CHAPTER 5 - ORAL PATHOLOGY

Oral pathology is the science that treats the nature, causes, and development of oral diseases. It includes both the clinical and the microscopic study of structural and functional changes that cause, or are caused by, oral and other diseases. Either the calcified or the soft tissues of the oral cavity, or both, may be involved.

Some of the abnormal conditions that exist in the oral cavity and cause patients to request treatment will be described in this chapter and chapter 6, "Treatment of Oral Diseases." Occasionally, the Dental Technician might be the first one to observe these pathologic conditions in the patient's mouth. Always notify a dental officer if you observe a condition you may have in question. Never make a diagnosis or tell a patient what you think he/she might have. That area of expertise is the sole responsibility of the dental officer.

Although there are many oral anomalies (deviations from normal), this chapter is limited to the two classes of prime interest to Dental Technicians. These classes are discussed in the following statements:

Congenital anomalies-Occur before birth.

Examples of such are cleft palate, cleft lip (fig. 5-1), and supernumerary teeth.

Acquired anomalies-Occur after birth.

Examples are periodontal disease and dental caries.

Pathogenic conditions of the oral cavity may be caused by:

-Pathologic micro-organisms: Destroy the calcified tissues and inflame the soft tissues in the oral cavity.

-Defective development: Involves the calcified tissues as a result of infection, trauma, nutritional deficiencies, disease, or heredity.

-Degeneration: Involves the hard or soft tissues.

-Malocclusion: Results from defective development of the jaws or loss of teeth, and produces excessive stress on portions of the periodontium.

-Trauma: Involves either the calcified or soft tissues.

Figure 5-1.\Cleft lip of an infant.

\Neglect: Result of the lack of proper oral hygiene.

MICRO-ORGANISMS

Salivary glands secrete about 1,500 ml of saliva on a daily basis. Microscopic counts in saliva show an average of 750 million micro-organisms per milliliter. Because the temperature in the oral cavity is around 98.6 Fahrenheit, the mouth is the perfect environment for micro-organisms to live. Micro-organisms have a dark, moist, warm area, and a good source of food supply to live. These micro-organisms can be divided into four major classifications-bacteria, protozoa, viruses, and fungi\which will be discussed in chapter 9, "Infection Control."

ORAL LESIONS

Oral lesions can be defined as any pathological or traumatic disorder of tissue that creates a loss of function of the area affected. They can include wounds, sores, and any other tissue damage resulting from disease or injury. Many types of lesions can occur in the mouth. The location of the lesion can assist in determining the type.

LESIONS BELOW THE SURFACE

The types of lesions that extend below the surface of the mucosa and are the most common in oral pathology are the following:

Abscess\A localized collection of pus in a specific area of soft tissue or bone. Often it is confined in a particular space, and is commonly caused by a bacterial infection.

Cyst\An enclosed pouch or sac that contains fluid or semisolid material.

Ulcers\A disruption of the superficial covering of the mucosa or skin. May be caused by biting, denture irritation, toothbrush injury, viruses or other irritants.