DH 213 - Oral Pathology

Credits: 3
Instructional Contact Hours: 3

Introduces the process, identification, and classification of oral diseases. Emphasizes the prevention of the diseases with the scope of responsibility and practice of the dental hygienist.

Prerequisite(s): DH 124B, DH 130, DH 131, DH 135 and LWA 206B each with a "C" (2.0) minimum grade.
Corequisite(s): DH 210W, DH 214W, DH 215, DH 216W and DH 219W.
Lecture Hours: 45 Lab Hours: 0
Meets MTA Requirement: None
Pass/NoCredit: No

Outcomes and Objectives

Describe the clinical findings that require monitoring, treatment, or management of oral conditions.
1. Define each of the relevant words in the vocabulary list.
2. Discuss the eight diagnostic categories that contribute to the diagnostic process.
3. Name a diagnostic category and give an example of a lesion, anomaly, or condition for which this category contributes to the diagnosis.
4. Describe the radiographic appearance and historical data that are relevant to periapical cemento-osseous dysplasia (cementoma).
5. Define leukoplakia and erythroplakia.
6. Define "variant of normal".
7. Give three examples of "variants of normal" that involve the tongue.
8. Describe and identify the clinical appearance of the following:
  1. Fordyce Granules
  2. Torus palatinus
  3. Mandibular tori
  4. Melanin pigmentation
  5. Retrocuspid papilla
  6. Lingual varicosities
  7. Linea alba
  8. Leukoedema
9. Describe the clinical histologic differences between leukoedema and linea alba.
10. Define lingual thyroid.
11. List three symptoms associated with lingual thyroid.
12. Describe and identify the clinical characteristics of the following:
  1. Median rhomboid glossitis
  2. Erythema migrans
  3. Fissured tongue
  4. Hairy tongue
Demonstrate an understanding of the role inflammation and repair plays in oral conditions and diseases.
1. Define the words in the vocabulary list for this subject.
2. List the five signs of inflammation that are visible at the site of inflammation.
3. List three systemic signs of inflammation.
4. Describe the microscopic events that are associated with each of the signs of inflammation.
5. List and describe the microscopic events of the inflammatory process, beginning with injury and ending with phagocytosis of foreign and necrotic substances.
6. Describe the types of white blood cells that participate in inflammation.
7. Describe the differences between acute and chronic inflammation.
8. Contrast hyperplasia, hypertrophy, and atrophy.
9. Describe the microscopic events that occur during the repair of a mucosal wound.
10. Contrast healing by primary intention, secondary intention, and by tertiary intention.
11. List local and systemic factors that can impair healing.
12. Contrast attrition, abrasion, and erosion.
13. Describe the pattern of erosion seen in bulimia.
14. Describe the relationship between bruxism and abrasion.
15. Describe the cause, clinical features, and treatment of each of the following:
  1. Oral mucosal burns
  2. Aspirin burns
  3. Phenol and other chemical burns
  4. Electric burns
  5. Thermal burns
  6. Lesions from cocaine use
  7. Self-induced injuries
  8. Hematomas
  9. Traumatic ulcers
  10. Frictional keratosis
  11. Linea alba
  12. Nicotine stomatitis
16. Describe the clinical features, cause (when known), treatment, and histologic appearance of each of the following:
  1. Traumatic neuroma
  2. Amalgam tattoo
  3. Melanosis
  4. Solar cheilitis
  5. Mucocele
  6. Ranula
  7. Sialolith
  8. Necrotizing sialometaplasia
  9. Sialadenitis
  10. Pyogenic granuloma
  11. Peripheral giant cell granuloma
  12. Chronic hyperplastic pulpitis
  13. Denture-induced fibrous hyperplasia
  14. Irritation fibroma
17. Differentiate among a periapical abscess, a periapical granuloma, and a radicular cyst.
18. Describe and contrast internal and external tooth resorption.
Describe the role immunity plays in oral conditions.
1. Define words the vocabulary list for this subject.
2. Describe the primary difference between the immune response and the inflammatory response.
3. List the three main types of lymphocytes and their origins.
4. Describe the activities of macrophages in the immune response.
5. Describe, using the cells involved, the difference between the humoral immune response and the cell-mediated immune response.
6. Describe the difference between active and passive immunity.
7. List one example of active immunity and list one example of passive immunity.
8. Define herd immunity.
9. Describe four types of hypersensitivity reactions and give an example of each.
10. Describe how autoimmunity can result in disease.
11. Define immunodeficiency and describe how it results in disease.
12. Describe the clinical features of each of the three types of aphthous ulcers.
13. List systemic diseases associated with aphthous ulcers.
14. Compare the clinical features of urticaria, angioedema, contact mucositis, and fixed drug eruption.
15. Describe the clinical features of erythema multiforme and Stevens-Johnson syndrome.
16. Describe the clinical and histologic features of lichen planus.
17. Describe the triad of systemic signs that comprise reactive arthritis (Reiter syndrome).
18. Describe the oral manifestations of each of the following autoimmune diseases:
  1. Sjögren syndrome
  2. Lupus erythematosus
  3. Pemphigus vulgaris
  4. Mucous membrane pemphigoid
  5. Behçet syndrome
  6. Sarcoidosis
19. Describe the clinical features of desquamative gingivitis.
20. List three diseases in which desquamative gingivitis may occur.
21. Describe the components of Behçet's syndrome.
22. Describe the difference between primary and secondary immunodeficiency.
23. Describe three examples of primary immunodeficiency.
24. List four causes of secondary immunodeficiency.
Describe the clinical findings and significant deviations of infectious diseases that require monitoring, treatment, or management of oral conditions.
1. Define each of the words in the vocabulary list.
2. Describe the mechanism that allows opportunistic infection to develop.
3. Describe the name of the organism causing disease, the route of transmission, how diagnosis can be made and oral manifestations for the following:
  1. Impetigo
  2. Tuberculosis
  3. Actinomycosis
  4. Syphilis (primary, secondary, tertiary)
  5. Necrotizing ulcerative gingivitis
  6. Pericoronitis
  7. Osteomyelitis (acute and chronic)
4. Describe the relationship between streptococcal tonsillitis, pharyngitis, scarlet fever and rheumatic fever.
5. List what infectious diseases strawberry tongue and Pastia lines may be seen in.
6. Describe four forms of oral candidiasis.
7. Describe the three benign lesions caused by HPV in the oral cavity.
8. Describe the two major types of the herpes simplex virus.
9. Describe the clinical features of herpes labialis.
10. Describe the clinical features of intraoral herpes simplex infection.
11. Describe the clinical characteristics of herpes zoster when it affects the facial area and oral cavity.
12. Describe the diseases associated with the Epstein-Barr virus.
13. Describe two diseases caused by coxsackieviruses.

