Oral Medicine - A Clinical Guide

Foreword
Preface
Contents
Part I: The Oral Medicine Patient
	1: History Taking
		1.1	 Introduction
		1.2	 The Presenting Complaint
		1.3	 History of the Presenting Complaint
		1.4	 Medical History
		1.5	 Dental History
		1.6	 Family and Social History
		Recommended Reading
	2: Clinical Examination
		2.1	 Introduction
		2.2	 General Examination
		2.3	 Extra-oral Head and Neck Examination
		2.4	 Intra-oral Examination
		2.5	 Variations of Normal Anatomical Oral Structures and Orofacial Anatomy
		2.6	 Differential Diagnosis
		Recommended Reading
	3: Blood Tests
		3.1	 Introduction
		3.2	 Haematology: Full Blood Count
		3.3	 Blood Chemistry: Blood Sugar Estimation
		3.4	 Haematinics
		3.5	 Inflammatory Markers, Serology, Human Leukocyte Antigen (HLA), and Antinuclear Cytoplasmic Antibody (ANCA) Testing
		3.6	 Coagulation Panel
		Recommended Reading
	4: Imaging
		4.1	 Introduction
		4.2	 Ionising Radiation-Based Imaging Techniques
		4.3	 Non-ionising Radiation-based Imaging Techniques
		4.4	 Functional Imaging Techniques
		Recommended Reading
	5: Tissue Pathology and Cytopathology
		5.1	 Introduction
		5.2	 Tissue Pathology
			5.2.1	 Histopathology
			5.2.2	 Immunofluorescence
			5.2.3	 Molecular Biological Tests
		5.3	 Cytopathology
		Recommended Reading
Part II: Oral Mucosal and Salivary Pathology
	6: Oral Human Herpes Virus Infections
		6.1	 Introduction
		6.2	 Clinical Presentation and Investigations
		6.3	 Management and Prognosis
		Recommended Reading
	7: Coxsackie Viruses
		7.1	 Introduction
		7.2	 Clinical Presentation and Investigations
		7.3	 Management and Prognosis
		Recommended Reading
	8: Orofacial Human Papillomavirus Infections
		8.1	 Introduction
		8.2	 Clinical Presentation and Investigations
			8.2.1	 Squamous Papilloma
			8.2.2	 Verruca Vulgaris
			8.2.3	 Condyloma Acuminatum
			8.2.4	 Multifocal Epithelial Hyperplasia (Heck’s Disease)
		8.3	 Management and Prognosis
		Recommended Reading
	9: Orofacial Viral Infections
		9.1	 Measles
			9.1.1	 Introduction
			9.1.2	 Clinical Presentation and Investigations
			9.1.3	 Management and Prognosis
		9.2	 Mumps
			9.2.1	 Introduction
			9.2.2	 Clinical Presentation and Investigations
			9.2.3	 Management and Prognosis
		9.3	 Rubella
			9.3.1	 Introduction
			9.3.2	 Clinical Presentation and Investigations
			9.3.3	 Management and Prognosis
		Recommended Reading
	10: Necrotising Periodontal Disease
		10.1	 Introduction
		10.2	 Clinical Presentation and Investigations
		10.3	 Management and Prognosis
		Recommended Reading
	11: Oral Manifestations of Actinomycosis
		11.1	 Introduction
		11.2	 Clinical Presentation and Investigations
		11.3	 Management and Prognosis
		Recommended Reading
	12: Oral Manifestations of Tuberculosis
		12.1	 Introduction
		12.2	Clinical Presentation and Investigations
		12.3	Management and Prognosis
		Recommended Reading
	13: Oral Manifestations of Syphilis
		13.1	 Introduction
		13.2	Clinical Presentation and Investigations
		13.3	Management and Prognosis
		Recommended Reading
	14: Oral Manifestations of Bacterial Infections
		14.1	 Introduction
		Recommended Reading
	15: Non-Candida Fungal Infections
		15.1	 Introduction
		Recommended Reading
	16: Candidosis and Candida-Associated Conditions
		16.1	 Introduction
		16.2	 Clinical Presentation and Investigations
		16.3	 Management and Prognosis
		Recommended Reading
	17: Oral Lichen Planus
		17.1	 Introduction
