Dentistry for Medical Professionals

Student Family Health Care Center

Rutgers, The State University of New Jersey

Anush Shah, RSDM Class of 2019
 Anatomy

• Maxilla – maxillary division of trigeminal

nerve (V2)
• Mandible – mandibular division of
trigeminal nerve (V3)

• Enamel – outer layer, not innervated

• Dentin – yellow shade, is innervated
• Pulp – nerve and blood supply
Cavities
• Oral bacteria digest fermentable
carbohydrates from our food and
produce acid
• Acid breaks down enamel and dentin to
cause cavities (tooth decay) and bacteria
penetrate further into the tooth
• Bacterial invasion of the pulp
compromises the nerve and tooth dies
Periodontitis (Gum Disease)
• Bacteria begin to aggregate on tooth surfaces within minutes
of brushing and professional cleanings
• Lack of removal through mechanical means such as brushing
and flossing causes plaque to accumulate and calcify
• Presence of plaque and calculus (aka tartar) causes
inflammation of gum tissues and leads to bone loss
Oral Manifestations of Systemic Diseases
• Diabetes
– Increased rate and progression of gum disease
– Studies have shown that treating gum disease can improve diabetic
status
• Leukemia
– Spontaneous gingival bleeding, gingival swelling and erythema
– Ulcerations, prone to fungal, viral, and bacterial infections
• Sjogren’s Syndrome
– Dry mouth due to decrease salivary flow, difficulty eating and swallowing
– Thick, ropy saliva
– Increased rate of cavities and gum disease
• Metastases
– Lung and breast cancers often spread to oral cavity
Variations in Anatomy

Tori (bony growths, also seen on hard palate) Lingual varices (dilated veins)

Cheek biting Lingual tonsils

Variations in Anatomy (cont.)

Physiologic pigmentation (usually symmetrical

Leukoedema (generalized white-grey on and seen throughout the gums)
cheek which disappears when stretched)

Fordyce Granules (sebaceous glands

often seen in cheek) Fissured tongue
 Oropharyngeal Cancer
• Most commonly squamous cell
carcinoma
• Risk Factors – smoking, alcohol, betel
quid, chewing & smokeless tobacco,
diet, HPV, sun exposure
• Common sites – lateral tongue, lower
lip, floor of the mouth, tonsillar region,
palate
• Early signs – erythroplakia (highest
malignant potential), erythroleukoplakia,
leukoplakia, ulcers
– Lesions that do not improve or resolve in 2
weeks should be re-evaluated by a dentist to
possibly be biopsied
Oral Cancers
Oral Cancer Screening
 Thank you!

Rutgers, The State University of New Jersey