DH 213 - Oral Pathology
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
Outcomes and Objectives 1. Recognize the normal range of clinical findings and significant deviations that require monitoring, treatment, or management of oral
A. Define the vocabulary list for this subject.
B. List and define the eight diagnostic categories that contribute to the diagnostic process.
C. Name a diagnostic category and give an example of a lesion, anomaly, or condition for which this category contributes greatly to the
D. Describe the clinical appearance of Fordyce's granules (spots), torus palatinus mandibular tori, and lingual varicosities, and identify them
on a slide.
E. Describe the radiographic picture and historical data (including the age, sex, and race of the patient) that are relevant to periapical
cemental dysplasia (cementoma).
F. Define “variant of normal” and give three examples of such lesions involving the tongue.
G. List and describe the clinical characteristics and identify a clinical picture of fissured tongue, median rhomboid glossitis, geographic
tongue, ectopic geographic tongue, and hairy tongue.
H. Describe the clinical and histologic differences between leukoedema and linea alba.
2. Understand the role inflammation and repair plays in oral conditions and diseases.
A. Define the words in the vocabulary list for this subject.
B. List the five “cardinal signs” of inflammation that are visible at the site of inflammation.
C. List three systemic signs of inflammation.
D. Describe the microscopic events that are associated with each of the cardinal signs of
E. List and describe the microscopic events of the inflammatory process, beginning with injury and ending with phagocytosis of foreign and
F. Define the terms “flare” and “wheel.”
G. List the types of white blood cells that participate in inflammation and describe the function of neutrophils and monocytes.
H. Describe the differences between acute and chronic inflammation.
I. Define and contrast hyperplasia and hypertrophy.
J. Describe the microscopic events that occur during the repair of a mucosal wound.
K. Describe and contrast healing by primary intention, healing by secondary intention, and healing by tertiary intention.
L. Describe and contrast attrition, abrasion, and erosion.
M. Describe the pattern of erosion seen in bulimia.
N. Describe the relationship between bruxism and abrasion.
O. Describe the cause, clinical features, and treatment of each of the following:
1. Aspirin and phenol burns
2. Electric burn
3. Traumatic ulcer
4. Frictional keratosis
5. Linea alba
6. Nicotine stomatitis
P. Describe the clinical features, cause (when known), treatment, and histologic appearance of each of the following:
1. Traumatic neuroma
2. Post inflammatory melanosis
3. Solar cheilitis
6. Necrotizing sialometaplasia
7. Pyogenic granuloma
8. Giant cell granuloma
9. Chronic hyperplastic pulpitis
10. Irritation fibroma
Q. Describe the difference between a mucocele and a ranula.
R. Define sialolithiasis.
S. Describe the difference between acute and chronic sialoadenitis.
T. Describe the clinical features, radiographic appearance, and histologic appearance of a periapical abscess, a periapical granuloma, and a
periapical (radicular) cyst.
U. Describe and contrast internal and external tooth resorption.
3. Recognize the role immunity plays in oral conditions, disease etiologies, treatment alternatives and prognoses with the patient and
A. Define words the vocabulary list for this subject.
B. Describe the primary difference between the immune response and the inflammatory response.
C. List the two main types of lymphocytes and their origins.
D. List three activities of macrophages.
E. Describe, using the cells involved, the difference between the humoral immune response and the cell-mediated immune response.
F. Describe the difference between active and passive immunity.
G. Give one example of active immunity, and give one example of passive immunity.
H. List and describe four types of hypersensitivity reactions, and give an example of each.
I. Define autoimmunity, and describe how it results in disease.
J. Define immunodeficiency, and describe how it results in disease.
K. Describe and contrast the clinical features of each of the three types of aphthous ulcers.
L. List three systemic diseases associated with aphthous ulcers.
M. Describe and compare the clinical features of urticaria, angioedema, contact mucositis, fixed drug eruption, and erythema multiforme.
N. Describe the clinical and histologic features of lichen planus.
O. List the triad of systemic signs that compose Reiter’s syndrome, and describe the oral lesions that occur in this syndrome.
P. Name the three diseases that are traditionally included in the classification of histiocytosis X. Sate the range of ages affected and the oral
manifestations, if any, and the prognosis of each disease. Name the two cells that characterize these diseases histologically.
Q. Describe the oral manifestations of each of the following autoimmune diseases:
1. Sjögren’s syndrome
2. Lupus erythematosus
3. Pemphigus vulgaris
4. Cicatricial pemphigoid
5. Behçet’s syndrome
R. Describe the clinical features of desquamative gingivitis, and list three diseases in which it may occur.
S. Describe the components of Behçet’s syndrome.
T. Describe how infection occurs and the factors involved.
U. Describe the mechanism that allows opportunistic infection to develop.
V. For each of the following infectious diseases, name the organism causing it; list the route or routes of transmission of the organism and the
oral manifestations of the disease; and describe how the diagnosis is made:
3. Syphilis (primary, secondary, tertiary)
4. Verruca vulgaris
5. Condyloma acuminatum
6. Primary herpetic gingivostomatitis
W. List and describe four forms of oral candidiasis.
X. List two examples of opportunistic infections that can occur in the oral cavity.
Y. Describe the clinical features of herpes labialis.
Z. Describe the clinical features of intraoral herpes simplex infection, and compare them with the clinical features of minor aphthous ulcers.
AA. Describe the clinical characteristics of herpes zoster when it affects the facial area and oral cavity.
BB. List two oral infectious diseases for which a cytologic smear may be helpful to the diagnosis.
CC. List the four diseases associated with the Epstein-Barr virus that occurs in the oral region.
4. Recognize the developmental disorders clinical findings and significant deviations that require monitoring, treatment, or management
of oral conditions.
