NEET MDS Lessons
Oral Pathology
Macroglossia
- Feature: Crenated (scalloped) lateral tongue borders
Lymphangioma of Tongue
- Appearance: Tapioca pudding/Frog's egg
Geographic Tongue
- Associated With: Fissured tongue
- Histopathology: Similar to psoriasis
- Key Feature: Munro's abscesses
Median Rhomboid Glossitis
- Unique Sign: "Kissing lesion" on soft palate due to tongue contact
Hairy Tongue
- Misnomer: Elongated filiform papillae—not actual hair
Leukoedema
- Diagnostic Feature: Lesions do not rub off; disappear when cheek is stretched
Heck's Disease (Focal Epithelial Hyperplasia)
- Appearance: Cobblestone mucosa
- Also Seen In: Pyostomatitis vegetans, Keratosis follicularis
Infectious Mononucleosis
- Nickname: Kissing disease
- Etiology: Epstein–Barr Virus (EBV)
| Species | Role |
|---|---|
| Streptococcus mutans | Initiates caries; highly acidogenic/aciduric |
| Streptococcus sobrinus | Similar to S. mutans, less adhesive |
| Lactobacillus spp. | Progression in dentin; acid-loving |
| Actinomyces naeslundii/viscosus | Linked with root surface caries |
| Veillonella spp. | Lactate metabolizers in advanced lesions |
| Scardovia wiggsiae | Emerging cause in early childhood caries |
| Propionibacterium, Bifidobacterium, Rothia | Found in deep dentinal lesions |
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Hyperplastic Candidiasis: The only form of candidiasis that is non-scrapable. Often appears as admixed white and red areas, known as speckled leukoplakia or erythroleukoplakia.
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Median Rhomboid Glossitis: Etiology is controversial (developmental vs. fungal); if forced to choose, developmental.
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Gilchrist's Disease: Another name for North American Blastomycosis.
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Mucormycosis: More common in diabetic patients. Has a strong propensity to invade blood vessels.
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Zone 1 – Normal Dentin:
Healthy tissue; no treatment needed -
Zone 2 – Subtransparent Dentin:
Acid-demineralized, no bacteria, remineralizable; preserve -
Zone 3 – Transparent Dentin:
Softened, no bacterial invasion; remineralizable; preserve -
Zone 4 – Turbid Dentin:
Bacterial invasion; not remineralizable; must be removed -
Zone 5 – Infected Dentin:
Fully decomposed; heavily infected; must be removed
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Pioneer Bacteria: S. mutans are considered pioneer bacteria as they multiply and synthesize extracellular matrix polymers, initiating biofilm formation.
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Caries Progression - Key Bacteria:
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Initiation of caries: S. mutans.
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Progression of caries / Dentinal caries: Lactobacillus.
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Root surface caries: Actinomycetes.
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Body of the Lesion (Enamel Caries): Shows increased prominence of the striae of Retzius.
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Sugar Intake: Frequency of sugar intake is of more importance than the total amount consumed in caries development.
Benign Migratory Glossitis
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Also called Erythema migrans, wandering rash, or geographic tongue.
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Associated with fissured tongue.
Fissured Tongue
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Seen in:
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Melkersson-Rosenthal syndrome
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Down syndrome
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Benign migratory glossitis
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Melkersson-Rosenthal Syndrome
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Triad:
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Bell’s palsy
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Cheilitis granulomatosa (lip/facial swelling)
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Fissured tongue
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Ankyloglossia
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Tongue-tie may cause speech defects.
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Affects articulation of: l, r, t, d, n, th, sh, z