smoking and inhaled steroids (need to rinse mouth)
        
        atrophic filiform papiilae
    - - Chronic hyperplastic Candidosis
        
        CANNOT be rubbed off
        
        NOT leukoplakia because antifungal therapy can show so resolution
        
        REQUIRE biopsy
    - - Denture associated erythematous stomatitis
        
        Ill fitting denture - reline? new ones?
        oral hygiene
        remove dentures at night (dry)
        
        practise denture hygiene first before referring to see if need antifungal
- - - - what we are looking for
        
        What are we looking for potential cancer?
        nonhealing ulcers, exophytic, indurated margins,
        red, white
        
        who is more likely to get cancer
        
        Who is more likely to get cancer?
        genetic, alcohol, smoking, dietary, viruses e.g. HPV, Epstein-barr virus
  - - - depends on
        
        tumour size
        metastasis
        nodal size and spread
        
        chemotherapy
        
        e.g. methotrexate
        
        surgery : excision with a margin of normal tissue
        
        radiotherapy
        
        Reversible: mucositis, loss of sense of taste
        Irreversible: salivary gland damage, osteoradionecrosis, radiation caries, trismus, decreased healing
        
        radiation caries
        
        Osteoradionecrosis
- - - - 3rd decade, round 2-3mm tends to fuse, most non-kertainised oral site, 7-14 days
    - - 80%
        
        late teens/early 20s, 1-5, 7-14 days healing, <10mm, non-keratinised , round
        
        Management:
        steroid cream/mth washes in severe cases
        Topical anaesthetic paste/mth wash
        antibacterial mth rinse
        reduce stress, avoid aggravating foods
        
        Benzocaine, Dexamethasone elixir
        
        refer to gp for gi issues
    - - 1st decade/puberty, 1-10, >10mm, irregular/oval, 2-12 weeks, most oral sites
- - - - Secondary infection: Shingles
        
        reactivation along dermatomes and trigeminal nerve
- - - - asymptomatic/discomfort/ burning
      - idiopathic
    - - DD
        
        Candidosis
        
        OLP
        
        Leukoplakia
        
        Lupus Erythematosus
- - - - tx: fluid intake, no evidence for antivirals
- - - - Tx: Duration 3-4 sweeks minor cases, self limiting, can recur
      - tx: supportive therapy for dehydration, analgesia, topical/systemic steroids
      - can have body lesions too