The ADA Practical Guide to Soft Tissue Oral Disease

Michael A. Kahn, J. Michael Hall

• Publisher: Wiley-Blackwell
• Year: 2018
• Print ISBN: 9781119437338
• eBook ISBN: 9781119437307
• Edition: 2
• Topic: Medicine
• Subtopic: Dentistry

The ADA Practical Guide to Soft Tissue Oral Disease, Second Edition is a fully updated new edition of this popular guide to oral and maxillofacial diseases likely to be encountered in general or specialist dental practices.

• Easy-to-use, updated resource with brief synopses for everyday clinical reference
• Includes self-testing clinicopathologic exercises to help readers further their skills and gain confidence in their knowledge
• Focuses on decision making, from communicating diagnoses to developing and discussing treatment plans
• Presents clinically oriented information on the most important aspects of common oral and maxillofacial diseases
• Features detailed color illustrations, treatment algorithms, differential diagnosis, and case examples with discussion

Section II
Diagnosis and Management

3
Common Oral Soft Tissue Lesions

White Lesions

1. White‐coated tongue (Fig. 3.1)
   • Site – Tongue dorsum.
   • Morphology – Thin film or plaque from sloughing keratin.
   • Color – White.
   • Signs and symptoms – Can be scraped off with difficulty. Some diffuse lesions cannot be scraped off.
   • Treatment – Brush tongue daily to minimize accumulation of bacterial debris and keratinized slough.
2. CandidiasisAcute pseudomembranous type (also called thrush) (Fig. 3.2)
   • Site – Buccal mucosa, palate, and dorsal tongue are most common.
   • Morphology – Plaques composed of tangled masses of hyphae, yeasts, desquamated epithelial cells, and debris.
   • Color – Creamy white.
   • Signs and symptoms – Resembles cottage cheese or curdled milk; can be scraped or rubbed off with dry gauze, leaving an underlying pink or red mucosa. There may be no symptoms or a mild burning sensation or an unpleasant “salty” or “bitter” taste. Thrush can be initiated by impairment of the immune system or by broad‐spectrum antibiotics, which eliminate competing bacteria.
   • Treatment – Prescription of antifungal agents: cream, ointment, liquid, and tablets.
   Chronic hyperplastic type (candidal leukoplakia) (Fig. 3.3)
   • Site – Usually anterior buccal mucosa; tongue.
   • Morphology – Plaque.
   • Color – White.
   • Signs and symptoms – Cannot be scraped off and so cannot be clinically distinguished from leukoplakia. Candidal leukoplakia often can have a red component intermingled (i.e. speckled leukoplakia).
   • Treatment – Antifungal agents (cream, ointment, liquid, tablets). If the lesion fails to resolve (essentially confirming the diagnosis), then a biopsy is mandatory.
3. Morsicatio (nibbling habit) (Fig. 3.4a,b,c)
   • Site – Most often buccal mucosa (morsicatio buccarum) centered along occlusal plane, also labial mucosa (morsicatio labiorum), and lateral tongue (morsicatio linguarum).
   • Morphology – Roughened, ragged, thickened surface plaque; may also see ulceration and erosion intermixed.
   • Color – White.
   • Signs and symptoms – A conscious or subconscious chronic nibbling habit or, rarely, suction; asymptomatic. The superficial portion (i.e. tissue tags) can be scraped or peeled off but the remainder cannot. Lesions are usually bilateral, with or without other site involvement.
   • Treatment – None required.
4. Thermal burn (Fig. 3.5a,b)
   • Site – Palate or posterior buccal mucosa.
   • Morphology – Red macule (erythema) with ulcer, often with remnant of the epithelium at the periphery.
   • Color – White.
   • Signs and symptoms – Usually results from history of accidental ingestion of hot foods or beverages. Superficial white change can be scraped off or is wipeable due to surface coagulative necrosis.
   • Treatment – Resolves without treatment.
5. Chemical burn (aspirin burn) (Fig. 3.6a,b)
   • Site – All oral mucosal sites.
   • Morphology
     • Mhort exposure time – Superficial wrinkled plaque.
     • Longer exposure time – Surface epithelium becomes separated from underlying tissue, easily desquamates into erosion.
   • Color
     • Short exposure time – White.
     • Longer exposure time – White surface removed, leaving necrotic red, bleeding connective tissue.
   • Signs and symptoms – History of accidental oral mucosal contact with caustic agents such as aspirin, hydrogen peroxide, silver nitrate, phenol, and endodontic materials. Overuse of mouthwashes with high alcohol content can also cause a superficial ...

Table of contents

• Cover
• Title Page
• Table of Contents
• Preface to the Second Edition
• Preface to the First Edition
• Acknowledgments
• Section I: Detection and Documentation
• Section II: Diagnosis and Management
• Section III: Clinicopathologic Exercises
• Appendix A: Glossary of Descriptive Terminology
• Appendix B: Formulary of Over‐the‐Counter and Prescription Medications Based on Disease Classification
• Answers to End‐of‐Chapter Questions
• Index
• End User License Agreement