COLLEGE OF DENTISTRY
DEPARTMENT OF MAXILLOFACIAL SURGERY DIAGNOSTIC SCIENCES [MDS]
ORAL MEDICINE – II [511 MDS]
STUDY GUIDE
1
Message from the Dean
Assalamualaikumwarahamatullahiwabarakatahu
It is my pleasure to welcome you to the College of Dentistry - Zulfi at Majmaah University, Kingdom of
Saudi Arabia. College of Dentistry aims to improve the dental health of the people in Kingdom of Saudi
Arabia through providing the students with excellent clinical training, supporting research and learning
environment. Towards this goal the Department of Maxillofacial Surgery & Diagnostic Sciences has
prepared a study guide in Oral Medicine – II for the benefit of the students.
I have read this study guide and would like to assure you that the team has done an excellent job in
addressing all the questions a student will have at the start of the course. This study guidealso contains
all the schedule of lectures and practical classes. I would like to congratulate the teamfor coming up
with this study guide.
I am happy to be the Dean of the College of Dentistry and I am sure that the assurance from the
dedication of our energetic and benevolent faculty and staff prompts you to be skilled and
knowledgeable in attaining high standard of education.
Best wishes
Dr. Abdur Rahman Al Atram
2
Message from the members of the committee
Dear Students,
We are delighted to welcome you to the course of Oral Medicine- II. This is a course which you
will be studying in the fifth year first semester; this study guide will inform and update you about the
various topics to be covered in the course.
The topics covered in this module are highly relevant and have clinical implications which will be
of great help in your professional life. This subject is one of the very important foundation courses in
clinical dentistry and focuses on the management of complex diseases affecting the mouth and jaws.
Hence we the committee suggest you to use this study guide to prepare yourself during the course and
gain maximum benefit.
Best wishes & Good luck
Members of the Committee
3
APPROVAL FOR THE COURSE
This course has been reviewed, revised and approved by:



The Department of Maxillofacial Surgery and Diagnostic Sciences
College Curriculum Committee
College Council
4
TABLE OF CONTENTS
Page No
1
Message from the Dean
1
2
Message from the members of committee
2
3
Approval of the course
3
4
General course information
5
5
Course description
6
6
General course objectives
7
7
Course contents
8
7
Detailed objectives of lectures
13
8
Detailed objectives of practicals
17
9
Student additional private study hours per week & student support
21
10
Teaching & learning resources
22
12
Facilities required
23
13
Students Assessment
24
14
Course evaluation & Improvement process
24
5
GENERAL COURSE INFORMATION
Course Title
Oral Medicine – II
Course Code
511 MDS
Course
components
&
Credit Hours
Theory
Second
semester
1
Clinical
Total
3
4
113 ANA; 113 PSL; 213PHL; 211 PDS; 242 MDS; 331 MDS
Prerequisites
Basic Knowledge of oral biology, oral pathology , general facial landmarks and oral
diagnosis
Co-requisites
Anatomy of head and neck, oral pathology, oral radiology, oral diagnosis and
microbiology
Year / Level
In 5thyear 1st semester of dentistry.
General Course Description
This course deals with the clinical features and therapeutic management of orofacial diseases.
Students will be trainedto corelate the signs and symptoms expressed by the patient to the probable
disease and manage them by therapeutic or palliative treatment whichever is necessary. This course
also includes answering the questions of the patients, their attendants and allay their fears regarding
the dental treatment. Students will further learn to request proper investigative procedures, and
properly manage the condition or refer the patient to a specialist. Special emphasis is given in this
course to patient’s referral procedure and dental report writing. This course is completed in 5th year
1st semester with a 1 hour theory and 3hours practical, hence has 4 contact hours and 2 credit points.
6
General Course objectives
At the end of the session students will be able to –
1. Understand the clinical features of various orofacial diseases.
2. Build the attitude of asking about the specific lesions and improve the approach towards the
questioning related to the lesions.
3. Understand different lesions of oral cavity and the approach towards adequate therapeutic
management.
4. Identify the medically compromised patient and plan their dental treatment appropriately.
7
8
COURSE CONTENTS:
A - Lectures: 15
S.
No.
1
List of topic
Introduction
Detailed content



2
Pigmented
lesions- 1



No
of Contact
weeks
hours
1
It introduces the students to 1
the course
Teach
students
the
importance of the course
Helps them understand the
protocol to be followed for
this course
Understand the various 1
causes of pigmentation in
the orofacial region.
Understand the exogenous
and endogenous pigments
contributing
to
pigmentation.
Learn about the clinical
features and management
of
certain
common
pigmented lesions of the
orofacial region such as
melanotic
macule
and
nevus.
1
3
Pigmented
lesions – 2

Learn about the clinical 1
features and management
of pigmented lesions such as
malignant melanoma and
systemic
and
genetic
diseases associated with
orofacial pigmentation.
1
4
Red lesions

Learn the various common 1
red lesions of the oral cavity.
Understand the clinical
features and management
of these lesions.
1
Learn the various common 1
benign tumors of the oral
soft tissue.
1

5
Benign Tumors-1

9
6
Benign Tumors2

Understand the clinical
features and management
of these lesions.