		17.2	 Clinical Presentation and Investigations
		17.3	 Management and Prognosis
		Recommended Reading
	18: Lupus Erythematosus
		18.1	 Introduction
		18.2	 Clinical Presentation and Investigations
		18.3	 Management and Prognosis
		Recommended Reading
	19: Pemphigus Vulgaris
		19.1	 Introduction
		19.2	 Clinical Presentation and Investigations
		19.3	 Management and Prognosis
		Recommended Reading
	20: Mucous Membrane Pemphigoid
		20.1	 Introduction
		20.2	 Clinical Presentation and Investigations
		20.3	 Management and Prognosis
		Recommended Reading
	21: Epidermolysis Bullosa
		21.1	 Introduction
		21.2	 Clinical Presentation and Investigations
		21.3	 Management and Prognosis
		Recommended Reading
	22: Erythema Multiforme, Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
		22.1	 Introduction
		22.2	Clinical Presentation and Investigations
		22.3	Management and Prognosis
		Recommended Reading
	23: Oral Graft-Versus-Host Disease
		23.1	 Introduction
		23.2	 Clinical Presentation and Investigations
		23.3	 Management and Prognosis
		Recommended Reading
	24: Allergy and the Mouth
		24.1	 Introduction
		24.2	 Clinical Presentation and Investigations
		24.3	 Management and Prognosis
		Recommended Reading
	25: Orofacial Granulomatosis
		25.1	 Introduction
		25.2	 Clinical Presentation and Investigations
		25.3	 Management and Prognosis
		Recommended Reading
	26: Crohn’s Disease
		26.1	 Introduction
		26.2	 Clinical Presentation and Investigations
		26.3	 Management and Prognosis
		Recommended Reading
	27: Other Granulomatous Disorders
		27.1	 Introduction
		27.2	 Granulomatosis with Polyangiitis
			27.2.1	 Clinical Presentation and Investigations
			27.2.2	 Management and Prognosis
		27.3	 Sarcoidosis
			27.3.1	 Clinical Presentation and Investigations
			27.3.2	 Management and Prognosis
		27.4	 Tuberculosis
			27.4.1	 Clinical Presentation and Investigations
			27.4.2	 Management and Prognosis
		Recommended Reading
	28: Benign Salivary Gland Disorders
		28.1	 Introduction
		28.2	 Clinical Presentation and Investigations
		28.3	 Management and Prognosis
		Recommended Reading
	29: Salivary Hypofunction and Xerostomia
		29.1	 Introduction
		29.2	 Clinical Presentation and Investigations
		29.3	 Management and Prognosis
		Recommended Reading
	30: Sjögren’s Syndrome
		30.1	 Introduction
		30.2	 Clinical Presentation and Investigations
		30.3	 Management and Prognosis
		Recommended Reading
	31: Benign Mucosal Lesions
		31.1	 Introduction
		31.2	 Conclusion
		Recommended Reading
	32: Oral Potentially Malignant Disorders
		32.1	 Introduction
		32.2	 Clinical Presentation and Investigations
		32.3	 Management and Prognosis
		Recommended Reading
	33: Oral Leukoplakia
		33.1	 Introduction
		33.2	 Clinical Presentation and Investigations
		33.3	 Management and Prognosis
		Recommended Reading
	34: Erythroplakia
		34.1	 Introduction
		34.2	 Clinical Presentation and Investigations
		34.3	 Management and Prognosis
		Recommended Reading
	35: Oral Submucous Fibrosis
		35.1	 Introduction
		35.2	 Clinical Presentation and Investigations
		35.3	 Management and Prognosis
		Recommended Reading
	36: Malignant Potential of Oral Lichen Planus
		36.1	 Introduction
		36.2	 Differentiating Oral Lichen Planus from Oral Lichenoid Lesions
		36.3	 Oral Lichen Planus and Epithelial Dysplasia
		36.4	 Clinical Factors Increasing Malignant Potential of Oral Lichen Planus
		Recommended Reading
	37: Oral Lichenoid Lesions
		37.1	 Introduction
