Clinical Challenges Q&A

14. facial paralysis


(a) Stroke is characterized by loss of brain activities (temporary or not), usually due to ischaemia or haemorrhage, causing an inability to move limbs, speak and/or understand and see. The main...

11. Ulcers

Osteochondroma of the Mandibular Condyle: an Unusual Case of Dentofacial Asymmetry. Dent Update 2015; 42: 372. Figure 6 appeared upside down. See corrected Figure 6 below..

10. Dental appearance

The main cause of tooth discoloration is external staining..

9. Buccal and palatal soreness

(c) Lupus erythematosus (LE) is the answer; LE, discoid or systematic, is an auto-immune disease which, although rarely affecting the mouth, shows single or multiple lesions with a white reticular...

8. lumps under tongue

(a) Piercing. This is now quite commonplace but rarely seen in such a number. The placement in a fairly symmetric pattern is a giveaway (Figure 1). Some patients have the habit of inserting foreign...

4. Diffuse brown discoloration of permanent dentition

c) Tetracycline staining is the cause here. Tetracycline given in pregnant mothers or in children <8 years old causes a diffuse discoloration in deciduous and permanent teeth, respectively, as it is...

3. Persistent lip swelling

(c) Orofacial granulomatosis. The history and clinical findings are most consistent with a diagnosis of orofacial granulomatosis (OFG), of which the cheilitis is one part, or Crohn's disease. Chronic...

2. A sweaty face

(b) Frey syndrome: this is characterized by unilateral sweating and flushing of facial skin in the area of the parotid gland during mastication.

1. Sore gums

d) Vesiculobullous disease: this can involve the gingivae in middle-age, causing chronic erythema and desquamation. The absence of skin or other mucosal lesions here suggests pemphigoid rather than...