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Oral Medicine & Radiology 
Oral 
Diagnosis 
Oral 
Medicine 
Oral 
Radiology
Definitions 
Oral Diagnosis is defined as an art and science of 
identifying an oral disease from its symptoms and signs. 
Oral Oral Medicine Radiology is is defined defined as as that a science branch composed of dentistry 
of 
which technical deals and with: 
interpretative procedures that 
1. Diagnosis, treatment and prevention of: 
interdependently result in useful diagnostic data. 
a. Oral mucosal diseases 
b. Local oral diseases 
c. Oral manifestations of systemic diseases 
Oral Radiography is defined as an art and science of 
producing photographic image of oral tissues through 
use of x-radiation. 
2. Dental management of physiologically compromised 
patients.
Reading Material 
 Lecture notes 
 Burket’s Oral Medicine 
by Malcolm Lynch, 8th / 9th Edition 
 Oral Radiology: Principles & Interpretation 
by Goaz & White, 2nd / 3rd Edition 
 Differential Diagnosis of Oral Lesions 
by Goaz & Wood, 2nd / 3rd Edition
Oral Medicine is defined as that branch of 
dentistry which deals with: 
1. Diagnosis, treatment and prevention of: 
a. Oral mucosal diseases 
b. Local oral diseases 
c. Oral manifestations of systemic 
diseases 
2. Dental management of physiologically 
compromised patients.
Oral Medicine 
Oral mucosal 
diseases 
Local oral 
diseases 
• Oral manifestations of systemic diseases 
• Dental management of physiologically 
compromised patients.
CLASSIFICATION OF ORAL DISEASES 
Some ways of classifying oral diseases : 
~ Based on etiology 
e.g. viral, traumatic 
~ Based on the pathological process involved 
e.g. inflammatory, neoplastic 
~ Based on symptoms 
e.g. recurrent, painful conditions, tumorous 
conditions 
~ Based on clinical appearance of lesions 
e.g. ulcerative, vesicular, erosive 
~ Based on origin 
e.g. developmental, acquired
“A lesion is a localized area of disease or 
injury in any organ or tissue of the body” 
ORAL SOFT TISSUE LESIONS 
WHITE 
ULCER 
EXOPHYTIC 
YELLOW DRAINING 
and PITS 
BROWNISH, 
BLUISH 
or BLACK 
RED 
Keratotic 
Necrotic 
Solitary Generalized Tongue
Fordyce’s granules, 
Leukoplakia, Lichen 
Fibroma, Lip pits, 
Mucocele, 
Aphthous, Traumatic, 
Lipoma, Jaundice, 
planus, Burns 
Draining abscess, 
Tori, Pyogenic 
ORAL SOFT TISSUE LESIONS 
WHITE 
CarotMeneelamnioama, 
Oro-antral fistula 
granuloma 
Mucocele, Petechiae 
Erythroplakia, Acute 
& ecchymoses 
atrophic candidiasis, 
ULCER 
Malignant 
Glossitis 
EXOPHYTIC 
YELLOW DRAINING 
and PITS 
BROWNISH, 
BLUISH 
or BLACK 
RED 
Keratotic 
Necrotic 
Solitary Generalized Tongue
Another way of classifying oral lesions : 
PRIMARY 
LESION 
SECONDARY 
LESION 
Macule, Plaques, Papule, Patch 
Nodule, Tumor 
Vesicle, Bulla, Pustule 
Petechia, Ecchymosis
Macule: Sharply circumscribed discoloration (flat) up to 1 
cm in diameter 
Patch: Sharply circumscribed discoloration (flat) more 
than 1 cm in diameter
Papule: Well circumscribed, solid, flat-topped raised lesion 
up to 1 cm in diameter 
Plaque: Well circumscribed solid raised lesion more 
than 1 cm in diameter
Nodule: Well circumscribed solid, rounded projection up 
to 1 cm in diameter 
Tumor: Well circumscribed solid, rounded projection 
more than 1 cm in diameter
Vesicle: Sharply circumscribed serous fluid-filled elevation 
up to 1 cm in diameter 
Bulla: Sharply circumscribed serous fluid-filled elevation 
more than 1 cm in diameter
Vesicle: Sharply circumscribed serous fluid-filled elevation 
up to 1 cm in diameter 
Bulla: Sharply circumscribed serous fluid-filled elevation 
more than 1 cm in diameter
Vesicle: Sharply circumscribed serous fluid-filled elevation 
up to 1 cm in diameter 
Bulla: Sharply circumscribed serous fluid-filled elevation 
more than 1 cm in diameter
Pustule: Sharply circumscribed pus-filled elevation similar 
to vesicle or bulla
Petechiae: Sharply circumscribed deposit of blood or 
blood pigments up to 1 cm in diameter 
Ecchymosis: Sharply circumscribed deposit of blood or 
blood pigments more than 1 cm in diameter
Petechiae: Sharply circumscribed deposit of blood or 
blood pigments up to 1 cm in diameter 
Ecchymosis: Sharply circumscribed deposit of blood or 
blood pigments more than 1 cm in diameter
Another way of classifying oral lesions : 
PRIMARY 
LESION 
SECONDARY 
LESION 
Erosion, Ulcer, Scar 
Infiltration
Erosion: Loss of superficial layers of epithelium 
Ulcer: Break in the continuity of the epithelium (deeper 
than an erosion)
Scar: Deposit of highly fibrous tissue subsequent to ulcer or 
injury 
Infiltration: Extension of the primary lesion into the 
deeper tissue causing fixity or induration
“Colour Atlas of Oral Diseases” 
George Laskaris 
2nd Edition, 1994
DESCRIPTION OF A DISEASE PROCESS 
Definition 
Etiology & Pathogenesis 
Epidemiology 
Clinical Features : age, sex, site, symptoms & signs 
Radiographic Features 
Histological Features 
Investigations, Diagnosis & Differential Diagnosis 
Treatment & Prognosis

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Introduction oral medicine-primary and secondary lesions

  • 1.