		37.2	 Clinical Presentation and Investigations
		37.3	 Management and Prognosis
		Recommended Reading
	38: Actinic Cheilitis
		38.1	 Introduction
		38.2	 Clinical Presentation and Investigations
		38.3	 Management and Prognosis
		Recommended Reading
	39: Oral Squamous Cell Carcinoma
		39.1	 Introduction
		39.2	 Clinical Presentation and Investigations
		39.3	 Management and Prognosis
		Recommended Reading
	40: Other Mucosal Malignancies: Oral Melanoma, Oral Lymphomas, and Oral Kaposi Sarcoma
		40.1	 Introduction
		40.2	 Clinical Presentation and Investigations
		40.3	 Management and Prognosis
		Recommended Reading
	41: Pleomorphic Adenoma
		41.1	 Introduction
		41.2	 Clinical Presentation and Investigations
		41.3	 Management and Prognosis
		Recommended Reading
	42: Warthin’s Tumour and Other Benign Neoplasms of the Salivary Glands
		42.1	 Warthin’s Tumour (Papillary Cystadenoma Lymphomatosum)
			42.1.1	 Introduction
			42.1.2	 Clinical Presentation and Investigations
			42.1.3	 Management and Prognosis
		42.2	 Other Benign Salivary Gland Tumours
		Recommended Reading
	43: Mucoepidermoid Carcinoma
		43.1	 Introduction
		43.2	 Clinical Presentation and Investigations
		43.3	 Management and Prognosis
		Recommended Reading
	44: Adenoid Cystic Carcinoma
		44.1	 Introduction
		44.2	 Clinical Presentation and Investigations
		44.3	 Management and Prognosis
		Recommended Reading
	45: Other Malignant Salivary Gland Tumours
		45.1	 Acinic Cell Carcinoma
		45.2	 Polymorphous Adenocarcinoma
		45.3	 Secretory Carcinoma
		45.4	 Epithelial-Myoepithelial Carcinoma
		Recommended Reading
	46: Differential Diagnosis of Mucosal Swellings
		Recommended Reading
	47: Differential Diagnosis of Localised Gingival Swellings
		Recommended Reading
	48: Differential Diagnosis of Diffuse Gingival Swelling
		48.1	 Introduction
		Recommended Reading
	49: Differential Diagnosis of Oral Ulceration
		Recommended Reading
	50: Traumatic Oral Ulceration
		50.1	 Introduction
		50.2	 Clinical Presentation and Investigations
		50.3	 Management and Prognosis
		Recommended Reading
	51: Aphthae and Recurrent Aphthous Stomatitis
		51.1	 Introduction
		51.2	 Clinical Presentation and Investigations
		51.3	 Management and Prognosis
		Recommended Reading
	52: Infection-Related Oral Ulceration
		52.1	 Introduction
		52.2	 Viral
			52.2.1	 Herpes Simplex Virus 1 and 2 (HSV 1 & 2)
		52.3	 Bacterial
			52.3.1	 Tuberculosis
			52.3.2	 Syphilis
		52.4	 Fungal
		Recommended Reading
	53: Drug-Induced Ulceration
		53.1	 Introduction
		53.2	 Clinical Presentation and Investigations
		53.3	Management and Prognosis
		Recommended Reading
	54: Chronic Ulcerative Stomatitis
		54.1	 Introduction
		54.2	 Clinical Presentation and Investigations
		54.3	Management and Prognosis
		Recommended Reading
	55: Traumatic Ulcerative Granuloma with Stromal Eosinophilia
		55.1	 Introduction
		55.2	 Clinical Presentation and Investigations
		55.3	 Management and Prognosis
		Recommended Reading
	56: Necrotising Sialometaplasia
		56.1	 Introduction
		56.2	 Clinical Presentation and Investigations
		56.3	Management and Prognosis
		Recommended Reading
	57: Ulceration Related to Systemic Disorders
		57.1	 Introduction
		57.2	 Clinical Presentation and Investigations
		57.3	 Management and Prognosis
		Recommended Reading
	58: Differential Diagnosis of Pigmented Lesions
		58.1	 Introduction
		58.2	 Clinical Presentation and Investigations
		58.3	Management and Prognosis
