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 Textbook of
ORAL MEDICINE
 DISCLAIMER NOTICE

The information in this book should not be used by unqualified personnel to do

any self diagnosis. All dental surgeons are requested to kindly verify the latest
prescribing practices prior to making decision. Most values are indicative and
have been checked against latest reliable sources, but the publisher and author
does not have any direct or indirect liability to the use or misuse of this information.
Prior to prescribing any medication please check that they are from ethical
drug manufactures following sound quality control practice. Follow the
manufacture direction in most prescription and please confirm side effect, safety
in children and pregnancy.

Author
 Textbook of
ORAL MEDICINE
Second Edition

Anil Govindrao Ghom

JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD

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Textbook of Oral Medicine

© 2010, Jaypee Brothers Medical Publishers

All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any
means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editor and the publisher.
This book has been published in good faith that the material provided by contributors is original. Every effort is made to ensure
accuracy of material, but the publisher, printer and editor will not be held responsible for any inadvertent error(s). In case of any
dispute, all legal matters to be settled under Delhi jurisdiction only.

First Edition: 2005

Second Edition: 2010
ISBN 978-81-8448-

Typeset at JPBMP typesetting unit

Printed at Nutech
 To
My Mother,
My Daughter Milini,
My Son Sanvil
and
My Family
 Contributors

Vikas Meshram Sachin Manglekar Savita Ghom

Reader, Reader, School of Lecturer,
Chhattisgarh Dental Science, Chhattisgarh
Dental College and Krishna Institute of Dental College and
Research Institute, Medical Science Research Institute,
Rajnandgaon, University, Karad, Rajnandgaon,
Chhattisgarh Maharashtra Chhattisgarh
Ch 48: Emergency Ch 46: Desensitizing Ch 43: Anticancer
Drugs Used in Agents, Gum Paints Drugs
Dentistry and Mouthwashes

Raghvendra Shetty Amit Parate Vaishali Gawande

Reader, Lecturer, Lecturer,
Chhattisgarh Government dental Chhattisgarh
Dental College and college and Dental College and
Research Institute, hospital, Nagpur, Research Institute,
Rajnandgaon, Maharashtra Rajnandgaon,
Chhattisgarh Ch 20: Oral Chhattisgarh
Ch 40: Antibiotics Pigmentation Ch 42: Antifungal
Drugs
Ch 44. Antiviral
Drugs

Abhishek Soni Anjusha Ganar Neeta Wasnik

Reader, VSPM Ex-lecturer, Lecturer,
Dental College and Chhattisgarh Chhattisgarh
Research Institute, Dental College and Dental College and
Nagpur, Research Institute, Research Institute,
Maharashtra Rajnandgaon, Rajnandgaon,
Ch 24: Gingival and Chhattisgarh Chhattisgarh
Periodontal Diseases Ch 45: Corticosteroids Ch 41: Analgesic and
Anti-inflammatory
Drugs
 Foreword

“Enthusiasm is driving force that overcome all obstacles”

It is my proud privilege to write a forward for second edition of this book by Dr. Anil Ghom. In
short time this book has become most popular among undergraduates & postgraduates all over
the country.
In the second edition numbers of chapters have been presented in a better organized manner.
This book carries updated information of the subject in this rapidly changing word of science. A
new chapter “Controversial Diseases” is incorporated, also there are number of new photographs,
radiographs, MCQ’s & references. I am sure this new updated second edition will be more beneficial
for the undergraduate and postgraduates students for reference and regular reading.

RN Mody
Professor and Head
Department of Oral Medicine and Radiology
Hitkarini Dental College
Jabalpur, MP
 Preface to the Second Edition

‘We become strong only after we have acknowledged our weakness. Gather knowledge,
insight, and experience and then make your own decision’

