Maxillofacial surgery

Question 1

DDx between:
- Oral candidiasis
- Oral lichen planus
- Leukoplakia

Answer 1

Oral candidiasis
- Thick white marks
- Associated with smoking or immunosupression

Oral lichen planus
- Lace like appearance
- Purple, polygonal, pruritic rash on flexor surfaces.

Leukoplakia
- Raised edges
- Cannot be rubbed out like candida
- Associated with smoking
- Can transform into squamous cell carcinoma.

Question 2

What is the most common type of oral cancer?

Answer 2

Squamous cell carcinoma.

Question 3

What are the symptoms and features of oral cancer?

Answer 3

• Soreness of the throat;
• Lump in the mouth or throat;
• Can involve the tonsils;
• Otalgia;
• Difficulty in swallowing;
• Associated with smoking;
• Lymphadenopathy;
• Weight loss.

Question 4

What is the management of oral cancer?

Answer 4

Suspected cancer pathway referral
- Oral ulceration > 3 weeks;
- Persistent lumpin the neck.

Urgent referral
- Red/white patch on oral cavity.

Both pathways have appointments within 2 weeks.

Question 5

What is the management of temporomandibular joint dysfunction?

Answer 5

• Jaw exercises;
• Bite guards;
• Soft diet;
• Analgesics.