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When detected at the earliest stages, oral cancer has an ___ survival rate
80%
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What are the four risk factors of oral cancer
- Age - Incidence peaks in persons 55 to 74 years.
- Gender - Men are 2x more likely than women to develop it.
- Sunlight - Exposure is a risk factor for lip cancer.
- Tobacco and Alcohol Use - Use of either one increases risk; use in combination poses even higher risk
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What are the two lesions that might signal oral cancer
- Leukoplakia (white lesions) - possible precursor to cancer
- Erythroplakia (red lesions) - greater potential for becoming cancerous than leukoplakia
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What are some symptoms of oral cancer that patients might report
- Soreness
- Lump or thickening
- Numbness
- Hoarseness
- Feeling as if something is caught in throat
- Difficulty chewing or swallowing
- Ear pain
- Difficulty moving jaw or tongue
- Jaw swelling that causes ill-fitting dentures
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What are the two components of the EO exam
- A systematic visual inspection
- Palpation
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What are the three types of palpitation methods
- Bidigital
- Bilateral
- Bimanual
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What is the technique used for palpitation
Use circular motion to compress tissues against the underlying bone
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What are the four EO subgroups
- Overall appraisal of head, neck, face, and skin
- Temporomandibular joint
- Salivary and thyroid glands
- Lymph nodes of head and neck/Salivary and thyroid glands (Inferior border of mandible, SCM and Trachea).
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Crepitation
dry, crackling sound, noted when patient opens and closes
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Luxation
a complete dislocation. The head of the condyle moves anteriorly over the articular eminence and cannot be returned voluntarily
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Nodes can enlarge over ____ across with a virus
a half-inch to 1 inch
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Nodes can enlarge over _____ across with a bacterial infection
1 inch
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What are the nodes to palpate
- Occipital
- Postauricular (Exam question only)Preauricular
- Submental
- Submandibular
- Cervical anterior
- Cervial posterior
- supraclavicular
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Where is the parotid gland located
on the surface of the masseter muscle between the ear and jaw
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Where are the submandibular glands located
below the jaw toward the back of the mouth
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Where are the sublingual glands located
located under the tongue, beneath the mucous membrane of the floor of the mouth
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In the thyroid gland the left lobe is frequently ____ than the right.
larger
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What are the two types of skin cancer
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Name some of the aspects on melanoma
- Much more likely to spread to other parts of the body
- Account for more than 60% of skin cancer deaths
- Always treatable if caught soon enough
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Name some of the aspects of non-melanoma
- Most common cancers of the skin
- Rarely spread to other parts of the body
- Less likely than melanoma to be fatal
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What is a soft lesion
An area of abnormal-appearing skin or oral mucosa that does not resemble the soft tissue surrounding it
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What are the two types of flat lesions
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What does it mean for a lesion to be Sessile
base is as wide as the lesion itself
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What does it mean for a lesion to be Pedunculated
attached by a narrow stalk
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What are the four types of elevated lesions
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What are the three types of fluid filled lesions
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What are the two types of depressed lesions
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Define Crust
an outer layer, covering or scab. Formed from coagulated blood, serum or pus
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Define Exophytic
growing outward
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Define Indurated
hardened lesion
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Define Papillary
Describing a small nipple-shaped projection of elevation usually found in clusters
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Define Pseudomembrane
loose membrane of exudate. May contain organisms, precipitated fibrin, necrotic cells, inflammatory cells
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Oral cancer is the ______ deadliest type of cancer
sixth
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What are some of the qualities of infected lymph nodes
- Swollen
- feels a bit like a grape
- Firm
- Tender
- Enlarged and warm
- Bilateral swelling (on both sides of head or neck)
- Freely moveable from underlying structures
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What are some qualities of malignant lymph nodes
- Enlarged
- Firm
- Nontender
- Matted (stuck to each other)
- Fixed (stuck to underlying tissue)
- Unilateral (enlarged on only one side of head or neck)
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Angioedema
(swelling) of lower lip caused by allergy to latex gloves
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Opening of the parotid gland
Stenson's duct
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Fungiform papilla is found ____
- Anterior 2/3 of the mouth
- contains taste buds
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Foliate papilla is found
- On the posterior 1/3 on the lateral border of the tongue
- contains taste buds
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If first molars are not present for classification of occlusion what can be substituted
canines
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To determine the class of occlusion we look at the position of the _______ of the _______