Learn the various common 1
benign tumors of bone
affecting
the
orofacial
region.
Understand the clinical
features and management
of these lesions.
1
Learn the various common 1
bacterial lesions occurring in
the orofacial region.
Understand the clinical
features and management
of these lesions.
Learn the various common 1
viral lesions occurring in the
orofacial region.
Understand the clinical
features and management
of these lesions.
1
Learn the various common 1
fungal lesions occurring in
the orofacial region.
Understand the clinical
features and management
of these lesions.
1

7
Bacterial lesions
of oral cavity


8
Viral lesions of
oral cavity


9
Fungal lesions of
oral cavity


Midterm exam
10
Vesiculo bullous
lesions-1


1
Learn
some
common 1
vesiculo bullous lesions
occurring in the orofacial
region such as erythema
multiforme and pemphigus.
Understand the clinical
features, various clinical
manifestations,
investigations
and
management
of
these
1
1
1
10
lesions.
11

Vesiculo bullous
lesions-2

12
13
Management of
Temporo
mandibular joint
disorders

Patient
up


Follow
1
1
Learn
the
clinical 1
presentation
of
some
common
Temporo
mandibular joint disorders.
Understand the principles
and various techniques of
management
of
these
disorders.
Meaning and importance of 1
patient follow up
1
Learn some common
vesiculo bullous lesions
occurring in the orofacial
region such as pemphigoid
and lupus erythematosus.
Understand the clinical
features, various clinical
manifestations,
investigations and
management of these
lesions.
Final exam
1
1
1
B - PRACTICALS: 12
S.No
List of topic
Detailed content

1
Introduction
2
Pigmented
Lesions 1

No of Contact
weeks Hours
1
Importance of the course and 1
understanding
of
its
components
1
Learn
the
clinical 1
examination of exogenous
pigmented lesions
Learn to identify the features
11
3
Pigmented
Lesions -2


4
Red lesions


5
Benign Tumors
1


6
Benign Tumors
2


7
Bacterial
lesions of oral
cavity
8
Viral lesions of
oral cavity

of amalgam tattoo.
•
Learn
the
clinical
examination of endogenous
pigmented lesions.
Learn to identify the clinical 1
features
of
smoker's
melanosis.
Learn to identify the features
suggestive of malignant
transformation of benign
nevus
into
malignant
melanoma.
Learn to identify the clinical 1
features and perform the
clinical
examination
of
Erythroplakia.
Learn to identify the clinical
features and perform the
clinical examination of
atrophic candidiasis.
Learn to identify the clinical
features of benign tumors
1
arising from oral soft tissue.
There will be personal
supervision on each student
while they perform this
examination.
Learn to identify the clinical 1
features of benign tumors of
both odontogenic and non
odontogenic origin of bone.
They will be trained in
recording the findings and
putting them in detail.
Learn to collect specimens 1
for pus culture and antibiotic
sensitivity test.
Learn to prepare a smear of
the specimen in the glass
slide for bacterial staining
and identification.
Learn to identify the clinical 1
features of viral infections
occurring in orofacial region.
1
1
1
1
1
1
12

9
10
Learn to write a prescription
for orofacial viral infection.
Fungal lesions
 Learn to identify the 1
clinical features of oral
of oral cavity
candidiasis.
 Learn to make a smear of
the specimen for KOH
staining
for
the
identification of Candida.
 Learn
to
write
a
prescription for oral
candidiasis.
Mid term exam
Examination of
Learn the various diseases 1
vesiculobullou
which manifest as vesiculo –
s lesions-1
bullous lesions in the
orofacial region
1
1
Learn the various vesiculo –
bullous lesions of viral
etiology in the orofacial
region and the method of
examination of these lesions
11
Examination of
vesiculobullou
s
lesions-2