		Recommended Reading
	59: Common Causes of Oral Pigmentation
		59.1	 Introduction
		59.2	 Clinical Presentation and Investigations
		59.3	 Management and Prognosis
		Recommended Reading
	60: Melanotic Macules, Naevi, and Melanoma
		60.1	 Introduction
		60.2	 Clinical Presentation and Investigations
		60.3	Management and Prognosis
		Recommended Reading
	61: Oral Mucosal Pigmentation Secondary to Systemic Disorders and Medications
		61.1	 Introduction
		61.2	 Clinical Presentation and Investigations
		61.3	 Management and Prognosis
		Recommended Reading
	62: Differential Diagnosis of White Oral Mucosal Lesions
		62.1	 Introduction
		Recommended Reading
	63: Differential Diagnosis of Red Oral Mucosal Lesions
		63.1	 Introduction
		Recommended Reading
Part III: Oral Considerations in Systemic Disease
	64: Anaemia and Iron Deficiency
		64.1	 Introduction
		64.2	 Iron Absorption and Testing
		64.3	 Oral Manifestations of Iron Deficiency
			64.3.1	 Atrophic Glossitis
			64.3.2	 Plummer-Vinson Syndrome
			64.3.3	 Fungal Infection
		Recommended Reading
	65: Bleeding Diathesis and Anti-thrombotic Drugs
		65.1	 Introduction
		65.2	 Dental Considerations
		Recommended Reading
	66: Haematological Malignancies: Leukaemia, Lymphoma and Multiple Myeloma
		66.1	 Introduction
		66.2	 The Leukaemias
			66.2.1	 Clinical Presentation and Investigations
			66.2.2	 Management and Prognosis
		66.3	 Lymphoma
		66.4	 Multiple Myeloma
		Recommended Reading
	67: Chronic Graft-Versus-Host Disease
		67.1	 Introduction
		67.2	 Early Adverse Effects of Haematopoietic Stem Cell Transplantation
		67.3	 Graft-Versus-Host Disease
		67.4	 Late-Effects of Haematopoietic Stem Cell Transplantation
		67.5	 Clinical Presentation
			67.5.1	 Oral Chronic Graft-Versus-Host Disease
			67.5.2	 Salivary Gland
			67.5.3	 Musculoskeletal
		67.6	 Management and Prognosis
		Recommended Reading
	68: Vermilion Disorders
		68.1	 Introduction
		68.2	 Recurrent Ulceration
		68.3	 Acute Widespread Denudation
		68.4	 Persistent Keratosis, Erythema or Ulceration
		68.5	 Chronic UV-Related Changes
		68.6	 Persistent Lip Enlargement
		68.7	 Conclusion
		Recommended Reading
	69: Sleep Disordered Breathing
		69.1	 Introduction
		69.2	 Clinical Presentation and Investigations
		69.3	 Management and Prognosis
		Recommended Reading
	70: Oral Appliance Therapy for Sleep Disordered Breathing
		70.1	 Introduction
		70.2	 Principles of Mandibular Advancement Appliance Therapy
		70.3	 Side Effects of Mandibular Advancement Appliance Therapy
		Recommended Reading
	71: Diabetes Mellitus
		71.1	 Introduction
		71.2	 Complications
		Recommended Reading
	72: Endocrinopathies
		72.1	 Introduction
		72.2	 The Pituitary Gland
		72.3	 The Parathyroid Glands
		72.4	 The Adrenal Glands
		Recommended Reading
	73: Osteoporosis and Medication-Related Osteonecrosis of the Jaws
		73.1	 Introduction
		73.2	 Clinical Presentation and Investigations
		73.3	Management and Prognosis
		Recommended Reading
	74: Immunology and the Oral Cavity
		74.1	 Introduction
		74.2	 Hypersensitivity Responses
			74.2.1	 Angioedema
		74.3	 Immune-Mediated Dermatologic Diseases and Autoimmunity
		74.4	 Immunodeficiency Disorders
		Recommended Reading
	75: Connective Tissue Disorders
		75.1	 Introduction
		75.2	Systemic Lupus Erythematosus (SLE)
		75.3	Dermatomyositis
		75.4	Sjogren’s Syndrome (SS)
		75.5	Mixed Connective Tissue Disease (MCTD)
		Recommended Reading
