Oral Medicine

Oral cancer red flags – a case of misdiagnosis

A 65-year-old male presented to the emergency department with pain on the left-hand side of his mandible after feeling a ‘crack’ whilst eating cornflakes. The patient was a retired builder living with...

Spontaneous oral mucosal bleeding unmasking undiagnosed sarcoidosis: a case report

A 39-year-old female was referred to the Acute Dental Care Department by her dentist, with a 4-day history of spontaneous gingival bleeding. At the time of her consultation she also complained of...

Mouth cancer for clinicians part 10: cancer treatment (surgery)

Surgery and radiation are the only definitive treatment modalities for both early and locally advanced mouth cancer. Surgical resection, wherein the tumour is completely removed with uninvolved...

Return of the great pox

Now recognized as infection with the bacterium Treponema pallidum and known for centuries, a syphilis epidemic broke out among the soldiers of Charles VIII of France. In 1495 he invaded Naples, and by...

Allergy to chlorhexidine

Chlorhexidine is a widely used antiseptic with which all dental practitioners are familiar. It has been extensively used in dentistry, most frequently for the control of dental plaque and reduction of...

Mouth cancer for clinicians part 9: the patient and care team

Coping with a diagnosis of cancer, both practically and emotionally, is taxing for all concerned. Patients are likely to feel very upset, frightened, confused and out of control. They need support. It...

Mouth cancer for clinicians part 8: referral

Generally speaking, the earlier a cancer is found and treated, the better the outcome is likely to be with lesser adverse treatment sequelae. In general, cancer prognosis decreases with advanced...

Warfarin and drug interactions: prescribing vigilance

A 68-year-old male attended the Oral Medicine Department of the Liverpool University Dental Hospital. The patient had been referred by his GDP regarding ‘soreness of the gums and roof of mouth’..

Mouth cancer for clinicians part 7: cancer diagnosis and pre-treatment preparation

Clinical diagnosis of an early cancer can be quite straightforward if the clinician has adequate level of awareness and suspicion, but potentally malignant disorders (PMDs) that are likely to...

A case of undiagnosed harlequin syndrome presenting in general dental practice

A 45-year-old female presented to her general dental practitioner for routine dental care. She had rushed to the appointment and presented to her dentist with distinctly demarcated unilateral facial...

Mouth cancer for clinicians part 6: potentially malignant disorders

Some mouth cancers are preceded by clinically obvious potentially malignant disorders (PMDs). There is a range of PMDs known but the most important recognized are erythroplakia (erythroplasia),...

Case report: beware the silver nitrate stick – a risk factor for bisphosphonate-related osteonecrosis of the jaw (BRONJ)

A 61-year-old carpenter was referred to the oral and maxillofacial department by his GDP in March 2011 regarding an asymptomatic ‘white patch’ on the hard palate. Otherwise unaware of the lesion or...

Mouth cancer for clinicians part 5: risk factors (other)

The cause of cancer in most people is still unknown but risk depends on a combination of genes, environment and aspects of our lives (Article 1). It is impossible to control some mouth cancer risk...

Mouth cancer for clinicians part 4: risk factors (traditional: alcohol, betel and others)

Alcohol is a depressant. A small amount depresses anxiety and inhibitions and can make the user feel sociable and talkative; too much and a hangover may result, and the person may not even remember...

Facial skin lesions dentists should know

BCC is the most common type of skin cancer on the sun-exposed areas of face, head and neck. It accounts for about 75% of non-melanoma skin cancers.1,2 BCC presents as an epidermal neoplasm; a...