12
Examination of
vesiculobullou
s lesions-3


13
Management
of
Temporo
Mandibular
Joint Disorders
(TMDs)



Learn the various vesiculo –
bullous lesions of auto –
Immune etiology affecting
the orofacial region.
Learn the method of
examination of these lesions.
Know the various clinical and
chairside tests done for the
various
vesiculobullous
lesions.
Know the procedure for
performing the above tests
Learn to write a prescription 1
for the medical management
of Temporo mandibular joint
disorders.
Learn to perform jaw
exercises.
Learn about the splint
therapy for TMDs.
1
13
Detailed Objectives of the Content –
LECTURES
Lecture 1 – Introduction
At the end of the lecture students will be able to know–



Introductionto the course
The importance of the course
Understand the protocol to be followed for this course
Lecture 2 – Pigmented lesions- 1
At the end of the lecture students will be able to –



Understand the various causes of pigmentation in the orofacial region.
Understand the exogenous and endogenous pigments contributing to pigmentation.
Learn about the clinical features and management of certain common pigmented lesions of the
orofacial region such as melanotic macule and nevus.
Lecture 3 –Pigmented lesions – 2
At the end of the lecture students will be able to –

Learn about the clinical features and management of pigmented lesions such as malignant
melanoma and systemic and genetic diseases associated with orofacial pigmentation.
Lecture 4 – Red lesions
At the end of the lecture students will be able to –

Learn the various common red lesions of the oral cavity.
14

Understand the clinical features and management of these lesions.
Lecture 5 – Benign Tumors-1
At the end of the lecture students will be able to –
•
Learn the various common benign tumors of the oral soft tissue.
•
Understand the clinical features and management of these lesions.
Lecture 6 –Benign Tumors- 2
At the end of the lecture students will be able to •
Learn the various common benign tumors of bone affecting the orofacial region.
•
Understand the clinical features and management of these lesions.
Lecture 7 –Bacterial lesions of oral cavity
At the end of the lecture students will be able to 
•
Learn the various common bacterial lesions occurring in the orofacial region.
Understand the clinical features and management of these lesions.
Lecture 8 –Viral lesions of oral cavity
At the end of the lecture students will be able to•Learn the various common viral lesions occurring in the orofacial region.

Understand the clinical features and management of these lesions.
Lecture 9 – Fungal lesions of oral cavity
At the end of the lecture students will be able to•Learn the various common fungal lesions occurring in the orofacial region.
15
•Understand the clinical features and management of these lesions.
Lecture 10 –Vesiculo bullous lesions-1
At the end of the lecture the students will be able to –


Learn some common vesiculo bullous lesions occurring in the orofacial region such as erythema
multiforme and pemphigus.
Understand the clinical features, various clinical manifestations, investigations and management
of these lesions.
Lecture 11 – Vesiculo bullous lesions-2
At the end of the lecture the students will be able to
•Learn some common vesiculo bullous lesions occurring in the orofacial region such as pemphigoid
and lupus erythematosus.
•
Understand the clinical features, various clinical manifestations, investigations and management
of these lesions.
Lecture 12 –Management of Temporo mandibular joint disorders
At the end of the lecture the students will be able to
•
Learn the clinical presentation of some common Temporo mandibular joint disorders.
•
Understand the principles and various techniques of management of these disorders.
Lecture 13 –Patient Follow up
At the end of the lecture the students will be able to –

Understand the meaning and importance of patient follow up.
16
Clinicals
Clinical1 – Introduction
At the end of the session students will be able to –



Know the protocol for entering into the clinical practice
Importance of better presentation of himself
How he has to be ready and attentive in the clinic to manage any eventuality
Procedure to be followed-



Each student will be allotted one clinic.
Each student will be given individual User ID and password to log into the computer in his clinic.
Each student shall adhere to the prescribed dress code.
17
Clinical 2 –Pigmented Lesions 1
At the end of the session students will be able to –
•Learn the clinical examination of exogenous pigmented lesions
Learn to identify the features of amalgam tattoo.
Procedure to be followed

Students will be shown powerpoints and pictures to identify different exogenous pigmented
lesions and appreciate their clinical characteristics.
Students will be shown powerpoints and pictures to identify different exogenous pigmented
lesions and appreciate their clinical characteristics.
Clinical3 – Pigmented Lesions -2
At the end of the session students will be able to –
•
Learn to identify the clinical features of smoker's melanosis.
•
Learn to identify the features suggestive of malignant transformation of benign nevus into
malignant melanoma.
Procedure to be followed

