Crispian Scully

Bristol Dental Hospital, Lower Maudlin Street, Bristol BS1 2LY, UK

28. erythematous gingivae around the crown of a wisdom tooth

Pericoronitis is the most likely cause of the gingival inflammation here. This inflammation is caused by bacteria and food debris beneath the operculum of the partially erupted wisdom tooth. The short...

Sore or swollen lips part 3: diagnosis and treatment

The diagnosis of sore/swollen lips is based mainly on:.

27. soreness in the floor of the mouth

The history and clinical information suggest a chemical burn is most likely. Direct application of aspirin to the mucosa can cause severe local necrosis seen as a large ulceration covered with white...

Sore or swollen lips part 2: systemic causes

Lips are the site of primary or secondary manifestations of various systemic infections; neoplasms and immune-related disorders. A plethora of bacteria, fungi and viruses can affect the lips causing...

26. Mouth and skin ulcerations


Pemphigus vulgaris, an autoimmune intraepithelial blistering disease affecting skin and mucous membranes, is the cause of oral and skin ulcerations in this patient. The presence of intact bullae in...

Sore or swollen lips part 1: causes and diagnosis

There is a wide range of causes of lip soreness/swelling, as seen in Table 1..

25. White gingivae

The gingivae of this patient show a mild inflammation causing loss of stippling and white diffuse lesions due to Lichen planus. Lichen planus is a chronic inflammation disease which affects the...

Mouth cancer for clinicians part 14: cancer prevention

The goal of primary prevention is to protect healthy people from developing cancer. Primary prevention is by far the most ideal approach; strategies include education of the public, high-risk...

24. Dark gingivae

Racial pigmentation is the answer here. This is a very common finding in Afro-Caribbean patients and appears as diffuse hyperpigmentation symmetrically in all parts of the oral cavity but mainly in...

Mouth cancer for clinicians part 13: life after mouth cancer treatment

Survival rates for mouth and oropharyngeal cancers have risen slightly over the last 20 years. The best outcome for overall 5-year survival rates for treated oral cancers is over 90% for lip cancer....

23. Lip swelling


Crohn's disease is the likely cause. This chronic inflammatory bowel disease affects any part of the gastro-intestinal tract causing abdominal pain, diarrhoea and weight loss and may be associated...

Mouth cancer for clinicians part 12: cancer treatment (chemotherapy and targeted therapy)

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. However, these agents also damage other rapidly-dividing cells, especially in epithelia and haematopoietic tissue, and...

22. Red mark on face and lip


(a) Infantile haemangioma (superficial) is one of the most common benign tumours of infancy. It is a vascular neoplasm which can affect the face and other parts of the body and is characterized by...

Mouth cancer for clinicians part 11: cancer treatment (radiotherapy)

Radiotherapy alone is used to treat some types of mouth and oropharyngeal cancers. RT is an extremely effective treatment for oral squamous cell carcinoma (OSCC), sometimes as a primary modality or as...

21. Lump in the floor of mouth


(a) Dermoid cyst is a true hamartoma caused when skin and skin structures become trapped during foetal development. The dermoid cyst presenting in the floor of the mouth is rare but represents the...