1-2-3-Oral Lesions

These are open sores that may be red or white in color (blue arrow) and usually associated with a denture border (yellow arrow). The area may bleed and be painful.

Trauma or enlarged tissues can form in an area that is repeatedly hurt. The injured area is usually by denture boarders and/or cracked teeth and may form a growth (blue arrows). It may be present on the cheeks, tongue, or where irritation/trauma occurs. Color is usually lighter than the hurt tissue.

Also known as Apthous Ulcers. Usually found on the inside surface of cheeks and under the tongue.

Caused by:

• trauma
• stress
• certain foods such as citrus fruits, spicy foods, or tomatoes

Should go away within 7 days.

Oral cancer is a common type of cancer.  In its early forms there are usually white, red or red/white patches in the mouth skin.  Early detection is important and leads to less severe consequences.  Patches should be seen by a dentist as soon as possible.

Oral cancer may also look like an ulcer (open sore) that may or may not be painful, and does not heal within 7 days.  Any ulcer lasting more than 3 weeks without a known cause (like trauma) should be seen by a dentist.

Any ulceration (blue arrow) or noted tissue change that has not healed in 3 weeks should be reported to a healthcare provider. The following slides are all examples of oral lesions to be documented and/or reported.

When plaque on the tooth is left too long, inflammation of the gum tissue may occur (blue arrow).  Inflammation is reversible with good oral hygiene.

Inflammation can look like:

• Redness
• Swelling
• Bleeding from brushing

Periodontal disease is an inflammatory disease of the tissue and bone around the teeth. It is non-reversible and can lead to loose teeth and tooth loss. Some signs to look for are:

• Tissue and bone loss
• Redness at the gum line
• Swelling at the gum line
• Bleeding from brushing
• Tenderness or painful when touched (blue arrow)

Thrush is the most common oral fungal (yeast) infection.

• May be seen on a small area
• May cover a large area of mouth tissue and become painful
• Typically seen as white patch (blue arrow)
• Most commonly found on the cheek and tongue
• More common among individuals with uncontrolled diabetes, people with suppressed immune systems or those taking antibiotics for an extended period of time

Denture Stomatitis is an inflammation of the tissues underneath a denture.  Caused by poor hygiene of the denture and not removing it at night.  Often seen as red, swollen tissue that may be painful, possibly associated with a yeast infection.  The blue arrow indicates inflamed skin (in area not covered by the denture), and the yellow arrow indicates normal skin color (area not covered by the denture).

Make sure to always document changes in a person’s mouth, including:

1. Changes in skin color inside the mouth: from pink to white, red, or red/white
2. Bleeding: remember it is relatively common to see bleeding after brushing a patient’s teeth.
3. Pain: acute/throbbing, burning, or tingling sensations.

If a person reports any of these sensations, determine the location, and look for possible causes.

Medication side effects: medication(s) may cause changes to..

1. Oral tissue and/or tissue color.
2. Certain oral lesions (like gingival gum overgrowth or thrush, which is defined later)
3. Change in taste for the person.

Bad breath: a common oral condition which can make oral care and general care of the person more difficult.