Students will be shown powerpoints and pictures to identify smoker's melanosis and appreciate
its clinical characteristics.
Students will be shown powerpoints and pictures to identify the clinical features which suggest
the malignant transformation of benign nevus into malignant melanoma.
Clinical4 –Red lesions
At the end of the session students will be able to –
•
Learn to identify the clinical features and perform the clinical examination of Erythroplakia.
•
Learn to identify the clinical features and perform the clinical examination of atrophic
candidiasis.
18
Procedure to be followed

Students will be shown and explained with the aid of powerpoints and photographs the clinical
presentation of Erythroplakia.
Students will be shown and explained with the aid of powerpoints and photographs the clinical
presentation of atrophic candidiasis.
Clinical5 –Benign Tumors 1
At the end of the session students will be able to –
•
Learn to identify the clinical features of benign tumors arising from oral soft tissue.
•
There will be personal supervision on each student while they perform this examination.
Procedure to be followed
Students will be shown powerpoints and photographs of benign tumors arising from oral soft
tissue and they will be taught how to perform their examination and recording the relevant
findings.
Clinical 6 – Benign Tumors 2
At the end of the session students will be able to –
•
Learn to identify the clinical features of benign tumors of both odontogenic and non
odontogenic origin of bone.
•
They will be trained in recording the findings and putting them in detail.
•
There will be personal supervision on each student while they perform this examination.
Procedure to be followed•
Students will be shown powerpoints and photographs of benign tumors arising from bone and
they will be taught how to perform their examination and recording the relevant findings.
Clinical 7- Bacterial lesions of oral cavity
At the end of the session students will be able to –
19


Learn to collect specimens for pus culture and antibiotic sensitivity test.
Learn to prepare a smear of the specimen in the glass slide for bacterial staining and
identification.
Procedure to be followed

Studentswill be demonstrated and taught the method of specimen collection for pus culture and
antibiotic sensitivity test.
Students will be demonstrated and taught the method of smear preparation for bacterial
staining and identification.
Clinical 8- Viral lesions of oral cavity
At the end of the session students will be able to –
•
Learn to identify the clinical features of viral infections occurring in orofacial region.
•
Learn to write a prescription for orofacial viral infection.
Procedure to be followed

Students will be shown powerpoints and photographs of viral infections occurring in orofacial
region and they will be taught how to perform their examination and recording the relevant
findings.
Students will be taught and explained the method of writing a prescription for orofacial viral
infections.
Clinical 9- Fungal lesions of oral cavity
At the end of the session students will be able to –
•
Learn to identify the clinical features of oral candidiasis.
•
Learn to make a smear of the specimen for KOH staining for the identification of Candida.
•
Learn to write a prescription for oral candidiasis.
Procedure to be followed-
20



Students will be shown powerpoints and photographs of oral candidiasis and they will be taught
how to perform its examination and recording the relevant findings.
Students will be demonstrated and taught the method of smear preparation for KOH staining for
the identification of Candida.
Students will be taught and explained the method of writing a prescription for oral candidiasis.
Clinical 10 – Examination of vesiculobullous lesions-1
At the end of the session students will be able to –


Learn the various diseases which manifest as vesiculobullous lesions in the orofacial region.
Know the various vesiculobullous lesions of viral etiology in the orofacial region and the method
of examination of these lesions.
Procedure to be followed
Students will be shown and explained with the aid of powerpoints and photographs the various
diseases whichmanifest as vesiculobullous lesions in the orofacial region and the method of
examination of the vesiculobullous lesions with viral etiology.
Clinical 11 –Examination of vesiculobullous lesions-2
At the end of the session students will be able to –


Know the various vesiculobullous lesions of autoimmune etiology affecting the orofacial region.
Know the method of examination of these lesions.
Procedure to be followed
Students will be shown and explained with the aid of powerpoints and photographs the various
forms in which vesiculobullous lesions of autoimmune etiology manifest in the orofacial region
and the method of examination of these lesions.
Clinical 12 – Examination of vesiculobullous lesions-3
At the end of the session students will be able to –


Know the various clinical and chairside tests done for the various vesiculobullous lesions.
Know the procedure for performing the above tests.
21
Procedure to be followed
Students will be demonstrated and explained the various clinical and chairside tests done for
different vesiculobullous lesions and the procedure of performing the same.
Clinical 13- Management of Temporo Mandibular Joint Disorders (TMDs)
At the end of the session students will be able to –
•
Learn to write a prescription for the medical management of Temporo mandibular joint
disorders.
•
Learn to perform jaw exercises.
•
Learn about the splint therapy for TMDs.
Procedure to be followed


