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