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oral pathology

Dental lesions, simplified

Aug. 6, 2024
Oral pathology can be complex, confusing, and sometimes hard to differentiate. This reference guide includes tongue conditions, red ulcerative lesions, white lesions, fibromas, pink and brown skin lesions, and clinical manifestations of HSV and HPV.
Vicki Cheeseman, Associate Editor

Dental clinicians have an opportunity to identify and diagnose oral and facial lesions sooner rather than later. And this means a greater chance of a successful resolution for patients.

Dental anomalies can be complex, confusing, and sometimes hard to differentiate. This roundup of articles from RDH magazine covers many of the common lesions you’re likely to encounter during your day, whether you’re performing a standard clinical exam or a head and neck oral cancer screening.

Keep this quick guide handy for future reference on oral pathology, including clinical manifestations of HSV and HPV, pink and brown skin lesions, tongue conditions, red ulcerative lesions, white lesions, and fibromas.

Viruses and the oral cavity

Human papillomavirus and herpes simplex virus (cold sores) have diverse manifestations. Understanding the various viral presentations of each is crucial to accurately diagnose harmless bumps and even potentially precancerous lesions.

HPV and HSV

Face and neck screening

A thorough inspection of the skin of the face and neck is an essential part of a comprehensive head and neck cancer screening for dental patients. Here’s what you need to know to become familiar with the appearance of these common skin lesions.

Pink and brown skin lesions

Tongue conditions that suggest a more serious systemic story

Respiratory, autoimmune, and inflammatory issues often manifest in the oral cavity, especially on the tongue. Here are four conditions that may warrant special attention.

Systemic tongue issues

Intrinsic and extrinsic factors associated with tongue lesions

Several factors—such as a history of allergies, the presence of certain medical conditions, and the use of medications—are associated with an increased probability of tongue lesions. Whether the tongue lesions are caused by intrinsic or extrinsic factors, each has different etiologies.

Classifying tongue lesions

Serious pathologies of the tongue

With immunological pathologies, the spectrum of differential diagnosis widens. These are serious pathologies such as squamous cell carcinoma, herpes simplex, drug-induced lesions, lupus, and lichen planus.

Identifying immunological pathologies

Identifying variances in normal presentation

Differentiating red ulcerative lesions (“those nonwhite lesions”) from other mixed lesions can be challenging. These lesions resemble white lesions, depending upon the onset of a breakout and when dental examination is sought.

Red ulcerative lesions

Identifying lesions that need to be referred to a specialist

Any new or existing leukoplakia-type finding should be biopsied, identified, monitored, and referred (as needed) for appropriate care. These lesions are characterized as white patches or plaques that cannot be wiped off or otherwise described clinically.

White lesions

Isolating benign fibromas from not-so-benign

Fibromas and giant cell fibromas (GCF) are two common benign growths in the buccal mucosa. But there are malignant lesions that mimic fibromas. Here’s what you need to know.

Distinguishing bumps

Since dental professionals often see their patients more frequently than their medical counterparts, they are well positioned to catch oral lesions that require treatment or referral early. Make routine, careful screening second nature in your clinical day. Your patients are counting on you for their health.

Editor’s note: This article first appeared in Clinical Insights newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe.

About the Author

Vicki Cheeseman | Associate Editor

Vicki Cheeseman is an associate editor in Endeavor Business Media’s Dental Group. She edits for Dental Economics, RDH, DentistryIQ, and Perio-Implant Advisory. She has a BS in mathematics and a minor in computer science. Early on she traded numbers for words and has been happy ever since. Vicki began her career with Dental Economics in 1987 and has been fascinated with how much media production has changed through the years, yet editorial integrity remains the goal. In her spare time, you’ll find her curled up with a book—editor by day, reader always.