Students will be taught and explained the method of writing a prescription for the medical
management of Temporo mandibular joint disorders.
Students will be demonstrated and taught the method of performing various jaw exercises.
Students will be shown powerpoints and pictures of various types of splints.
22
23
Student additional private study hours per week & student support:
In Additional to the credit hours in the college hours the student is expected to put in 5 hours of private
study/learning hours per week. (This is an average for the semester not a specific requirement in each
week).
The students are encouraged to interact with the tutors of the course for any additional help required
during the course. The staff members are instructed to inform the students regarding the office hours
when they can approach the faculty for their help
After each class the faculty member allocates a few minutes to clear the doubts of the students if
needed
The power point presentation of each class is uploaded on the faculty member’s website from where
the students can easily retrieve it and come prepared for the lecture.
Group of three students are allotted to one faculty member, who is their mentor, the students can even
approach their respective mentors if they have any additional problems with the subject.
24
Teaching and learning resources:Students will be shown power point presentations, quiz, and essay
competition. During the practicals students will be demonstrated the various procedures to be
performed to give them in depth knowledge and understanding of the subject.
Use of more teaching aids during classes with special emphasis on the applied aspects of the structures,
impromptu questions asked during the class would also aid in developing cognitive skills. In addition we
would design quizzes and assignments in such a way that the students would have to correlate the
various topics and information given to them.
The students will be asked oral questions, debates, group discussions group tasks will be designed so
that the students learn to interact with their batch mates. In addition project work will be assigned to
small groups so that they learn to take up the responsibility and complete it.
Recommended text books:
Textbook
Burket's Oral Medicine 11th edition 2008
Authors – Greenberg, Glick and Ship
Textbook
Text book of General And Oral Medicine 5th edition 2011
Author – Crispian and Scully
Lab guide
Oral And Maxillofacial Medicine 5th edition 2011
Author – Crispian and Scully
25
Facilities Required:
Theory: A class room with a seating capacity of atleast 30 students, equipped with a projector and smart
board.
Practical: A well equipped clinical department with a dental chair, doctor chair equipped with diagnostic
instruments and basic chair side investigation tests.
A record maintenance room
Physical examination room having basic equipment like height and weight checking machine; apparatus
for Blood pressure, Pulse and respiratory rate examination. An emergency room with an ambulance
should be available to tackle with any untoward eventuality.
STUDENT ASSESSMENT:
Evaluation & assessment of students:
By Oral and Written examination, periodic assessment through assignments, evaluation of the projects
and group tasks.
Assessment of student communication skills will be through the seminars and term papers.
The oral skills will be tested in the oral exams.
5th year 1st Semester
ASSESSMENT TOOLS
Assessment
IN COURSE ASSESSMENT – 60%
FINAL- 40%
Percentage
Behavior/Attitude
5%
Presentation
2%
Research
2%
Quiz
1%
Mid Term Theory
20%
Mid Term Practical
10%
Weekly Practical assessment
10%
Oral Exam
10%
Final Exam Theory
30%
Final Practical Exam
10%
THEORY-50% AND PRACTICAL- 100%
50%
26
SEMINARS
A.
Guidelines for seminar sessions:
1.
One seminar per student is scheduled during the semester.
2.
Duration of each seminar will be of 15 minutes.
3.
The students will be given the topics for seminar at least two weeks in advance. The topics will
be selected randomly by the students by a picking a slip (lottery method).
4.
The student is expected to prepare a power point presentation for the seminar. They can take
the help of a staff member in preparing themselves for the presentation.
5.
After each session group discussion will be allowed.
6.
The tutor (faculty member in charge) will give his comments and feedback about the
presentation.
7.
All the students are expected to be present during the seminars and also prepare themselves by
reading about the topic of presentation so as to have an active and productive group discussion.
8.
Seminars grading will be grouped under the theory assignment.
B. TOPICS OF SEMINAR
S.No.
1.
2.
3.
4.
Name of topic
27
5.
6.
7.
8.
9.
10.
11.
12.
Course Evaluation and Improvement Process:
The students will be given a feedback form, which can be submitted to the course director or to the
dean which will help in improvement of the subject teaching.
The head of the department or the Dean has informal meetings with groups of students to discuss the
contents of the course, method of teaching to evaluate the course and the instructor.
Meetings will be conducted every week in the department to update the status of each student and the
difficulties felt by the colleague will be resolved accordingly. The dean randomly attends lectures to
assess the instructor. The power point presentation of each lecture is distributed to all the staff
members of the department for evaluation and suggestions for improvement.
Teachers will be subjected to go for up gradation of knowledge by attending the relevant conferences
and will be encouraged to carry on a self improvement.
Other staff members are invited to attend the seminar presentation of students to verify the standards
of student learning and their work.
28