Common oral conditions.

Although some oral lesions, such as torus palatinus, are normal variants, and others, such as benign migratory glossitis, are self-limited, several common oral conditions require prompt diagnosis and treatment to reduce the potential for serious complications. Treatment of dental and periodontal abscesses may include incision and drainage, antibiotic therapy, pain control and dental extraction. Treatment of sialolithiasis (blockage of the salivary gland ducts) may require application of moist heat, antibiotics and surgical removal of impacted stones. Hyperkeratosis, a white patch on the oral mucosa that does not rub off or bleed (as does the white patch of candidiasis) commonly occurs in persons who use smokeless tobacco products. The lesion may require biopsy if it still persists two to four weeks after discontinuation of the tobacco product. Squamous cell carcinoma, which accounts for 95 percent of all oral cancers and is most commonly associated with alcohol and tobacco use, is usually asymptomatic until the late stage of the disease. Suspicious lesions should be biopasied to confirm the diagnosis.

Osteomyelitis associated with chronic periodontitis: a report of three cases.

Correctly differentiating between periodontal abscess (localized, acute suppurative infection of the periodontium) and osteomyelitis (the extension of an infection into the bone medullary cavity) is crucial since the former may not require antibiotics for resolution, while the latter will. Initial assessment and treatment of osteomyelitis should be based on clinical examination, radiographic interpretation, and experience. Three case histories of osteomyelitis are presented, ranging from a periodontally well-localized case to one involving a hemimandible and crossing the midline. Successful early diagnosis and case management may benefit from scintigraphic interpretation and culture-and-sensitivity studies.