A. Define the words in the vocabulary list for this subject.
B. Define inherited disorders.
C. Recognize developmental disorders of the dentition.
D. Describe the embryonic development of the face, oral cavity, and teeth.
E. Define, describe, and identify all the developmental anomalies discussed in this chapter.
F. Identify clinically, radiographically, or both, the developmental anomalies discussed in this chapter.
G. Distinguish between intraosseous cysts and extraosseous cysts.
H. Describe the differences between odontogenic and nonodontogenic cysts.
I. Name four odontogenic cysts that are intraosseous.
J. Name two odontogenic cysts that are extraosseous.
K. Name four nonodontogenic cysts that are intraosseous.
L. Name four nonodontogenic cysts that are extraosseous.
M. List and define three anomalies that affect the number of teeth.
N. List and define two anomalies that affect the size of the teeth.
O. List and define five anomalies that affect the shape of the teeth.
P. Identify anomalies affecting tooth eruption.
Q. Identify the diagnostic process that contributes most significantly to the final diagnosis of each developmental anomaly discussed in this
5. Recognize the neoplasia clinical findings and significant deviations that require monitoring, treatment, or management of oral
A. Define each of the words in the vocabulary list for this subject.
B. Explain the difference between a benign tumor and a malignant tumor.
C. Define leukoplakia and erythroplakia.
D. Define each neoplasm.
E. Describe the clinical features of each neoplasm.
F. Explain the usual treatment for each neoplasm.
G. Describe the clinical and histologic features of the calcifying odontogenic cyst, and explain why it is sometimes considered a neoplasm.
H. Describe the clinical features, radiographic appearance, and management of periapical cemental dysplasia and florid osseous dysplasia.
6. Recognize the genetic disorders clinical findings and significant deviations that require monitoring, treatment, or management of oral
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 is meant by the Lyon hypothesis, and give an example of its clinical significance.
E. Explain what is meant by a gross chromosomal abnormality, and give three examples of syndromes that result from gross chromosomal
F. List the four inheritance patterns.
G. Explain what is meant by X-linked inheritance.
H. State the inheritance pattern, and describe the oral manifestations and, if appropriate, the characteristic facies for each of the following:
1. Cyclic neutropenia
2. Papillon-Lefèvre syndrome
4. Chondroectodermal dysplasia (Ellis-van Creveld syndrome)
5. Mandibulofacial dysostosis (Treacher Collins syndrome)
6. Osteogenesis imperfecta
7. Hereditary hemorrhagic telangiectasia
8. (Osler-Rendu-Parkes Weber syndrome)
9. Peutz-Jeghers syndrome
10. White spongy nevus (Cannon’s disease)
11. Hypohidrotic ectodermal dysplasia
13. Hypophosphatemic vitamin D-resistant rickets
I. State the inheritance pattern, the oral or facial manifestations, and the type and location of the malignancy associated with each of the
1. Gardner’s syndrome
2. Nevoid basal cell carcinoma syndrome (Gorlin syndrome)
3. Multiple mucosal neuromas, medullary carcinoma of the thyroid gland, and pheochromocytoma syndrome (MEN 2B)
4. Intestinal polyps are a component of both Peutz-Jeghers syndrome and Gardner’s syndrome.
J. State the location and malignant potential of the intestinal polyps in each of these syndromes.
K. List the four types of amelogenesis imperfecta.
L. Briefly compare and contrast dentinogenesis imperfecta, amelogenesis imperfecta, and dentin dysplasia, including the inheritance patterns
and the clinical manifestations and radiographic appearance of each.
7. Recognize the normal range of clinical findings and significant deviations of oral manifestations of systemic disease that require monitoring, treatment, or management of oral conditions.
A. Define each of the words in the vocabulary list for this subject.
B. Describe the difference between gigantism and acromegaly, and describe the physical characteristics of each.
C. State the oral manifestation of hyperthyroidism.
D. Describe the difference between primary and secondary hyperparathyroidism.
E. Define diabetes mellitus, and describe the oral manifestations.
F. Describe the differences between type I and type II diabetes.
G. Define Addison’s disease, and describe the changes that occur on the skin and oral mucosa in a patient with Addison’s disease.
H. Compare and contrast monostotic fibrous dysplasia with polyostotic fibrous dysplasia.
I. Compare and contrast the radiographic appearance, histologic appearance, and treatment of fibrous dysplasia of the jaws with those of
ossifying fibroma of the jaws.
J. Compare and contrast the three types of polyostotic fibrous dysplasia.
K. Describe the histologic appearance of Paget’s disease of bone, and describe its clinical and radiographic appearance when the maxilla or
mandible is involved.
L. State the cause of osteomalacia and rickets.
M. 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.
N. Compare and contrast the definitions and oral manifestations of thalassemia and sickle cell anemia.
O. Define celiac sprue.
P. Describe the difference between primary and secondary aplastic anemia.
Q. Explain why platelets may be deficient in polycythemia vera.
R. Describe the oral manifestations of polycythemia.
S. Describe the most characteristic oral manifestations of agranulocytosis.
T. Describe and contrast acute and chronic leukemia.
U. State the purpose of each of the following laboratory tests: platelet count, bleeding time, prothrombin time, partial thromboplastin time.
V. List two causes of thrombocytopenic purpura.
W. Describe the oral manifestations of thrombocytopenia and nonthrombocytopenic purpura.
X. Define hemophilia, and describe its oral manifestations and treatment.
Y. Describe the difference between primary and secondary immunodeficiency.
Z. Describe the spectrum of HIV disease, including initial infection and the development of AIDS.
AA. List five oral manifestations of HIV infection.
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