General and Oral Pathology for the Dental Hygienist (DeLong, General and Oral Pathology for Dental Hygienists) PDF
Preview General and Oral Pathology for the Dental Hygienist (DeLong, General and Oral Pathology for Dental Hygienists)
96322_ch 06 9/12/07 1:46 PM Page 127 96322_FM 9/14/07 9:17 AM Page i 96322_FM 9/14/07 9:17 AM Page ii 96322_FM 9/14/07 9:17 AM Page iii Leslie DeLong Lamar Institute of Technology Beaumont,TX Nancy W. Burkhart Baylor College of Dentistry Texas A&M Health Science Center Dallas,TX 96322_FM 9/14/07 9:17 AM Page iv Acquisitions Editor: Barret Koger Managing Editor: Kevin Dietz Marketing Manager: Nancy Bradshaw Production Editor: Gina Aiello Designer: Risa Clow Compositor: Maryland Composition Cover photo courtesy of Dr. Valerie Murrah Copyright © 2008 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street 530 Walnut Street Baltimore, MD 21201 Philadelphia, PA 19106 Printed in Colombia All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. govern- ment employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at [email protected], or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data DeLong, Leslie. General and oral pathology for the dental hygienist / Leslie DeLong, Nancy Burkhart. p. ; cm. Includes bibliographical references. ISBN-13: 978-0-7817-5546-7 ISBN-10: 0-7817-5546-8 1. Mouth--Diseases. 2. Teeth--Diseases. 3. Pathology. 4. Dental hygienists. I. Burkhart, Nancy. II. Title. [DNLM: 1. Mouth Diseases. 2. Dental Hygienists. 3. Tooth Diseases. WU 140 D361g 2008] RK307.D43 2008 617.5'22--dc22 2007025134 DISCLAIMER Care has been taken to confirm the accuracy of the information present and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from appli- cation of the information in this book and make no warranty, expressed or implied, with respect to the currency, complete- ness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the pro- fessional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reac- tions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638-3030or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: http://www.lww.com. Lippincott Williams & Wilkins customer service 96322_FM 9/14/07 9:17 AM Page v To my father and mother, Earl and Muriel Yarrington. You always told me I could do any- thing I put my mind to. I wish you could have seen the completed project. To my husband Richard and my son Brian. You are never-ending sources of strength and encouragement, and I thank you for having patience with me while I worked on this project. Leslie DeLong I would like to dedicate my work and efforts in this book to two people. First to my husband Alan, who displayed true courage during his treatment of oral can- cer and his subsequent recovery—you have been admirable. Thank you for the support and encouragement that you have provided me while writing this book. The second dedication is to Mr. Vernon B. Strickland who believed in me and encouraged me throughout my life. Thank you for the many years of being a true role model and mentor to me. I offer my sincere thanks to Dr. Terry Rees, Dr. John Jacoway, and Dr. Jeff Burkes. My inter- ests in oral disease/pathology would not have occurred if you had not been mentors to me. Thank you for supporting me and above all, teaching me. As an educator, I know that noth- ing takes the place of experience. Nancy Burkhart 96322_FM 9/14/07 9:17 AM Page vi 96322_FM 9/14/07 9:17 AM Page vii General and Oral Pathology for the Dental Hygienist is a • Name. Each disorder may be called by different yet comprehensive study of the general concepts of patho- similar names in older texts, by different instructors physiology as they relate to systemic and oral conditions. or clinicians, or in different regions of the country The material in the first part of the book is organized by or world. The most common names and some of major determinants of disease and then by a quasi systems the less common or outdated names of the disor- approach, whereby different systems are looked at from ders are listed, enabling the student to identify the viewpoint of a practicing dental hygienist reviewing a them when necessary. medical history. The second part of the book focuses on • Etiology. The etiology of each disorder, if known, is oral pathology. The different disorders are organized into identified in this section. In instances where the eti- distinct clinical/radiographic features of oral lesions. ology is unknown, the prevailing theories of the eti- Students do not see immunity lesions or genetic lesions, ology may be stated with information on the cur- they see red lesions, white lesions, raised lesions, radiolu- rent focus of research. cent lesions, etc. The student needs a recognizable char- • Method of Transmission. This section contains a acteristic in order to group diseases/lesions of varying concise description of how the disorder is transmit- causes into categories that can be easily identified. When ted. If appropriate, this includes the method of students see an ulcer, they can go back into their memo- transmission of infectious organisms and inheri- ries and pull out the things that look like ulcers. White tance patterns or genetic transmission. lesions do not look like ulcers, neither do soft tissue • Epidemiology. Basic statistical information, such as enlargements; therefore, they do not need to consider incidence and prevalence, and information about these. They still know what causes the lesions, but they the epidemiological aspects of each condition, such will not have to sift through numerous dissimilar lesions as age, sex, ethnicity, and geographical location, are to get to the lesion that is most likely present. It is hoped essential for students to know in order to develop that this organization strategy will assist the students in an understanding of the disorders and to develop their efforts to learn the important and exciting subject of an appropriate differential diagnosis for a patient. Oral Pathology. This book has been developed with many • Pathogenesis. Students need to know the why and unique features that will enhance learning and practical the how of the disorders they are learning about in application of the material. order to understand how the concepts of patho- physiology relate to