This is the second edition of the textbook and I am gratified by the acceptance and
support that the book has received over the years from educators, students and
practitioners. The purpose of second edition of this book is twofold. One is to include
what is new & recent knowledge and second is correct shortcoming of the first edition. I
have evaluated and utilize suggestions from all the critical reviews and recommendations
from the faculty members.
Obviously each successive edition of textbook finds the edition with more information.
So in this edition I have attempted to solidify and include recent knowledge. This book
also includes a new chapter controversial diseases and terminology. Purpose of this chapter is that as knowledge is
changing everyday with advanced diagnostic technique, many old terminologies are discarded and new one are introduced.
My first book is criticized a lot for not including references and not having enough photographs in the book. So in this
second edition I include references and around 1000 photographs/illustrations for easy understanding of the diseases.
MCQ chapter is completely revised and all the new MCQ are added at the end of chapter. I have also included
diagnosis of each lesion in diseases, so that students can understand key point in disease and they can easily remember
it.
Again as a human being, mistakes are bound to happen. I tried this second edition to best of my efforts, still there can
be shortcoming and I request readers to make note of it and I will try to rectify it in next edition.

Anil Govindrao Ghom

sanvil@rediffmail.com
anil_ghom@yahoomail.com
 Preface to the First Edition

“You must not be discouraged if the world does not rush to you, demanding what you have; neither must
you quietly sit down to let world wonder and then seek you; you must be aggressive, you must carry your
truths to people and cause them to see them so clearly that they must accept them”
The student looked for a reference on which to build an educational foundation with regard
to basic principle. A few years ago much of the information offered in this text was not available.
Since the principle and treatment modalities offered herein will continue to evolve, it
behooves the student to be fully informed of the state of art to be able to critically evaluate the
worthiness or applicability of any future development.
The author has endeavored to ensure that a consistent style has emerged and is in harmony
where appropriate with the diseases of oral region along with the differential diagnoses which are covered in detail.
The purpose of this book is to correlate the gross and microscopic pathological features with the radiographic appearance
of oral diseases and systemic diseases manifested in the jaw.
In our increasingly litigious society, it is vital that the dentist understands the law as it relates to dentistry. The Chapter
on Medicolegal Issue is Essential Reading, along with the Consumer Protection Act.
Diseases can be understood best when the interpreter understands not only the disease process but also the basic
science associated with it. For this reason, author has included separate section for basic science.
Recently, as exam pattern is changing and MCQs are getting importance, MCQs are added in separate chapter.
I tried my best, to cover all the aspects of oral diseases in my book. If this goal is achieved, then this textbook may
contribute, in a small way to better care of patients who suffer from these diseases.

Anil Govindrao Ghom

 Acknowledgements

‘The man who really wants to do something finds a way, the other finds an excuse’

No work will be complete without help of your friends and well wishers and I am lucky to have them with me in this
venture.
First of all, I am immensely thankful to Dr Vaishali Gawande for her untiredly help in completion of this project. My
special thanks to Dr Neeta Wasnik and Dr Anjusha Ganar who helped me a lot.
I am also thankful to Dr Swapnil Diwakirti for her help in preparation of diagrams in the book. I am thankful to all the
contributors for their contribution in this book.
My sincere thanks to Dr Pravin Lambade, Dr Jitendra Sachdeo, Dr Vikas Meshram, Dr Bhaskar Patle, Dr Revant Chole,
Dr Amit Parate, Dr Sanjay Pincha, Dr Milind Chandurkar, Dr Ashok L, Dr Umaraji, Dr Tapasya Karemore, Dr Avinash
Kshar, Dr M Shimizu, Dr Fusun Yasar, Dr Iswar, Dr Bande, Dr Kadam, Dr R Kamikawa, and Dr Suwas Darvekar for
providing clinical and radiological photographs in the book.
Beauty is God’s gift but to utilize it in proper direction is in your hand. I am thankful to all those beautiful faces in book-
Dr Gagandeep Chawala, Dr Smiriti Goswami, Dr Uma Rohra, Dr Swapnil Dewakirti, and Dr Pragya Jaiswal.
I would like to thank Dr Ranit Chhabra, Dr Priyanka Aggarwal, Dr Shaheen Hamdani, Dr Payal Tapadiya and Dr
Vivek Lath for their help in proof reading.
I offer my humble gratitude to my guide Dr R N Mody for his guidance during my post graduation and after post
graduation.
Friends are always big supporters so I am greatful to Dr Pravin Sundarkar, Dr Neeraj Alladwar and Dr Ravindra
Govindwar for heartily wished. I am also thankful to my brothers and sisters especially elder brother Sadanand for their
moral support in my life.
I am thankful to Jaypee brother publisher and especially Mr. Vij for publishing this book.
Whenever I think who completely change my life is my wife Savita, who is there in my thick and thin. Whenever I am
down she is there to uplift me with her prayer and support. She is person with heart and I am thankful to god to give gift
like her to me in my life.
Lastly I offer my earnest prayers to the almighty for endowing me the strength and confidence in accomplishing to the
best of my abilities.
 Contents