Describe the developmental disorders clinical findings and significant deviations that require monitoring, treatment, or management of oral conditions.
1. Define the words in the vocabulary list for this subject.
2. Define inherited disorders.
3. Describe the differences between odontogenic and nonodontogenic cysts.
4. Describe the differences between intraosseous cysts and extraosseous cysts.
5. List the odontogenic cysts that are intraosseous.
6. List the odontogenic cysts that are extraosseous.
7. List the nonodontogenic cysts that are intraosseous.
8. List the nonodontogenic cysts that are found in the soft tissues of the head, neck and oral region.
9. Describe the abnormalities that affect the number of teeth.
10. Describe the abnormalities that affect the shape of teeth.
11. Describe the abnormalities that affect the structure of teeth.
Describe the clinical findings and significant deviations of neoplasia that require monitoring, treatment, or management of oral conditions.
1. Define each of the words in the vocabulary list for this subject.
2. Describe neoplasia, including its causes.
3. Explain the difference between a benign tumor and a malignant tumor.
4. Define leukoplakia and erythroplakia.
5. Describe the clinical features and treatment of each of the following:
  1. Papilloma
  2. Squamous cell carcinoma
  3. Verrucous carcinoma
  4. Basal cell carcinoma
6. Describe leukoplakia, erythroplakia, and erythroleukoplakia.
7. Describe the significance of the premalignant condition, epithelial dysplasia.
8. Describe the clinical features and treatment of each of the following:
  1. Pleomorphic adenoma
  2. Monomorphic adenoma
  3. Warthin tumor
  4. Adenoid cystic carcinoma
  5. Mucoepidermoid carcinoma
I. Describe the clinical features and treatment of each of the following odontogenic tumors:
1. 1. Ameloblastoma
2. 2. Calcifying epithelial odontogenic tumor
3. 3. Adenomatoid odontogenic tumor
4. 4. Odontogenic myxoma
5. 5.Central ossifying fibroma 6.Cemntoblastoma
6. 7.Ameloblastic fibroma
7. 8. Ameloblastic fibro-odontoma
8. 9. Odontoma
J. Describe the clinical features and treatment options for the following tumors of soft tissue:
1. Lipoma
2. Neurofibroma
3. Schwannoma
4. Granular cell tumor
5. Congenital epulis
6. Rhabdomyoma
7. Leiomyoma
8. Hemangioma
9. Lymphangioma
10. Rhabdomyosarcoma
11. Malignant nerve sheath tumor
12. Kaposi sarcoma
13. Describe the clinical features and treatment options for the following tumors of melanin-producing cells and the treatment options:
  1. Melanocytic nevus
  2. Melanoma
14. Describe the clinical features and treatment options for the following tumors of bone and cartilage:
  1. Osteoma
  2. Osteosarcoma
  3. Chondrosarcoma
15. Describe the clinical features and treatment options for the following tumors of blood-forming tissues:
  2. 1. Leukemia
  3. 2. Lymphoma
  4. 3. Multiple myeloma
K. Describe the clinical features and treatment options for the following tumors of melanin-producing cells and the treatment options:
1. Melanocytic nevus
2. Melanoma
L. Describe the clinical features and treatment options for the following tumors of bone and cartilage:
1. Osteoma
2. Osteosarcoma
3. Chondrosarcoma
M. Describe the clinical features and treatment options for the following tumors of blood-forming tissues:
1. Leukemia
2. Lymphoma
3. Multiple myeloma
N. Describe Langerhans cell histiocytosis.