	76: Arthropathies of the Temporomandibular Joint
		76.1	 Introduction
		76.2	 Osteoarthritis
		76.3	 Inflammatory Arthropathies and Spondyloarthropathies
		Recommended Reading
	77: Scleroderma
		77.1	 Introduction
		77.2	 Clinical Presentation and Investigations
		77.3	 Management and Prognosis
		Recommended Reading
	78: Inflammatory Bowel Disease
		78.1	 Introduction
		78.2	 Oral Manifestations
		78.3	 Management of Oral Manifestations and Prognosis
		Recommended Reading
	79: Coeliac Disease
		79.1	 Introduction
		79.2	 Oral Manifestations
		79.3	 Management of Oral Manifestations and Prognosis
		Recommended Reading
	80: Other Gastrointestinal Conditions
		80.1	 Introduction
		80.2	 Gastro-Oesophageal Reflux Disease
		80.3	 Autoimmune Gastritis
		80.4	 Liver Diseases
		80.5	 Mucous Membrane Pemphigoid
		80.6	 Lichen Planus
		80.7	 Conclusion
		Recommended Reading
	81: Neurological, Neuromuscular, and Neuro-Sensory Disorders
		81.1	 Introduction
		81.2	 Epilepsy
		81.3	 Cerebrovascular Disease
		81.4	 Progressive Neuromuscular Conditions
			81.4.1	 Parkinson’s Disease
			81.4.2	 Huntington’s Disease
			81.4.3	 Multiple Sclerosis
		81.5	 Motor Neurone Disease
		81.6	 Myasthenia Gravis
		81.7	 Taste Disturbances
		Recommended Reading
	82: Bloodborne Infectious Diseases
		82.1	 Introduction
		82.2	 Clinical Presentation and Investigations
		82.3	 Management and Prognosis
		Recommended Reading
	83: Sexually Transmitted Infections
		83.1	 Introduction
		83.2	 Clinical Presentation and Investigations
		83.3	 Management and Prognosis
		Recommended Reading
	84: Oral Complications of Cancer Therapy
		84.1	 Introduction
		84.2	 Oral Mucosal Complications
			84.2.1	 Stomatitis
			84.2.2	 Infections
			84.2.3	 Other
		84.3	 Xerostomia and Salivary Gland Hypofunction
		84.4	 Musculoskeletal Complications
			84.4.1	 Medication-Related Osteonecrosis of the Jaw (MRONJ)
			84.4.2	 Dysphagia
		84.5	 Sensory Disturbances
			84.5.1	 Dysgeusia
			84.5.2	 Orofacial Pain
			84.5.3	 Other Neuropathies
		84.6	 Additional Considerations
		Recommended Reading
	85: Oral Mucositis
		85.1	 Introduction
		85.2	 Clinical Presentation and Investigations
		85.3	 Management and Prognosis
		Recommended Reading
	86: Radiotherapy and the Oral Cavity
		86.1	 Introduction
		86.2	 Clinical Presentation and Investigations
			86.2.1	 Acute Effects
			86.2.2	 Late Effects
		86.3	 Management and Prognosis
		Recommended Reading
Part IV: Orofacial Pain and Related Disorders
	87: Odontogenic Pain
		87.1	 Introduction
		87.2	Clinical Presentation and Investigations
		87.3	Management and Prognosis
		Recommended Reading
	88: Sinus Disorder-Related Orofacial Pain
		88.1	Introduction
		88.2	Clinical Presentation and Investigations
		88.3	Management and Prognosis
		Recommended Reading
	89: Cardiogenic Orofacial Pain
		89.1	Introduction
		89.2	Clinical Presentation and Investigations
		89.3	Management and Prognosis
		Recommended Reading
	90: Non-odontogenic Pain Related to Pathology
		90.1	 Introduction
		90.2	 Oral Mucosal Pain and Pain Related to Cancer
		90.3	 Pain from Intraosseous Pathology
		90.4	 Salivary Gland Pain
		90.5	 Conclusion
		Recommended Reading
	91: Neurovascular Orofacial Pain
		91.1	 Introduction
		91.2	Clinical Presentation and Investigations
		91.3	Management and Prognosis
		Recommended Reading
	92: Nociplastic Orofacial Pain
		92.1	Introduction
		92.2	Clinical Presentation and Investigations
		92.3	Management and Prognosis
		Recommended Reading