Section I
Basics
1. Oral Diseases: An Introduction .......................................................................................................................
2. Development and Eruption of Teeth ..............................................................................................................
3. Development and Anatomy of Craniofacial Region ..................................................................................
4. Immunity, Antigen Antibody Reaction .........................................................................................................
5. Neoplasm .............................................................................................................................................................
6. Infection Control in Dental Office .................................................................................................................

Section II
Diagnostic Procedures
7. Case History .........................................................................................................................................................
8. Investigation in Dentistry .................................................................................................................................

Section III
Disease of Oral Structure
9. Teeth Anomalies .................................................................................................................................................
10. Developmental Defect of Craniofacial Structure .......................................................................................
11. Keratotic and Non-keratotic Lesion ...............................................................................................................
12. Oral Premalignant Lesion and Conditions ...................................................................................................
13. Cysts of Jaw ........................................................................................................................................................
14. Odontogenic Tumor of Jaw ...............................................................................................................................
15. Benign Tumor of Jaw .........................................................................................................................................
16. Malignant Tumor of Jaw ...................................................................................................................................
17. Vesicular Bullous and Erosive Lesion ...........................................................................................................
12 Textbook of Oral Medicine
18. Orofacial Pain ......................................................................................................................................................
19. Infection of Oral Cavity ....................................................................................................................................
20. Oral Pigmentation ...............................................................................................................................................
21. Dental Caries .......................................................................................................................................................
22. Disease of Tongue ..............................................................................................................................................
23. Disease of Lip ......................................................................................................................................................
24. Gingival and Periodontal Disease ..................................................................................................................
25. Tmj Disorders ......................................................................................................................................................
26. Salivary Gland Disorders .................................................................................................................................
27. Disorders of Maxillary Sinus ...........................................................................................................................
28. Traumatic Injury of Oral Cavity .....................................................................................................................
29. Soft Tissue Calcification ...................................................................................................................................

Section IV
Systemic Disease
Manifested in Jaw
30. Bacterial Infection ..............................................................................................................................................
31. Viral Infection .....................................................................................................................................................
32. Fungal Infection ..................................................................................................................................................
33. Specific System Disorders ................................................................................................................................
34. Disease of Bone Manifested in Jaw ...............................................................................................................
35. AIDS .......................................................................................................................................................................
36. Endocrine Disorders ...........................................................................................................................................
37. Blood Disorders ...................................................................................................................................................
38. Vitamins ................................................................................................................................................................
39. Metabolic Disorders ...........................................................................................................................................

Section V
Drugs Used in Dentistry
40. Antibiotics ............................................................................................................................................................
41. Analgesic and Anti-inflammatory Drugs .....................................................................................................
42. Antifungal Drugs ................................................................................................................................................
43. Anticancer Drugs ................................................................................................................................................
44. Antiviral Drugs ....................................................................................................................................................
45. Corticosteroids .....................................................................................................................................................
46. Desensitizing Agents, Gum Paints and Mouthwashes .............................................................................
 Contents 13
47. Drugs Used in Pregnancy .................................................................................................................................
48. Emergency Drugs Used in Dentistry ..............................................................................................................

Section VI
Miscellaneous
49. Prof essional Hazards of Dentistry ................................................................................................................
50. Forensic Dentistry ...............................................................................................................................................
51. Controversial Disease and Terminology ......................................................................................................

Appendices I: Causes, Classification ..............................................................................................................

Appendices II: Syndrome of Oral Cavity .......................................................................................................
Appendices III: Glossary ....................................................................................................................................
Appendices IV: MCQ ...........................................................................................................................................

Index .........................................................................................................................................................

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