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 FOCA
ASSOCIA
GEO
FRICT
 WHITE SPONGE NEVUS

 Characterized by diffuse , spongy and

patchy white lesion on buccal mucosa,
tongue .
 Usually bilateral.
 Lesion are inherited as an autosomal
dominant condition .
 Biopsy is necessary for definitive diagnosis
 Treatment :- No treatment required.
 INCLUSION CYST

 One or more white , freely mobile circumscribed

nodular lesion encountered in 75% of new born.
 small, superficial , keratin containing cyst that are
classified according to content &location.
 1.EPSTEIN’S PEARLS:-
Along palatal mid line
contain squamative epithlium.
 2.BHON’S NODULES :-
 Junction of hard & soft palate.
 Contain mucous gland remnants
 3.DENTAL LAMINA CYST:-
 On the crest of alveolar ridge as preeruption
phenomenon.
 contain odontogenic epithelium.
 Treatment:- No treatment.
 FISSURED TONGUE
 Characterized by numerous , small furrows or
grooves on the dorsal surface.
 Radiating out from central groove along mid line
of tongue .
 Incidence increases with age.
 It is associated with chronic trauma or vitamin
deficiency.
 Usually painless. Food debries accumulates in
grooves & produces irritation.
 Treatment- Clean the tongue surface with tooth
brush & gauge sponge.
 FORDYCE’S GRANULES
 Developmental disturbance characterized by
inclusion of sebaceous gland in oral cavity .
 Appearance – granules appears as small
yellow whitish spots , either discretely
separated or forming relatively large plaque.
 Slightly projected above the surface of the
mucosa.
 Site:- buccal mucosa opposite the first
molar.
 Not seen in infants,appear after age of 5
year ,increases during puberty.
 Treatment :- required NO treatment.
 VESICULAR-
DESQUAMATIVE
LESIONS
 HERPETIC GINGIVOSTOMATITIS

 Caused by HSV-1
 Characterized as generalized marginal
gingivitis with involvement of primarily
mucous membranes with vesicular-
ulcerative lesion .
 Rarely occur before the age of 6 month.
 Incubation period :- 4 to 5 days.
 Prodromal period :- 1 to 2 days .
 Featuring malaise, fever,discomfort ,gingival
inflammation then yellowish or white vesicles
1 to 2 mm in diameter appear .Later these vesicles
rupture and leave very painful erosions.
 Duration :-10 to 14 days.
 Treatment:-
1.Supportive treatment.
2.Antipyretic,analgesic drugs.
3.Fluids
4.Topical anesthesia
5.Topical 5% acyclovir.
 HERPANGINA

 Also k/a apthous pharyngitis .

 Caused by coxsackie viruses A&B.
 Lesion characterized by appearanceof small
vesicular ulcerative lesion in anterior faucial
pillars , soft palate , tongue ,buccal mucosa.
 Before lesions – pharyngitis, fever,
headache, vomiting, abdominal pain &
regional lymphadenopathy.
 More common in young children in summer
season.
 Treatment:-
1.Supportive treatment.
2.Antipyretic, analgesic drugs.
3.Fluid.
4.Topical anesthesia.
5.Topical 5% acyclovir.
 CHICKEN POX(VARICELLA)
 Caused by herpes varicella zoster.
 most common in winter & spring season.
 Incubation period- 2 weeks.
 characterized by prodromal occurrence of
headache , nasopharyngitis , anorexia followed by
maculo-papular or vesicular eruption of skin &
low grade fever.
 These eruption usually benign on the trunk &
spread to involve face & extremities.
 They occur in successive crops so that many
vesicles in different stages of formation &
resorption may be found.
 Small blister like lesions occasionally involve the
oral mucosa , chiefly buccal mucosa, tongue ,
gingiva , palate , pharynx.
 these vesicles with surrounding erythema rupture
soon after formation &form small eroded ulcers
with red margins.
 Treatment- same as HSV
 MEASLES
 Viral infections affecting mainly children.
 Incubation period- 8-10 days
 Charactrized by fever, malaise, cough,
conjuctivites , photophobia , lacrimation &
eruptive lesion of skin & oral mucosa.
 Oral lesions are prodromal occur two to
three days before cutaneous rash &
pathognomic of disease.
 Oral lesions are called koplik’s spots.
 These spots occuring on buccal mucosa
small irregularly shaped flecks which
appear as bluish, white specks surrounded
by red margins.
ULCERATIVE
LESIONS
 Recurrent apthous stomatitis

 Occur as single or multiple lesion.

 They are shallow & flat have central white
fibrinous pseudomembrane & surrounded by an
erythematous halo.
 It may be minor, major or herpetiform apthous
ulcer.
 Minor ulcer- less than 0.5 cm. in diameter,single
or multiple, painful, heal within 10-14 days
without scaring.


