Cheek chewing

Cheek chewingMorsicatio buccarum, chronic chewing of cheek,DDx: idiopathic leukoplakia, lichen planus, linea

alba, chemical (aspirin) or thermal burn, toothpaste reaction, cheek chewing

Description-large ulcerated hyperkeratotic macule, ragged, appears to be pealing off, white and red, may or may not wipe off

Common locations- anterior buccal mucosa, labial mucosa, lateral boarder of tongue, along plane of occlusion

Aspirin burn

- habit of placing aspirin on gums, very painful, obtain hx from pt.

- D Dx: Chemical burn, cheek chewing, leukoplakia, toothpaste or mouthwash reaction, candidiasis, lichen planus, erythema migrans

- Large, white, may or may not be rubbed off, erythematous macule. painful

- On gingiva, buccal mucosa

Peroxide burn

• caused by pt rinsing with peroxide. (tx for ANUG), obtain hx from pt.

• D Dx: Chemical burn, cheek chewing, leukoplakia, toothpaste or mouthwash reaction, candidiasis, lichen planus, erythema migrans

• Large, white, may or may not be rubbed off, erythematous macule. painful

• Generalized in oral cavity

Thermal burns• Thermal most often caused by pizza, obtain hx

from pt. • Erythematous macule, may have

pseudomembranous covering, may be ulcerated, painful.

• D Dx: Chemical burn, cheek chewing, leukoplakia, toothpaste or mouthwash reaction, candidiasis, lichen planus, erythema migrans

• Located on vermillion boarder, tongue, hard palate.

Cotton roll stomatitis- iatrogenic, sizing (paste) sticks to tissue.

Obtain hx from pt. - Tx: Wet cotton before removing.- Sloughing traumatic lesion, erythematous

macule, may have pseudomembranous covering, may be ulcerated.

- D Dx: Chemical burn, cheek chewing, leukoplakia, toothpaste or mouthwash reaction, candidiasis, lichen planus, erythema migrans

Riga Fide

• early erupted tooth, infant w/ ulcer on undersurface of tongue

• D dx: riga fide, aphthous lesion• Age of pt will make dx.

Toothbrush abrasion

• horizontal pattern of erosion on attached gingival, erythematous, coalescing ulcers.

• D Dx: recurrent intraoral herpes simplex, tooth brush abrasion

Ionizing radiation damage

• skin damage: telangectasia, hair loss, mucositis, (serous glands), xerostomia (prevention with good oral hygiene is key!) Osteoradionecrosis: Damage to blood vessels, microorganisms can’t be controlled by body’s defenses, bone death results

• D Dx: burn, ionizing radiation damage, xerostomia due to medications

Acid erosion of enamel

• caused by stomach acid (reflux or bulimia), lemons, tomato juice.

• Teeth concave, cupped out cusps, unusual wear pattern, exposed dentin

• D Dx: acid erosion, attrition