Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- creamy white or yellowish plaques, fairly adherent to oral mucosa
- cracks, ulcers, or crusted fissures radiating from angles of the mouth
Other diagnostic factors
- lesions on any part of the oral mucosa
- atrophic, fiery red, flat lesions on the palate
- patchy areas of loss of filiform papillae on the dorsum of the tongue
- spotty red areas on the buccal mucosa
- lesions confined to the outline of a dental prosthesis
- burning oral pain
- dysphagia or odynophagia
- rhomboid outline on the dorsal aspect of the tongue
- continuous or patchy band of erythema, involving the free gingival margin
Risk factors
- hyposalivation/xerostomia
- age >60 years
- female sex
- poor oral hygiene, especially among denture wearers
- malabsorption and malnutrition
- advanced malignancy
- cancer chemotherapy and radiotherapy
- HIV infection
- endocrine disturbance (e.g., diabetes mellitus, hypoparathyroidism, pregnancy, hypoadrenalism)
- immunosuppressive agents (e.g., systemic corticosteroid therapy)
- inhaled corticosteroids
- current or recent past use of broad-spectrum or multiple narrow-spectrum antibiotics
Diagnostic investigations
Investigations to consider
- biopsy of lesion
- culture of mouth rinse sample
- upper GI endoscopy with or without biopsy of lesions
- urinalysis, random or fasting blood glucose, or glucose tolerance test to exclude diabetes
- HIV antibody test
- sialometry
- electrolyte panel
Treatment algorithm
Contributors
Authors VIEW ALL
Professor of Clinical Dentistry
Oral Medicine and Orofacial Pain
Vice Chair
Division of Oral Biology and Medicine
UCLA School of Dentistry
Los Angeles
CA
Disclosures
FSY has contributed to lectures and other educational events relevant to this topic in the community and in continuing education courses. FSY has also developed educational material on this topic for the American Academy of HIV Medicine, which is used to issue HIV Specialist Certification.
Peer reviewers VIEW ALL
Chair of Department of Oral Pathology
New York University College Of Dentistry
New York
NY
Disclosures
JAP declares that she has no competing interests.
Professor of Oral Medicine
Department of Oral Sciences
University of Palermo
Palermo
Italy
Disclosures
GC declares that she has no competing interests.
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