Oral Pathology

Question 1

what is the ratio of men: women for oral cancer?

Answer 1

men: women
2: 1

Question 2

when is the prognosis for mouth cancer generally considered better- front or back of mouth?

Answer 2

front of mouth better prognosis

Question 3

compare the prevalence of oral cancer with age and with deprivation?

Answer 3

as age increases, risk of oral cancer increases

as deprivation increases, risk of oral cancer increases

Question 4

what are the main risk factors for oral cancer?

Answer 4

tobacco
alcohol
diet/nutrition
previous head/neck cancer (especially in last 2 years)
HPV 
Ultra Violet Light
candida
(syphylis
other dental factors)

Question 5

what are the guidelines fr alcohol intake?

Answer 5

M: max 21 units per week
F: max 14 units per week

Question 6

how many units are in a pint of beer?

Answer 6

2-3 units

Question 7

how many units are in a glass of wine?

Answer 7

2-3 units

Question 8

what 3 nutrient deficiencies are known to cause an increase risk for oral cancer?

Answer 8

low vitamin A
low vitamin C
low iron

Question 9

why do low levels of vit A, vit C and iron increase risk of oral cancer?

Answer 9

because this causes atrophy of the oral mucosa making it more susceptible to local carcinogens

Question 10

compare the prognosis of HPV associated oropharyngeal cancer to prognosis of non-HPV associated oropharyngeal cancer?

Answer 10

prognosis HPV- associated oropharyngeal cancer is better

Question 11

what coloured lesions should you be worried about for oral cancer?

Answer 11

red or white

Question 12

when can lichen planus become a pre-malignant condition?

Answer 12

if it becomes erosive

Question 13

how does asking about pain usually differentiate between a regular ulcer and an early cancerous lesion?

Answer 13

regular ulcers are painful

early cancerous lesions are not painful
pain is a late stage manifestation

Question 14

where are the high risk sites within the mouth for oral cancer?

Answer 14

soft, non-keratinising sites
eg ventral tongue, lateral tongue, floor of the mouth, soft palate

(dorsal tongue and hard palate are much more rare)

Question 15

what site in the mouth is it much more common to get a cancerous lesion on in Asia than the UK?

Answer 15

buccal mucosa

- due to chewing tobacco

Question 16

what is lichen planus?

Answer 16

a white lacy looking atrophy, cause is unknown

Question 17

what are the 6 main warning signs for oropharyngeal cancer?

Answer 17

red/white/red+white lesion
ulcer (exclude trauma, drugs, systemic reasons)
numb feeling
unexplained pain in mouth or neck
change in voice
dysphagia

Question 18

why might oral cancer cause a numb face/lip or drooping eye lid/facial palsy?

Answer 18

cancer targeting a cranial nerve

Question 19

what key questions should be asked when a patient presents with a specific lesion?

Answer 19

What colour is the lesion?
How long has lesion been present?
Is it painful?
Social? (smoking and drinking quantification)

Question 20

how long do normal ulcers take to heal?

Answer 20

10 days

Question 21

when should the time length an ulcer has been present raise suspicion?

Answer 21

2-3 weeks

if no obvious cause- eg constant trauma

Question 22

what type of cancers are oral cancers usually?

Answer 22

squamous cell carcinoma