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Nicotine Stomatitis -Painless response of the palatal mucosa to chronic heat exposure usually from pipe or cigar smoking -Caused by inflammed minor salivary glands and ducts and production of excess keratin -Treatment if smoking is stopped, it should resolve on its own. -Is only a pre-malignant sign if reverse smoking is occuring (lit end in mouth) #nofilter

22. Fissured tongue -A benign condition caused by deep grooving of the dorsum of the tongue -Can occur with xerostomia and migratory glossitis (geographic tongue) -May have a burning sensation associated with it -Treatment tongue scraper for bad breath, otherwise no treatment

23. Leukoplakia -A condition where areas of keratosis appear as adherent white patches on the oral mucosa -Means white patch and is the diagnosis used when all other possibilities have been ruled out -Must biopsy (rule out dysplasias) refer to oral surgery -Really crisp and defined margins, cannot be wiped off -Papilloma appearance (wart like) can be pre-cancerous -This is a pre-malignant lesion that usually occurs in smokers or users of smokeless tobacco -Treatment monitoring for change and biopsy, smoking cessation therapy if needed

24. Geographic tongue (benign migratory glossitis) -An inflammatory condition of the mucous membrane of the dorsal tongue -Loss of the filiform papilla and a bald spot appears on the tongue resembling a mapping of the tongue -Can change over time and may present with a burning sensation -Treatment no treatment, completely benign and normal condition

25. Foliate Papilla -Short vertical folds on the posterior lateral side of the tongue -The underlying lingual tonsils are what can cause the enlargement of the foliate papilla -They are bilateral and symmetrical. They can also be of varying size (large or inconspicuous) -Treatment No treatment necessary. If the patient has an inflammed side of lateral tongue (asymmetric), it is the safe way to obtain a biopsy (rule out squamos cell carcinoma)

26. Mandibular tori -A bony growth in the mandible along the surface nearest to the tongue -Treatment no treatment needed. Tori need to be removed before fabricating an RPD

27. Parulis or a sinus tract (gumboil) -A dental abscess, that has converted to a cyst with chronic drainage through a fistulous tract -A parulis is the elevated spot at the site of the draining sinus tract -Treatment endo or extract tooth associated with the sinus tract

28. Pericoronitis -Inflammation of the soft tissue surrounding the crown of a partially erupted tooth -Pericoronitis is most commonly seen in younger adults during the age that their wisdom teeth are first erupting (the mandibular wisdom teeth are the most commonly affected teeth)

-Treatment - If the patient is so swollen you cant get them numb, remove the opposing wisdom teeth and rinse with chlorhexidine -Otherwise just rinse with chlorhexidine until inflammation is resolved, then removed the affected tooth

29. Actinic Lentigo -A small, pigmented spot on the skin with a clearly-defined edge, surrounded by normal skin -It is a harmless, benign, hyperplasia of melanocytes -This differentiates lentigos from ephilides (freckles have an abundance of melanin, not melanocytes) -Treatment no treatment necessary, although you need to adapt the ABCDEs of melanoma to differentiate lentigo from something precancerous A asymmetry B - border C - color D - diameter E evolving over time

30. Antral psuedocyst -Floor of the sinus is lifted up (cyst is not in the sinus) -If you actually have a cyst or mucocele in the sinus, they can be really destructive -Treatment no treatment needed as long as it is not a true cyst and it remains attached to the sinus floor

31. Epulis Fissuatum (denture induced fibrous hyperplasia) -A benign fibrous hyperplasia of connective tissue which develops as a reactive lesion to chronic mechanical irritation produced by the flange of a poorly made denture -Excess folds of tissue are created by constant rubbing up against the denture -Treatment excise and make a new denture. This is not a sign of cancer

32. Hairy Tongue -A condition which presents with defective desquamation of the filiform papillae that results from a variety of specific factors -Filiform papillae elongate with typical and brown or black color to them -Factors affecting hairy tongue are constant trauma to tongue with thermal stimulus, smoking, poor oral hygiene, and use of broad spectrum antibiotics -Treatment chlorhexidine and tongue scraper

33. Scattered ephilides with sebaceous hyperplasia -Sebaceous hyperplasia presents with oily complexion, small, doesnt bleed or grow -Sebaceous hyperplasia is a condition in which the sebaceous (oil glands of the skin) become enlarged and yellow, they can also resemble a cauliflower appearance (similar to a wart) -They closely resemble basal cell carcinoma -How you differentiate is by squeezing them and pus will come out if it is a sebaceous hyperplasia (basal cell will not ooze pus) -Ephilides (freckles) are tanned macules found on the skin, usually found on fair skinned people -No treatment is needed for either of these conditions

34. Palatal torus -A bony protrusion on the palate and is usually located on the midline of the hard palate -Torus palatinus can be of different sizes and can grow over time -Needs to be removed before RPD, otherwise no treatment are needed

35. Varix -An abnormally dilated or swollen vein, artery, or lymph vessel -Diagnosed by diascopy (glass side with blanching) -Blanching will not occur with blood clot or thrombosis, a varix will blanch -Can be treated by conservative excision if esthetically unappealing or traumatized frequently

36. Dermatosis Papillosa Nigra -A condition of the face in dark skinned individuals that presents as many small, benign skin lesions that increase in number as a patient ages -Treatment No treatment, unless the patient finds these unappealing or unesthetic. You can then excise them by curettage, cryotherapy, or laser therapy -If you excise these, the pigmentation will not come back (patient will have white spots on skin)

37. Traumatic Ulcer -An ulcer is any sore or open lesion in the mouth that occurs on the mucous membrane -Results in a loss of continuity of an epithelial or epidermal barrier -Can be either traumatic or cancerous (if the ulcer does not heal for weeks or months) -Diagnosis measure ulcer and bring back in 7 days (bigger = cancerous) -If you can feel a tumor or mass below it, get same day biopsy -Treatment no treatment, can be managed with OTC orajel or topical anesthetic if painful

38. Fordyce Granules -ectopic sebacecous glands (normally associated with a hair follicle) -They are small, painless, pale, raised, red or white spots 1-3 mm in diameter -Treatment no treatment is necessary unless for cosmetic purposes

39. Recurrent Herpes Labialis -An infection of the lip caused by the herpes simplex virus -An outbreak typically causes small blisters or sores on or around the mouth (referred to as cold sores) -The typical outbreak lasts around 2-3 weeks -Treatment if still has vescicles, prescribe valcyclovir or acyclovir

40. Idiopathic osteosclerosis -An asymptomatic, radioopaque area usually around the roots of teeth (typically a molar or premolar) -no clinical expansion, no clinical symptoms -lamina dura on associated tooth is completely intact and in place -It may be as a result of previous trauma or infection -Tooth is vital

-Treatment routine follow-up to see if changes have occurred, no treatment otherwise

41. Telengectasia (spider veins) -Small dilated blood vessels near the skin or mucous membranes -Sun exposure and liver damage are the causes of these, but can also arise from congenital or other acquired reasons -Diagnose with diascopy (will blanch since blood remains in vein) -These by themselves are harmless, but can be associated as a symptom of another underlying disease -Treatment laser therapy or, vein can be hardened and shrunk with sclerotherapy

42. Linea Alba -A horizontal streak on the inner surface of the cheek level with the biting plane -It is a very common finding and is associated with sucking, pressure, or biting of the cheek in one certain area -Treatment none

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