  • 2. Oral Medicine & Radiology Oral Diagnosis Oral Medicine Oral Radiology
  • 3. Definitions Oral Diagnosis is defined as an art and science of identifying an oral disease from its symptoms and signs. Oral Oral Medicine Radiology is is defined defined as as that a science branch composed of dentistry of which technical deals and with: interpretative procedures that 1. Diagnosis, treatment and prevention of: interdependently result in useful diagnostic data. a. Oral mucosal diseases b. Local oral diseases c. Oral manifestations of systemic diseases Oral Radiography is defined as an art and science of producing photographic image of oral tissues through use of x-radiation. 2. Dental management of physiologically compromised patients.
  • 4. Reading Material  Lecture notes  Burket’s Oral Medicine by Malcolm Lynch, 8th / 9th Edition  Oral Radiology: Principles & Interpretation by Goaz & White, 2nd / 3rd Edition  Differential Diagnosis of Oral Lesions by Goaz & Wood, 2nd / 3rd Edition
  • 5. Oral Medicine is defined as that branch of dentistry which deals with: 1. Diagnosis, treatment and prevention of: a. Oral mucosal diseases b. Local oral diseases c. Oral manifestations of systemic diseases 2. Dental management of physiologically compromised patients.
  • 6. Oral Medicine Oral mucosal diseases Local oral diseases • Oral manifestations of systemic diseases • Dental management of physiologically compromised patients.
  • 7. CLASSIFICATION OF ORAL DISEASES Some ways of classifying oral diseases : ~ Based on etiology e.g. viral, traumatic ~ Based on the pathological process involved e.g. inflammatory, neoplastic ~ Based on symptoms e.g. recurrent, painful conditions, tumorous conditions ~ Based on clinical appearance of lesions e.g. ulcerative, vesicular, erosive ~ Based on origin e.g. developmental, acquired
  • 8. “A lesion is a localized area of disease or injury in any organ or tissue of the body” ORAL SOFT TISSUE LESIONS WHITE ULCER EXOPHYTIC YELLOW DRAINING and PITS BROWNISH, BLUISH or BLACK RED Keratotic Necrotic Solitary Generalized Tongue
  • 9. Fordyce’s granules, Leukoplakia, Lichen Fibroma, Lip pits, Mucocele, Aphthous, Traumatic, Lipoma, Jaundice, planus, Burns Draining abscess, Tori, Pyogenic ORAL SOFT TISSUE LESIONS WHITE CarotMeneelamnioama, Oro-antral fistula granuloma Mucocele, Petechiae Erythroplakia, Acute & ecchymoses atrophic candidiasis, ULCER Malignant Glossitis EXOPHYTIC YELLOW DRAINING and PITS BROWNISH, BLUISH or BLACK RED Keratotic Necrotic Solitary Generalized Tongue
  • 10. Another way of classifying oral lesions : PRIMARY LESION SECONDARY LESION Macule, Plaques, Papule, Patch Nodule, Tumor Vesicle, Bulla, Pustule Petechia, Ecchymosis
  • 11. Macule: Sharply circumscribed discoloration (flat) up to 1 cm in diameter Patch: Sharply circumscribed discoloration (flat) more than 1 cm in diameter
  • 12. Papule: Well circumscribed, solid, flat-topped raised lesion up to 1 cm in diameter Plaque: Well circumscribed solid raised lesion more than 1 cm in diameter
  • 13. Nodule: Well circumscribed solid, rounded projection up to 1 cm in diameter Tumor: Well circumscribed solid, rounded projection more than 1 cm in diameter
  • 14. Vesicle: Sharply circumscribed serous fluid-filled elevation up to 1 cm in diameter Bulla: Sharply circumscribed serous fluid-filled elevation more than 1 cm in diameter
  • 15. Vesicle: Sharply circumscribed serous fluid-filled elevation up to 1 cm in diameter Bulla: Sharply circumscribed serous fluid-filled elevation more than 1 cm in diameter
  • 16. Vesicle: Sharply circumscribed serous fluid-filled elevation up to 1 cm in diameter Bulla: Sharply circumscribed serous fluid-filled elevation more than 1 cm in diameter
  • 17. Pustule: Sharply circumscribed pus-filled elevation similar to vesicle or bulla
  • 18. Petechiae: Sharply circumscribed deposit of blood or blood pigments up to 1 cm in diameter Ecchymosis: Sharply circumscribed deposit of blood or blood pigments more than 1 cm in diameter
  • 19. Petechiae: Sharply circumscribed deposit of blood or blood pigments up to 1 cm in diameter Ecchymosis: Sharply circumscribed deposit of blood or blood pigments more than 1 cm in diameter
  • 20. Another way of classifying oral lesions : PRIMARY LESION SECONDARY LESION Erosion, Ulcer, Scar Infiltration
  • 21. Erosion: Loss of superficial layers of epithelium Ulcer: Break in the continuity of the epithelium (deeper than an erosion)
  • 22. Scar: Deposit of highly fibrous tissue subsequent to ulcer or injury Infiltration: Extension of the primary lesion into the deeper tissue causing fixity or induration
  • 23. “Colour Atlas of Oral Diseases” George Laskaris 2nd Edition, 1994
  • 24. DESCRIPTION OF A DISEASE PROCESS Definition Etiology & Pathogenesis Epidemiology Clinical Features : age, sex, site, symptoms & signs Radiographic Features Histological Features Investigations, Diagnosis & Differential Diagnosis Treatment & Prognosis