7. Describe the genetic disorders clinical findings and significant deviations that require monitoring, treatment, or management of oral conditions.

A. Define each of the words listed in the vocabulary for this subject.

B. State the purpose of mitosis.

C. State the purpose of meiosis.

D. Explain what the Lyon hypothesis and give an example of its clinical significance.

E. Explain gross chromosomal abnormality.

F. List three examples of syndromes that result from gross chromosomal abnormalities.

G. List the four inheritance patterns.

H. Describe X-linked inheritance.

I. State the inheritance pattern, and describe the oral manifestations and, if appropriate, the characteristic facies for each of the following:

1. 1. Cyclic neutropenia
  2. Papillon-Lefevre syndrome
  3. Focal palmoplantar and gingival hyperkeratosis
  4. Gingival fibromatosis
  5. Laband syndrome
  6. Cherubism
  7. Ellis-van Creveld syndrome
  8. Cleidocranial dysplasia
  9. Gardner syndrome
  10. Mandibulofacial dysostosis
  11. Nevoid basal cell carcinoma syndrome
  12. Osteogenesis imperfecta
  13. Hereditary hemorrhagic telangiectasia
  14. Multiple endocrine neoplasia type 2B (MEN2B) syndrome
  15. Neurofibromatosis type 1
  16. Neurofibromatosis type 2
  17. Peutz-Jeghers syndrome
  18. White sponge nevus

J. List the four types of amelogenesis imperfecta.
K. Compare and contrast dentinogenesis imperfecta, amelogenesis imperfecta, and dentin dysplasia.

8. Describe the normal range of clinical findings and significant deviations of oral manifestations of systemic disease that require monitoring, treatment, or management of oral conditions.

1. Define each of the words in the vocabulary list for this subject.
2. Describe the difference between gigantism and acromegaly, and describe the physical characteristics of each.
3. State the oral manifestation of hyperthyroidism.
4. Describe the difference between primary and secondary hyperparathyroidism.
5. Define diabetes mellitus, and describe the oral manifestations.
6. Describe the differences between type I and type II diabetes.
7. Define Addison’s disease, and describe the changes that occur on the skin and oral mucosa in a patient with Addison’s disease.
8. Compare and contrast monostotic fibrous dysplasia with polyostotic fibrous dysplasia.
9. Compare and contrast the radiographic appearance, histologic appearance, and treatment of fibrous dysplasia of the jaws with those of ossifying fibroma of the jaws.
10. Compare and contrast the three types of polyostotic fibrous dysplasia.
11. Describe the histologic appearance of Paget’s disease of bone, and describe its clinical and radiographic appearance when the maxilla or mandible is involved.
12. State the cause of osteomalacia and rickets.
13. Compare and contrast the cause, laboratory findings, and oral manifestations of each of the following: iron deficiency anemia, pernicious anemia, folic acid deficiency, and vitamin B12 deficiency.
14. Compare and contrast the definitions and oral manifestations of thalassemia and sickle cell anemia.
15. Define celiac sprue.
16. Describe the difference between primary and secondary aplastic anemia.
17. Explain why platelets may be deficient in polycythemia vera.
18. Describe the oral manifestations of polycythemia.
19. Describe the most characteristic oral manifestations of agranulocytosis.
20. Describe and contrast acute and chronic leukemia.
21. State the purpose of each of the following laboratory tests: platelet count, bleeding time, prothrombin time, partial thromboplastin time.
22. List two causes of thrombocytopenic purpura.
23. Describe the oral manifestations of thrombocytopenia and nonthrombocytopenic purpura
24. Define hemophilia and describe its oral manifestations and treatment.
25. Describe the difference between primary and secondary immunodeficiency.
26. Describe the spectrum of HIV disease, including initial infection and the development of AIDS.
27. List the oral manifestations of HIV infection.