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Cheek chewing

Cheek chewing. Morsicatio buccarum, chronic chewing of cheek, DDx: idiopathic leukoplakia, lichen planus, linea alba, chemical (aspirin) or thermal burn, toothpaste reaction, cheek chewing

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Cheek chewing

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  1. Cheek chewing Morsicatio buccarum, chronic chewing of cheek, DDx: idiopathic leukoplakia, lichen planus, linea alba, chemical (aspirin) or thermal burn, toothpaste reaction, cheek chewing Description-large ulcerated hyperkeratotic macule, ragged, appears to be pealing off, white and red, may or may not wipe off Common locations- anterior buccal mucosa, labial mucosa, lateral boarder of tongue, along plane of occlusion

  2. Aspirin burn • habit of placing aspirin on gums, very painful, obtain hx from pt. • D Dx: Chemical burn, cheek chewing, leukoplakia, toothpaste or mouthwash reaction, candidiasis, lichen planus, erythema migrans • Large, white, may or may not be rubbed off, erythematous macule. painful • On gingiva, buccal mucosa

  3. Peroxide burn • caused by pt rinsing with peroxide. (tx for ANUG), obtain hx from pt. • D Dx: Chemical burn, cheek chewing, leukoplakia, toothpaste or mouthwash reaction, candidiasis, lichen planus, erythema migrans • Large, white, may or may not be rubbed off, erythematous macule. painful • Generalized in oral cavity

  4. Thermal burns • Thermal most often caused by pizza, obtain hx from pt. • Erythematous macule, may have pseudomembranous covering, may be ulcerated, painful. • D Dx: Chemical burn, cheek chewing, leukoplakia, toothpaste or mouthwash reaction, candidiasis, lichen planus, erythema migrans • Located on vermillion boarder, tongue, hard palate.

  5. Cotton roll stomatitis • iatrogenic, sizing (paste) sticks to tissue. Obtain hx from pt. • Tx: Wet cotton before removing. • Sloughing traumatic lesion, erythematous macule, may have pseudomembranous covering, may be ulcerated. • D Dx: Chemical burn, cheek chewing, leukoplakia, toothpaste or mouthwash reaction, candidiasis, lichen planus, erythema migrans

  6. Riga Fide • early erupted tooth, infant w/ ulcer on undersurface of tongue • D dx: riga fide, aphthous lesion • Age of pt will make dx.

  7. Toothbrush abrasion • horizontal pattern of erosion on attached gingival, erythematous, coalescing ulcers. • D Dx: recurrent intraoral herpes simplex, tooth brush abrasion

  8. Ionizing radiation damage • skin damage: telangectasia, hair loss, mucositis, (serous glands), xerostomia (prevention with good oral hygiene is key!) Osteoradionecrosis: Damage to blood vessels, microorganisms can’t be controlled by body’s defenses, bone death results • D Dx: burn, ionizing radiation damage, xerostomia due to medications

  9. Acid erosion of enamel • caused by stomach acid (reflux or bulimia), lemons, tomato juice. • Teeth concave, cupped out cusps, unusual wear pattern, exposed dentin • D Dx: acid erosion, attrition

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