	93: Pain-Related Temporomandibular Disorders
		93.1	 Introduction
		93.2	 Clinical Presentation and Investigations
		93.3	 Management and Prognosis
		Recommended Reading
	94: Intra-articular Temporomandibular Joint Disorders
		94.1	 Introduction
		94.2	 Clinical Presentation and Investigations
		94.3	 Management and Prognosis
		Recommended Reading
	95: Tension-Type Headache
		95.1	 Introduction
		95.2	 Clinical Presentation and Investigations
		95.3	 Management and Prognosis
		Recommended Reading
	96: Migraine
		96.1	 Introduction
		96.2	 Clinical Presentation and Investigations
		96.3	 Management and Prognosis
		Recommended Reading
	97: Trigeminal Autonomic Cephalalgias
		97.1	 Introduction
		97.2	 Clinical Presentation and Investigations
		97.3	 Management and Prognosis
		Recommended Reading
	98: Headache Disorders Related to Orofacial Pain
		98.1	 Introduction
		98.2	 Headache Red Flags
		98.3	 Giant Cell Arteritis
		98.4	 Cervicogenic Headache
		98.5	 Conclusion
		Recommended Reading
	99: Trigeminal Neuralgia and Other Craniofacial Neuralgias
		99.1	 Introduction
		99.2	 Trigeminal Neuralgia
			99.2.1	 Clinical Presentation and Investigations
			99.2.2	 Management and Prognosis
		99.3	 Glossopharyngeal Neuralgia
		Recommended Reading
	100: Post-Herpetic Neuralgia
		100.1	 Introduction
		100.2	 Clinical Presentation and Investigations
		100.3	 Management and Prognosis
		Recommended Reading
	101: Post-Traumatic Trigeminal Neuropathic Pain
		101.1	 Introduction
		101.2	 Clinical Presentation and Investigations
		101.3	 Management and Prognosis
		Recommended Reading
	102: Other Orofacial Neuropathies
		102.1	 Introduction
		102.2	 Clinical Presentation and Investigations
		102.3	 Management and Prognosis
		Recommended Reading
	103: Burning Mouth Syndrome
		103.1	 Introduction
		103.2	 Clinical Presentation and Investigations
		103.3	 Management and Prognosis
		Recommended Reading
	104: Persistent Idiopathic Facial Pain
		104.1	 Introduction
		104.2	 Clinical Presentation and Investigations
		104.3	 Management and Prognosis
		Recommended Reading
	105: Persistent Idiopathic Dentoalveolar Pain
		105.1	 Introduction
		105.2	 Clinical Presentation and Investigations
		105.3	 Management and Prognosis
		Recommended Reading
	106: Constant Unilateral Facial Pain with Additional Attacks
		106.1	 Introduction
		106.2	 Clinical Presentation and Investigations
		106.3	 Management and Prognosis
		Recommended Reading
	107: Orofacial Movement Disorders
		107.1	 Orofacial Dystonia
			107.1.1 Clinical Presentation and Investigations
		107.2	 Orofacial Dyskinesia
			107.2.1 Clinical Presentation and Investigations
		107.3	 Drug-Induced Extrapyramidal Reaction
			107.3.1 Clinical Presentation and Investigations
		107.4 Management and Prognosis
		Recommended Reading
	108: Bruxism
		108.1	 Introduction
		108.2	 Clinical Presentation and Investigations
		108.3	 Management and Prognosis
		Recommended Reading
	109: Psychosocial Considerations for Orofacial Pain
		109.1	 Depression and Anxiety
		109.2	 Somatic Symptom Disorder
		109.3	 Catastrophising and Fear Avoidance
		109.4	 Management and Prognosis
		Recommended Reading
	110: Halitosis
		110.1	 Introduction
		110.2	 Clinical Presentation and Investigations
		110.3	 Management and Prognosis
		Recommended Reading
	111: Facial Palsy
		111.1	 Introduction
		111.2	 Clinical Presentation and Investigations
		111.3	Management and Prognosis
		Recommended Reading