- Buccal groove
- mandibular first molars
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Each maxillary tooth has a ________ to its mandibular counterpart by the distance of about ______
- distal relationship
- one half a tooth
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The ideal position of the canine teeth: The maxillary canine will occlude in the ______ and the ________
- middle of the mandibular canine
- mandibular first premolar
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Class II occlusion division I
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What are the qualities of a class I occlusion
Buccal groove of mandibular first molar and mesiobuccal cusp of maxillary first molar
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What are the qualities of a class II division I occlusion
- Buccal groove of the mandibular 1st molar is distal to the MB cusp of the maxillary 1st molar
- The maxillary anterior teeth are protruded
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What are the qualities of a class II division II occlusion
- Buccal groove of the mandibular 1st molar is distal to the MB cusp of the maxillary 1st molar
- The maxillary anterior teeth are retruded
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What are the qualities of a class III occlusion
- Buccal groove of the mandibular 1st molar is mesial to the MB cusp of the maxillary 1st molar
- At least the width of a premolar
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Malocclusion
Any deviation from ideal positioning of the teeth
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Malocclusion affects:
- Bite
- Ability to maintain adequate plaque control
- Speech development
- Appearance
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Normal overbite is _____ the depth of the mandibular incisors
one third
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What is end to end contact
Contact between the cusp tips of both the maxillary and mandibular posterior teeth
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What kind of contact is this
Edge to edge
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What is underjet
A horizontal relationship where the maxillary anteriors are lingual to the mandibular anteriors
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What is a crossbite
A facially positioned mandibular tooth or teeth
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normal profile
Mesognathic
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profile where mandible retrudes
Retrognathic
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profile where mandible protrudes
Prognathic
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What is Labioversion or Buccoversion
A tooth positioned more facially than normal
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What is Linguoversion
A tooth positioned more lingually than normal
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What is Supraversion or Supraeruption
A tooth positioned above the plane of occlusion
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Infraversion
A tooth positioned below the plane of occlusion
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Torsiversion
A rotated tooth
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What are the reasons for recording lesions
- To document the finding to meet standards of care.
- To assist other clinicians in quickly locating the lesion.
- For referrals to dental specialists.
- To allow comparison of today’s findings with those of a week ago or months ago
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What are the characteristics of lesions that we look for
- Anatomic location
- Border traits
- Margin traits
- Color
- Configuration
- Dimensions
- Primary type
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What are the two border traits
Regular and Irregular
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What are the margin traits
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What are the four types of configuration
- Discrete
- Grouped
- Confluent
- Linear
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What are the five primary types of lesions
- Flat
- Elevated
- Fluid-filled
- Depressed
- Linear
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What are Nonblisterform lesions and what are the types
- solid and do not contain fluid.
- They may be papules, nodules, tumors, or plaques
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Polyp
mass of tissue that projects upward and outward
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Verrucous
wart-like lesion
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Candidiasis
a fungus, occurs in people with depressed immune systems. Naturally occurring flora that takes over
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Plaque
A slightly raised lesion with a broad flat top
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Tumor
A solid, raised mass that is larger than l cm. in diameter
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Pyogenic Granuloma
pregnancy tumor, associated with poor OH
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Pericornitis
tissue flap occurring over mandibular 3rd molars
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Lichen Planus
White lesion with striations. Most commonly seen on buccal mucosa.
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Ulcers
loss of epithelium, center is gray to yellow with a red border
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Erosion
shallow depressed lesion, doesn’t extend through the epithelium to the underlying tissue
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What are the two types of non-melanoma
- Basal cell 60%
- Squamous cell 20%
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- papule
- A small circumscribed lesion usually less than l cm in diameter that is elevated or protrudes above the surface of normal surrounding tissue
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- Sessile Nodule
- A palpable solid lesion up to 1 cm in diameter found in soft tissue
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- Wheal
- raised, irregular area of edema
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_______, _______ and ______ are characterized by their base or attachment.
- Papules, nodules and tumors
- sessile or pedunculated
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primary herpetic stomatitis
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