them. As the students under- stand more, less memorization will be required. FEATURES: This section focuses on a brief description of how 1. Chapter Outline. Each chapter begins with an outline the disease/condition develops. What happens on a to make locating material within the chapter easier. cellular, tissue, or organ level? How is the general 2. Learner Objectives and Key Terms. Learner objectives health of the individual affected? and a listing of key terms are also located at the • Extraoral Characteristics. Dental hygienists treat beginning of each chapter. Learner objectives help patients who have the potential to present with a students focus on the key elements of the material in myriad of health problems. In order to properly the chapter. Key terms are bolded and defined within assess the patient and plan for appropriate dental the text, in addition to being listed in a comprehen- hygiene care, the modern hygienist must be familiar sive glossary at the end of the book. with signs and symptoms of disease that may pre- 3. Disease Lists. The information related to specific oral sent in any area of the body. Clinically observable and systemic diseases/conditions is organized in a simi- characteristics associated with the lower and upper lar manner throughout most of the book. The template body, and the head and neck area, are described in facilitates the learning process by allowing students to this section. study the material in an organized fashion. The informa- • Perioral and Intraoral Characteristics. The perioral tion is organized into the following categories: and oral manifestations of each disorder are compre- vii 96322_FM 9/14/07 9:17 AM Page viii viii PREFACE hensively described in this section. In many • Suggest management techniques for patients who instances, these manifestations are linked to systemic present with specific problems. manifestations. As stated previously, lesions with sim- • Relate systemic pathology to oral conditions and ilar perioral and/or oral characteristics are grouped oral conditions to systemic pathology. together in the chapters dealing with oral lesions. • Discuss controversial or emerging issues and topics. • Distinguishing Characteristics. This section identi- • Suggest methods to educate patients about specific fies manifestations and sometimes microscopic fea- disorders. tures that may only be associated with a specific 5. Critical Thinking Activities. These activities are includ- disorder. This information is useful when adding/ ed in each chapter and encourage the student to reach eliminating conditions from a differential diagnosis. beyond memorizing the material to consider how the • Significant Microscopic Features. Many of the con- information will impact their practice of dental hygiene. ditions include a description of the histological 6. Case Studies. The case studies associated with each appearance of the affected tissues and/or cells. Often chapter were developed to encompass all aspects of this information is crucial in helping the student dental hygiene care, and require the student to “put it understand the pathological basis for the disorder. all together.” In addition, it is important for the student to know 7. Portfolio Possibilities. More and more dental hygiene that the microscopic examination of most lesions is programs are requiring their students to produce portfo- our only means of obtaining a definitive diagnosis. lios showcasing self-evaluation and the achievement of • Dental Implications. This section focuses on patient specific program competencies. Therefore, each chapter management issues that are associated with the spe- includes suggestions for student-directed projects that cific diseases/conditions. Information related to would be useful in showing progress toward meeting patient assessment, treatment modifications, poten- competencies associated with patient care, health pro- tial medical emergencies, homecare recommenda- motion, and disease prevention or professionalism. tions, and other topics enables the student to be 8. Clinical Protocols. References to numbered Clinical conscious of not only the specific disorder, but also Protocols are made throughout the book. Clinical pro- the impact that the disorder may have on tocols address the management of specific clinical or dental/dental hygiene treatment and on the individ- patient problems. They are excellent practice guide- ual’s ability to perform self-care procedures. lines and references for the student and/or practicing • Differential Diagnosis. A differential diagnosis has clinician. The Clinical Protocols are found in the back been developed for many of the disorders. The dif- of the book. ferential diagnosis includes the names of the disor- ders that may have similar manifestations and a ref- Student Resource Center erence to the chapter that discusses these disorders. At times, a brief explanation of why the condition The Student Resource Center has review questions with is listed in the differential diagnosis is included. answers and rationales and additional case studies asso- This is an excellent clinical reference for the stu- ciated with each chapter. dent and practicing clinician. • Treatment and Prognosis. The discussion of each Instructor Resource Center disease/condition concludes with possible treatment methods and the prognosis associated with the dis- The Instructor Resource Center has numerous aids for order. The dental implications of specific therapeu- instructors: tic regimens may also be described in this section. 4. Applications. Applications are specific for each chap- • Image bank containing all of the images included in ter and relate didactic knowledge to clinical practice. the text. The applications may accomplish one or more of the • Additional case studies that may be used for quizzes, following: tests, or classroom discussion. • Describe how information just learned is encoun- • Classroom discussion points for the Critical Thinking tered in everyday situations. Activities, case studies, and other chapter content. • Expand on information for those who might be • Test bank questions that can be used to generate interested in more detail. quizzes, tests, and final examinations.
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