ORAL PATHOLOGY
Cassandra Ligor
MEDICAL HISTORY
 46 year old Caucasian male
 No medications
 Regular dental visits
 No systemic diseases
 No contraindications to treatment
INTRA ORAL EXAM
 During examination of the tongue and ventral surface of the
tongue irregular shaped, flat, red patches were found.
DESCRIPTION OF
LESION
Most predominate lesion was found
on the ventral surface this was 4mm
by 3mm , flat, red, with a white
boarder around lesion (ring like) .
Lesions on the dorsal surface were
similar . Flat with a more red
appearance.
SYMPTOMS
 No reported pain
 Patient has never had a problem with the lesion or condition.
 Voice WNL
 Salivary glands and Lymph nodes WNL
 Patient presented with slight fissured tongue and
ankyloglossia of the tongue.
 All other intra and extra oral examinations were WNL
NEXT STEP??
 Instructor was consulted.
 Measurements taken.
 Intraoral photo graphs were taken.
 Patient was informed.
 Follow up questions asked to patient.
•
Patient is aware of lesions,
noticed them since he was young ,
never had problem with them , “not always seen in mouth”
 Routine care was provided.
DIFFERENTIAL DIAGNOSIS
 #1. -GEOGRAPHIC TONGUE (benign migratory glossitis)
 Benign lesion that typically is found on the tongue
 Usually effects females more than males
 Etiology is unknown
 can be found on other surfaces of oral cavity but usually is found on the
tongue
 These lesions present as multiple, well demarcated erythematous areas.
This appearance is because of the atrophy(decrease in size) of the filiform
papillae.
GEOGRAPHIC TONGUE
DIFFERENTIAL DIAGNOSIS
 #2- Geographic
Stomatitis (Areata Erythema Migrans)
 Inflammation of the mucous lining of soft tissues of the oral cavity.
 Often associated with fissured tongue.
 Red angular patches of the labial and buccal mucosa, soft palate and
occasional floor of the mouth.
 The patches are mild erosion of mucosa.
 Require no treatment
 Can respond well to topical steroids
 Occurs at different areas other than tongue, usually.
GEOGRAPHIC STOMATITIS
DIFFERENTIAL DIAGNOSIS
 #3- Primary Herpetic Gingivostomatitis
 Painful, erythematous and swollen gingiva.
 Multiple tiny vesicles.
 Systemic symptoms :fever, lymphadenopathy.
 Disease most likely in children but can occur at any age.
 Lesions heal spontaneously.
PRIMARY HERPETIC
GINGIVOSTOMATITIS
PRELIMINARY DIAGNOSIS
 GEOGRAPHIC TONGUE
 Confirmed by instructor.
 Patient reports no pain.
 Patches are not always in same areas.
 Patient does have some sensitivity to spicy foods, but rare.
 Lesions are not severe red in color.
BIBLIOGRAPHY
 Isben and Phelan: Oral Pathology for the Dental Hygienist 5th edition pg. 8,9 and 130
 Langlais and Miller: Color Atlas of Common Oral Diseases 3rd edition pg. 106 and 107
 Geographic Tongue: Clinical Characteristics of 188 Cases, estrip.org
 Benign migratory glossitis with fissured tongue. Full Text Available By: Goswami, M.; Verma, A.; Verma,
M. Journal of the Indian Society of Pedodontics & Preventive Dentistry. Apr-Jun2012, Vol. 30 Issue 2, p173175. 3p. DOI: 10.4103/0970-4388.100008. Subjects: PEDODONTICS; ULCERS; TONGUE -- Diseases;
ASTHMA; TONGUE -- Diseases -- DiagnosisDatabase: Dentistry & Oral Sciences Source
 ORAL PATHOLOGY. Full Text Available By: Houston, Glen D. Oklahoma Dental Association Journal.
Jul2010, Vol. 101 Issue 5, p28-28. 1p. 3 Color Photographs. Subjects: CASE studies; TONGUE -- Diseases;
DISEASES -- Causes & theories of causation; ANTISEPTICS; STEROID drugsDatabase: Dentistry & Oral
Sciences Source
THANK-YOU
THE END