Acute Ulcerative Gingivitis
Anaerobic fusiform and spirochaete bacteria
Ulceration at the tips of the dental papillae, soreness,
gingival bleeding and halitosis. There may also be evidence of systemic
This involves debridement and oral hygiene instruction,
peroxide mouthwash, metronidazole and then a periodontal assessment
once the acute phase of the disease has resolved.
Acute necrotising ulcerative
Amalgam particles can be incorporated in to healing
A biopsy may be required to distinguish from a naevus
or a melanoma.
Ankyloglossia (Tongue tie)
The lingual fraenum anchors the tongue tip, restricting
movement. Oral cleansing but not speech is impaired. Surgery to release
tongue if severe.
Basal Cell Carcinoma (Rodent
Common neoplasm of the skin of the face, particularly
in the elderly with a history of long exposure to UV radiation. Typically
a slow growing nodule that eventually ulcerates centrally.
Sebaceous glands are present in the
oral mucosa of 80% of adults and they can grow in size with age and
appear in the oral mucosa as soft, symmetrically distributed, creamy
spots a few millimeters in diameter. They are mainly located on the
buccal mucosa, but can also be present on the lips and rarely the
tongue. They are often mistaken for disease.
Occlusal bite lines
These white lines are caused by the teeth biting on
the inside of the cheeks. The epithelium is moderately hyperplastic.
Also called Linea Alba.
Black hairy tongue
Hair-like appearance on the dorsum of the tongue probably
produced by pigment-producing bacteria and fungi, but not Candida
Periodic scraping of the tongue with a toothbrush
may improve appearance. Harmless condition.
Palatal and mandibular tori
Palatal Tori (singular: torus) are slow growing asymptomatic bony lumps in the middle
of the palate. Mandibular tori (usually bilateral) are slow growing asymptomatic bony lumps growing on the lingual surfaces of the body of mandible. Usually require no treatment unless interfering with
the fitting of dentures.
Irritation causing fibrous hyperplasia
Requires excision for histolological examination
Fibro Epithelial Poly of the lower lip
Bluish/brownish macules seen most frequently.
May require a biopsy for exclusion of malignant melanoma
Non racial pigmentation
Possibly a reactive vascular lesion which usually
presents as a small red painless mass that bleeds easily, ulcerates
and grows rapidly. Seen on the gingival margin, tongue or rarely the
lip and usually requires excision.
Denture Irritation Hyperplasia
Hyperplastic mucosa at the periphery of an ill-fitting
Leaf-like folds of granulation tissue embracing the
over-extended of the denture (see diagram below)
Tissue firm in consistency and not grossly inflamed
but there are often areas of ulceration at the base.
May require surgical removal and better fitting dentures.