Oral Medicine

This is a revised edition of a bestselling handbook. The authors have fully updated the text to include the most up to date treatment options, have added a section on head and neck imaging (CT/MRI), a series of self-test clinical cases, and 100 new photographs. The book uses a symptom-based approach to assist the clinician in the diagnosis and management of those conditions that fall into the speciality of oral medicine. Dealing first with normal anatomy, physical examination and investigation – particularly lesional biopsy, haematological assessment and microbiological sampling – the authors cover all areas of those diseases, local and systemic, that manifest themselves in the lips and mouth. Conditions are grouped under their principal presenting sign – blistering, white patches, red patches, swelling, pigmentation, pain, dry mouth, altered tasted and halitosis. This comprehensive handbook is of value to professionals and trainees in medicine, dentistry and pathology. Michael A. O. Lewis, PhD, BDS, FDSRCPS, FRCPath Professor of Oral Medicine, University of Wales College of Medicine, Cardiff, UK Richard C. K. Jordan, DDS, PhD, MSc, FRCD, DipOPath Oral Pathologist, University of California, San Francisco, USA Reviews of the previous edition A well written, well presented text ....of interest, and clinical relevance to dental practitioners. - British Dental Journal A genuinely practical source of reference.... lavishly illustrated... will appeal to dental undergraduates who are sure to find its well-planned layout and wealth of colour images of real value in their studies. - Dental Update Key features Combines the advantages of a colour atlas with those of a short text/reference. Symptoms-based approach. New section on head and neck imaging (CT/MRI). New self-test clinical cases. Superb colour photos—100 new to this edition. Contents Preface (First edition) Preface (Second edition) Acknowledgements Abbreviations 1.Introduction A symptom-based approach to diagnosis History Clinical examination Normal structures Special investigation of orofacial disease Salivary gland investigations Imaging techniques 2.Ulceration General approach Traumatic ulceration Recurrent aphthous stomatitis Behçet’s disease Cyclic neutropenia Squamous cell carcinoma Necrotizing sialometaplasia Tuberculosis Syphilis Epstein–Barr virus-associated ulceration Bisphononate-related osteonecrosis of the jaws Acute necrotizing ulcerative gingivitis Erosive lichen planus Lichenoid reaction Graft versus host disease Radiotherapy-induced mucositis Osteoradionecrosis 3.Blisters General approach Primary herpetic gingivostomatitis Recurrent herpes simplex infection Chickenpox and shingles Hand, foot, and mouth disease Herpangina Epidermolysis bullosa Mucocele Erythema multiforme Mucous membrane pemphigoid Pemphigus Linear IgA disease Dermatitis herpetiformis Angina bullosa hemorrhagica 4.White patches General approach Lichen planus Lichenoid reaction Lupus erythematosus Chemical burn Pseudomembranous candidosis (thrush, candidiasis) Chronic hyperplastic candidosis (candidal leukoplakia) White sponge nevus Dyskeratosis congenita Frictional keratosis Nicotinic stomatitis (smoker’s keratosis) Leukoplakia Squamous cell carcinoma Skin graft Hairy leukoplakia Pyostomatitis vegetans Submucous fibrosis Cartilagenous choristoma 5.Erythema General approach Radiation therapy mucositis Contact hypersensitivity reaction Lichen planus Acute erythematous (atrophic) candidois (candidiasis) Chronic erythematous (atrophic) candidosis (candidiasis) Median rhomboid glossitis (superficial midline glossitis, central papillary atrophy) Angular cheilitis Geographic tongue (benign migratory glossitis, erythema migrans, stomatitis migrans) Iron deficiency anemia Pernicious anemia Folic acid (folate) deficiency Erythroplakia Squamous cell carcinoma Infectious mononucleosis (glandular fever) 6.Swelling General approach Bacterial sialadenitis Viral sialadenitis (mumps) Sialosis (sialadenosis) Mucocele and ranula Salivary gland tumor (major gland) Squamous cell carcinoma Crohn’s disease Orofacial granulomatosis Paget’s disease (osteitis deformans) Acromegaly Fibroepithelial polyp (focal fibrous hyperplasia, irritation fibroma) Drug-induced gingival hyperplasia Focal epithelial hyperplasia (Heck’s disease) Salivary gland tumor (minor gland) Denture-induced hyperplasia (denture granuloma) Pyogenic granuloma (pregnancy epulis) Peripheral giant cell granuloma (giant cell epulis) Squamous papilloma Infective warts (verruca vulgaris, condylomata acuminata) Bone exostosis Sialolith (salivary stone) Tongue piercing Lymphoma Lipoma 7.Pigmentation (including bleeding) General approach Amalgam tattoo (focal agyrosis) Hemangioma (vascular nevus) Sturge–Weber syndrome Melanocytic nevus (pigmented nevus) Melanotic macule Malignant melanoma Kaposi’s sarcoma Hereditary hemorrhagic telangiectasia (Rendu– Osler–Weber disease) Physiological pigmentation Addison’s disease Betel nut/pan chewing Peutz–Jegher’s syndrome Black hairy tongue Drug-induced pigmentation Smoker-associated melanosis Thrombocytopenia 8.Orofacial pain (including sensory and motor disturbance) General approach Trigeminal neuralgia Glossopharyngeal neuralgia Postherpetic neuralgia Giant cell arteritis Burning mouth syndrome Atypical facial pain Atypical odontalgia Temporomandibular joint dysfunction Facial nerve palsy (Bell’s palsy) Trigeminal nerve paresthesia or anesthesia 9.Dry mouth, excess salivation, coated tongue, halitosis, and altered taste General approach Xerostomia (dry mouth) Sjögren’s syndrome CREST syndrome Excess salivation (sialorrhea) Coated tongue Halitosis (bad breath) Altered taste Test yourself Further reading Index