• - any injury to the body; a state of altered structure and/or function of tissues, organs, or cells resulting from injury; a change from the normal structure or functioning of cells, tissues, or organs.

Lesion

-decrease, cessation or temporary stoppage of the symptoms of a disease

- the subjective manifestation of a disease; revealed disease severity

• Melanin pigmentation, retocuspid papilla, lingual varicosities, leukoedema, Fordyce granules, palatal & mandibular tori

• Lingual thyroid, fissured or scrotal tongue, Median rhomboid glossitis, geographic tongue or benign migratory glossitis, Cementoma or cemento-osseous dysplasia, hairy tongue

- PMN’s; first WBC to site of injury; primary cell in acute inflammation, produce lysozymes that break down proteins and destroy bacteria

• mature monocyte; second cell to respond and immigrate; acts as a helper in immune response; functions the same as a PMN and has full phagocytic capabilities.

- act directly against virus infected cells and tumor cells

Treatment: Surgery, radiation, chemotherapy, laser, interferon- now used to treat skin cancer (notes list only chemo and radiation for metastatic tumors.)

The best time for perio debridement for a chemo patient is before beginning chemo. All issues that may interrupt or complicate cancer treatment, or that may interfere with patient comfort should be taken care of before beginning chemo.

The sites of primary tumors that may metastasize to the maxilla/mandible:

• Breast, lung, prostate, kidney, thyroid

The diseases that are nikolsky + and  associated with Epstein Barr:

• Acute candidosis and cicatical pemphigoid and pemphigus vulgaris are N+
• Hairy leukoplakia, candidal leukoplakia= chronic hyperplastic and denture stomatitis and EBV are N-
• Epstein-barr- rheumatoid arthritis, chronic fatigue syndrome and persistent periapical infections with CMV, found in HIV patients

• May be inherited (amelogenesis imperfecta), febrile illness, vitamin deficiency (A,C, or D), infection of deciduous tooth (Turner’s tooth), fluoride, congenital syphilis, injury at birth or premature birth

• Pseudomembranous Candidiasis, hyperplastic Candidiasis, atrophic Candidiasis, angular chelitis, apthous ulcer, recurrent herpetic stomatitis, atypical ulceration, hairy leukoplakia, Kaposi’s sarcoma, papilloma virus lesions, salivary gland disease and xerostomia, non-Hodgkin’s lymphoma, linear gingival erythema, acute necrotizing gingivitis, acute necrotizing periodontitis.

• pernicious anemia, lack of B12 or intrinsic factor, malnutrition, increased metabolic requirements, weakness, fatigue, skin pallor, nausea, dizziness, diarrhea, abdominal pain, loss of appetite, weight loss and painful erythematous and depapillated tongue, oral ulcers and angular chelitis

• - iron deficiency anemia, chronic, possible predisposition to oral absorption, often asymptomatic, weakness, fatigue, skin pallor, angular chelitis, erythematous and depapillared tongue

• Behcet’s syndrome, crohn’s disease, ulcerative colitis, cyclic neutropenia, sprue, intestinal lymphoma

• non-healing ulceration or erosion, leukoplakia and erythroplakia, erythema, induration and fixation, chronicity, Lymphadenopathy, submucosal and neck mass.

A- asymmetry, B- border, C- color, D- diameter, E- evolving or changing, NEVUS: symmetrical, regular border, brown-dark brown, <6mm (smaller than eraser head) MELANOMA: Asymmetrical, irregular border, dark deep red, >6mm or History of growth

• malignant tumor of squamous epithelium that occurs on the skin, non-healing ulcer with rolled borders; 75% of all skin cancer, untreated penetrates subq, penetrates bone and brain, 50% of patients will develop a new cancer within 5 years

• - rapidly enlarging bluish to black mass on skin, rare intraorally, but have occurred on palate and maxillary gingiva, metastasizes early, malignant tumor of melanocytes, age usually over 40

• - malignant tumor of squamous epithelium, MOST common primary malignancy of the oral cavity, invasive to surrounding tissue, metastasized to distant sites- neck, lymph nodes, lungs, liver; Intraoral location- ventro-posterior lateral border of the tongue, floor of mouth, tonsillar pillars, including posterior edge of soft palate, dorsum of the tongue, and palate rugae are rarely involved; Extraoral lesions- vermillion border, skin of face, precursor- Chronic Actinic cheilosis- loss of vermillion border + crusty + opaqueness = skin cancer, types are leukoplakia, erythroplakia, verrucous carcinoma

• sun exposure, family history, blonde or red hair, marked freckling on the upper back, >3 blistering sunburns before age 20, >3 years of outdoor summer jobs as a teen, presence of actinic keratosis; precursor lesions- changing mole, congenital mole, dysplastic mole; Treatment- surgery, radiation, chemotherapy, prognosis poor, 100% mortality if not treated.

• - Sun exposure; treatment: biopsy, excision/interferon injections in early stages; prognosis: good, usually does not metastasize, very invasive and can kill by invasion.

  - tobacco use, alcohol use, fair skin, sun exposure, chronic actinic cheilosis, chronic iron deficiency/anemia, immune system defects, chronic lichen planus?? (check this) Treatment: remove irritation, treat fungal infection or Autoimmune disease, biopsy, excision

• Manifestations: oral cancer, leukoplakia, erythroplakia, snuff dipper’s pouch, smoker’s palate, smoker’s lip, smoker’s melanosis, tooth loss, tobacco stains, tooth abrasion, periodontitis, gingival recession, ANUG, gingival bleeding, halitosis, leukoedema, chronic hyperplastic Candidiasis, median rhomboid glossitis, hairy tongue, lichen planus, salivary changes, loss of taste and/or smell

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  1. Ask about tobacco use, relate it to overall health
  2. Advise users to quit in a clear, strong and personalized manner
  3. Assess willingness to quit- if yes, suggest aid and encourage them
  4. Assist in quit attempt- ex. Prep for quitting, pharmacological aids, support groups, pamphlets, educate patient
  5. Arrange- schedule a follow-up contact, and actions to be taken, set a date