PART 10 — ORAL CAVITY

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Study use: Rapid revision of oral-cavity anatomy, white/red lesions, ulcerative and vesicular disease, oral potentially malignant disorders, oral cancer, salivary cystic swellings, immunobullous disease, and oral-airway emergencies. Management points are intentionally concise and should be interpreted with lesion morphology, immune status, pathology, disease extent, and airway stability.

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Priority Guide: 🔴 Core / Must Know | 🟠 Important | 🟡 Additional

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🎯 High-Yield Overview

• Oral cavity extends from the lips to the anterior tonsillar pillars and includes vestibule, buccal mucosa, teeth/gingivae, anterior tongue, hard palate and floor of mouth.
• White lesion that scrapes off → candidiasis. White lesion that does not scrape off → think leukoplakia, hairy leukoplakia, lichen planus or chronic hyperplastic candidiasis according to morphology.
• Erythroplakia and erythroleukoplakia require biopsy because dysplasia/carcinoma is common.
• Areca/betel exposure + burning + blanching/fibrotic bands + trismus → oral submucous fibrosis.
• Oral SCC: tobacco/smokeless tobacco, alcohol and areca/betel are major risks; a persistent indurated/everted ulcer or exophytic lesion requires biopsy.
• Mucocele = bluish lower-lip lesion after minor salivary trauma; ranula = bluish floor-of-mouth lesion, usually from the sublingual gland.
• Ludwig angina = odontogenic floor-of-mouth cellulitis with tongue elevation/drooling → AIRWAY FIRST.
• Painful oral erosions + flaccid bullae + Nikolsky positivity + suprabasal acantholysis → pemphigus vulgaris.

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RED FLAG: Persistent unexplained oral ulcer, red/red-white lesion, induration, neck node, progressive tongue/floor-of-mouth swelling, drooling, stridor, or respiratory distress requires urgent evaluation.

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1. ORAL-CAVITY MAP & RAPID LESION APPROACH

2. WHITE & RED ORAL LESIONS

3. APHTHOUS & VIRAL ULCERATIVE DISEASE

4. ORAL SUBMUCOUS FIBROSIS & LICHEN PLANUS

5. ORAL & LIP SQUAMOUS-CELL CARCINOMA

6. MUCOCELE, RANULA & FLOOR-OF-MOUTH SWELLINGS

7. LUDWIG ANGINA & ANGIOEDEMA