Cheek chewing

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Cheek chewing. Morsicatio buccarum, chronic chewing of cheek, DDx: idiopathic leukoplakia, lichen planus, linea alba, chemical (aspirin) or thermal burn, toothpaste reaction, cheek chewing - PowerPoint PPT Presentation

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  • Cheek chewingMorsicatio buccarum, chronic chewing of cheek,DDx: idiopathic leukoplakia, lichen planus, linea alba, chemical (aspirin) or thermal burn, toothpaste reaction, cheek chewingDescription-large ulcerated hyperkeratotic macule, ragged, appears to be pealing off, white and red, may or may not wipe offCommon locations- anterior buccal mucosa, labial mucosa, lateral boarder of tongue, along plane of occlusion

  • Aspirin burnhabit 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 migransLarge, white, may or may not be rubbed off, erythematous macule. painfulOn gingiva, buccal mucosa

  • Peroxide burncaused 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 migransLarge, white, may or may not be rubbed off, erythematous macule. painfulGeneralized in oral cavity

  • Thermal burnsThermal 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 migransLocated on vermillion boarder, tongue, hard palate.

  • Cotton roll stomatitisiatrogenic, 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 tongueD dx: riga fide, aphthous lesionAge of pt will make dx.

  • Toothbrush abrasionhorizontal pattern of erosion on attached gingival, erythematous, coalescing ulcers.D Dx: recurrent intraoral herpes simplex, tooth brush abrasion

  • Ionizing radiation damageskin damage: telangectasia, hair loss, mucositis, (serous glands), xerostomia (prevention with good oral hygiene is key!) Osteoradionecrosis: Damage to blood vessels, microorganisms cant be controlled by bodys defenses, bone death resultsD Dx: burn, ionizing radiation damage, xerostomia due to medications

  • Acid erosion of enamelcaused by stomach acid (reflux or bulimia), lemons, tomato juice. Teeth concave, cupped out cusps, unusual wear pattern, exposed dentinD Dx: acid erosion, attrition