Crispian Scully

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

Oral medicine: 3.ulcers: cancer

Oral cancer is the most common malignant epithelial neoplasm affecting the mouth. More than 90% is oral squamous cell carcinoma (OSCC) (Table 1)..

Oral medicine: 2. ulcers: serious ulcers

The most important feature of ulceration is whether the ulcer is single, multiple or persistent..

Oral medicine: 1. ulcers: aphthous and other common ulcers

Ulceration is a breach in the oral epithelium, which typically exposes nerve endings in the underlying lamina propria, resulting in pain or soreness, especially on eating spicy foods or citrus fruits....

18. Dental management

The most important risk factors for oral complications of cancer therapy are pre-existent oral or dental disease and poor care after cancer therapy..

17. Osteonecrosis

Radiotherapy (RT) in high doses involving the oral cavity, maxilla, mandible and salivary glands may result in several undesired reactions, of which osteoradionecrosis (ORN) is probably the worst. ORN...

16. Infections

Oral cancer and its treatment can cause a variety of oral problems. Surgery and scarring may mutilate tissues – which can hamper function and cleaning the teeth. The patient may have complicated...

15. Salivary and taste complications

Saliva is essential to oral health. Low salivary flow (hyposalivation) causes lack of mucosal wetting, lubrication and defences, which affects many functions, and can predispose to infections..

14. Mucositis

RT is most often administered in small fractions over several weeks and to a localized area. Radiation-induced mucositis is invariable within the radiated field of mucosa and typically begins at...

13. Pain

Cancer pain may arise from tumour invasion (especially where nerves are infiltrated), ulceration and infection, and the effects of diagnostic or therapeutic procedures (surgery, RT or CTX). Cancer...

12. Radiotherapy and chemotherapy

X-rays were the first form of photon radiation to be used to treat cancer. The higher the energy of the x-ray beam, the deeper x-rays penetrate the target. Radiotherapy (RT) is an extremely effective...

10. Surgical management of oral cancer

Surgery was the original treatment developed for oral cancer. It is still widely carried out, in order to achieve more than one of the following goals..

9. Quality of life

Oral cancer and its management are associated with tremendous physical, emotional and psychosocial disruption, as discussed in Article 8. This affects patients' ‘quality of life’ (QoL) and impacts not...

8. Communicating about cancer

Several key skills underlie communication with all patients (Table 2)..

7. Staging and diagnostic clinical aids

Conventional oral exploration (visual and palpation examination) constitutes the current gold standard for oral cancer screening, while biopsy and histopathological examination are indispensable for...