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
• 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

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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

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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

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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.

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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

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Riga Fide

• early erupted tooth, infant w/ ulcer on
  undersurface of tongue
• D dx riga fide, aphthous lesion
• Age of pt will make dx.

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Toothbrush abrasion

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

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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 cant be
  controlled by bodys defenses, bone death results
• D Dx burn, ionizing radiation damage, xerostomia
  due to medications

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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