dental disorders
Oral Growths
Evaluation of Oral Growths
History of present illnessincludes questions about how long the growth has been present, whether it is painful, and whether there has been any injury to the area (eg, biting a cheek, scraping by a sharp tooth edge or dental restoration). Patients are asked about symptoms of systemic illness, particularly weight loss and malaise. should seek risk factors for Candidiasis (Mucocutaneous) , including recent antibiotic use, The physical examination focuses on the mouth and neck, inspecting and palpating all areas of the mouth and throat, including under the tongue. The neck is palpated for lymphadenopathy, which suggests possible cancer or chronic infection. The following findings are of particular concern: Weight loss Neck mass Persistent sore throat Difficulty swallowing The main concern is to not mistake an oral cancer or dysplastic lesion for a benign disorder. Clinicians should maintain a high degree of suspicion and refer the patient for biopsy if the lesion does not resolve in a few weeks. Suspected Candidiasis (Mucocutaneous) can be confirmed by finding yeast and pseudohyphae in 10% potassium hydroxide wet mounts of scrapings from a lesion. Other acute lesions, particularly those that appear related to local trauma or irritation, may be observed. However, most lesions that have been present for more than a few weeks, and those of unknown duration, should be biopsied because cancer is difficult to exclude clinically. 