Dental plaque + immune system

Extreme cases seen in immunocompromised patients

Also seen in Chediak-Higashi Syndrome, chronic granulomatous disease, SCID, neutropenia, lazy leukocyte syndrome, diabetes mellitus, and AIDS

Usually due to dental caries

Caused by a mixed flora

Complications

1) Ludwig's Angina - mandibular gland

2) Cavernous sinus infection - maxillary sinus/facial veins

1) HSV virus - blue, round, smudge cells histologically. Chromatic margination, Cowdry Type A inclusion bodies. Primary lesions occur in children on mouth, all inside surfaces. Secondary lesions occur only on NON-MOVABLE surfaces.

2) Aphthous Stomatosis - associated with IBD and Crohn's disease. Occurs on MOVABLE surfaces. Also called canker sores

3) Behcet's syndrome - Oral, Genital, Eye inflammation, Arthritis. Associated with vasculitis and thrombosis

Oral Neoplasms

Pre-neoplasms: leukoplakia (most norma, some dysplastic, very metastatic), erythroplakia (90% squamous cell carcinomas)

1) Squamous cell carcinoma - lateral borders of tongue, underside of mouth. Smoking and alcohol risk factors. Other etiological factors: Plummer-vinson syndrome, syphilis, beatle leaves, viruses

2) Oral/sinonasal melanoma - oral hard palate, maxillary gingiva, maxillary sinus

Salivary gland neoplasms

(parotid > submandibular > sublingual > minor)

Benign:

Pleomorphic adenoma: F, parotid

Warthin tumor: M, smokers, lymphoid and salivary tissues histologically

Malignant:

Mucoepithelial carcinoma: mucus + epithelial cells

Adenoid cystic carcinoma: minor glands, perineural invasion

Paranasal Neoplasm

(most common in maxillary sinus)

Squamous cell carcinoma

Adenocarcinoma (nasal, maxillary)

Risk factors: wood work, smoking, nickel, chromium