 Major ulcer-large painful, usually 1-10 in
number,take long time to heal & sometime
heal with scaring.
 Herpetiform ulcer - characterized by crops
of multiple small, shallow ulcer, up to 100
in number, 1-2 mm. in diameter.
 treatment - tetracyclin mouthwash, topical
corticosteroid
 Traumatic ulcers

 Occurs commonly in children as a result of variety

of self inflicted or iatrogenic dental insults.They
are classified according to location.
 1.Rega-fede disease- ulcerative lesion on the
lingual frenum & ventral tip of tongue of new
born or infants.
 caused by natal or neonatal teeth
 treatment- removal of irritation source
2.Lip biting- oftenly occur after administration
of mandibular block anesthesia in young children .
3.Pterygoid ulcer- superficial traumatic
abrasion of the palatal mucosa near the greater
palatine foramen resulting from attempts to clear
the mouth of foreign matter at birth.
 Treatment – self limiting & heal spontaneously
PIGMENTED
LESIONS
1.Nevus - nevi are plaque or dome shaped sessile
nodules that may occur on palate, buccal mucosa
& lips with blue & black pigmentation.
 Appear during childhood, increases in size &
persist into adulthood.
 Basic types of nevi are – junctional , intramucosal,
compound, blue nevi, spindle cell nevi.
 Treatment- surgical removal if in chronic
irritation condition.
2.Ephelis - Common freckle appearing on the lips
as a brown macule of varying size that lacks nevus
cells.
 COMPRESSIBLE LESIONS
1.Eruption cyst- bluish translucent , elevated,
compressible , dome shaped lesion of alveolar
ridge associated with an erupting primary or
permanent teeth.
 It is a soft tissue counterpart of dentigerous cyst.
 Painless unless secondarily infected.
 Treatment:- cyst may be punctured, marsupialized
or deroofed which facilitates eruption.
 If left untreated, may ruptured spontaneously.
2.Hemorrhagic cyst-bluish asymptomatic
lesion found overlying erupting teeth.
 Swelling is due to accumulation of tissue fluid,
blood or both in dilated follicular sac around the
erupting crown.
 Treatment:- not indicated , sometime incision is
performed.
3.Gingival parulis-intraoral drainage from an
abscessed tooth is created by a fistulous tract that,
if blocked results in swelling termed parulis.
4.Mucous retention cyst-pseudocystic
subepithelial lesion formed subsequent to
traumatic injury and breakage of a minor salivary
duct with resultant pooling of extraductal mucin &
inflammatory cells in the mucosal pseudocyst.
 It may be superficial or deep.
 Superficial lesion appear as elevated well
circumscribed vessicle with bluish hue.
 mainly seen on lip & buccal mucosa.
 If occur in floor of mouth reffered as ranula.
 Treatment:- should be excised with inclusion of
underlying salivary tissue to minimize
reoccurance.
5.Hemangioma-smooth, purplish red,
compressible lesion, partly elevated & partly
submerged & will blanch under pressure.
 Most of resolve with age.
 Site-most common on lips, tongue, buccal mucosa
& palate.
 Classified as capillary, cavernous & juvenile.
 Capillary-consist of numerous, diffused capillaries
that penetrates mucosa specially lip & cheeks.
 Cavernous- consist of few or numerous blood
containing spaces, that occupy the area especially
the tongue.
 Juvenile- consist of numerous small vessels that
infiltrate the site especially the salivary glands &
lip musculature.
 Treatment:-some hemangioma regress with age.
-superficial lesion can be removed by excision or
fibrosed by the induction sclerosing solutions.
6.Lymphangioma-Consist of large lymph containing
spaces.
 Common site- tongue
 Superficial lesion may be small clusters of
compressible excrescences whereas deep seated
lesion may produce diffuse enlargement of tongue
& obliterate it’s normal surface architecture.
 Severe cases cause macroglossia.
 Treatment- subtotal or total surgical removal is
treatment of choice.
NONHEMORRHAGIC
SOFT TISSUE
LESIONS
CONGENITAL EPULIS-Mostly congenital but
may also be neonatal.
 Appears as a single , elevated , pedunculated ,
smooth , non hemorrhagic tumor of mucosa of the
maxilla or rarely of mandible.
 Benign in nature.
 Treatment:- surgical excision
HEMORRHAGIC
SOFT TISSUE
LESIONS
1.Peripheral giant cell reparative
granuloma:-
o Bluish , aggressive, firm, benign tumor of
gingival tissues surrounding primary or permanent
teeth.
o Tumor is capable of eroding underlying bone.
o Treatment:- Scaling & curettage of the area &
surgical excision of the tumor.
2.Pyogenic granuloma- It is a reactive
gingival tumor that appear as growth of
granulation tissue, generally at the dental
papilla & results from chronic irritation.
 Treatment:- Scaling & curettage of the area
& surgical excision of the tumor.
PAPILLARY
LESIONS
1.Papilloma - It is a white pedunculated broad
based, cauliflower like lesion that might be
encounterd anywhere in the oral cavity.
 Lesion is slow growing & painless

 Treatment:- Excision
2.Verruca vulgaris (wart)- It is a white
papillary lesion usually seen on the vermillion
border of the lip.
 It is viral induced- papova virus
 Lesion is slow growing & painless.
 Treatment :- Local excision.
- Electrocoagulation.