| LO1/2/3 | Frictional keratosis | Chronic mechanical irritation → ↑keratin + benign epithelial hyperplasia | Ill-defined grey/white rough plaques; blends with mucosa ± erosions/ulcers | DDx: OPMD/leukoplakia. Remove trauma to test reactivity | Remove cause → review ~2 wks; biopsy if persists |
| LO1/2/3 | Linea alba | Pressure/irritation at occlusal plane; parafunction (clenching/bruxism/cheek biting) | Horizontal linear white ridge (often bilateral) ± scalloped tongue | Usually clinical dx; commonly mistaken for leukoplakia | Reassure; no tx |
| LO1/2/3 | Morsicatio buccarum | Parafunctional chewing/nibbling/sucking of non-keratinized mucosa | Irregular shaggy/macerated white plaques (often bilateral); may rub off | Mainly clinical; consider biopsy if atypical/risk factors | Reassure + habit awareness |
| LO1/2/3 | Traumatic ulceration | Mechanical trauma → loss of epithelium exposing CT | Ulcer with yellow fibrin base + erythematous halo; may have rolled keratotic edge | Must exclude SCC if persistent | Remove cause + supportive care → heals 10–14 d; biopsy if not healed |
| LO1/3 | Burns (thermal) | Hot foods/drinks, microwaved foods; cryogenic injury; e-cigarette explosions | Oval/circular erosions; commonly anterior hard palate/dorsal tongue | Hx timing is key | Supportive; usually heals 1–2 wks |
| LO1/3 | Burns (chemical) | Acids: coagulative necrosis (limits depth). Alkali: liquefactive necrosis (deeper) | Immediate erythema/edema → white slough/pseudomembrane over irregular ulcer | Hx exposure; biopsy rarely needed if clear | Remove agent; supportive; severe → topical steroids/other care ± debridement/ABx |
| LO4 | Exfoliative cheilitis | Unclear; assoc stress/anxiety + lip licking/chewing → chronic keratin overproduction/desquamation | Scaling/peeling + erythema/crusting/bleeding of both vermilion lips; burning/sensitivity | DDx: allergic contact/atopic cheilitis (hx ± patch test) | Often difficult: emollients/sunscreen; topical steroids/antimicrobial; tacrolimus/pimecrolimus (reported) |
| LO5 | Amalgam tattoo / exogenous pigmentation | Amalgam fragments implanted in mucosa during procedures | Blue/grey/black macule near restorations; may spread | X‑ray may show radiopaque flecks; biopsy if melanoma not excluded | Usually none; excise if cosmetic/uncertain dx |
| LO5 | Smoker’s melanosis | Tobacco stimulates melanin (protective response) | Diffuse brown pigmentation (site varies by smoking type) | DDx: syndromes/drug/endocrine causes | Smoking cessation → gradual fade (~years) |
| LO5 | Drug-related mucosal discoloration | Melanin stimulation or drug/metabolite deposition | Multiple/diffuse pigmentation; often dorsal tongue; variable colours | Med hx ± biopsy if unclear | Usually benign; may fade if stopped (not always) |
| LO6 | Radiotherapy complications (overview) | Acute + chronic soft tissue change post head/neck RT | Acute: mucositis/infection/pain. Chronic: fibrosis, xerostomia, caries, ORN | Clinical course + RT history | Prevent + manage: mouth care, analgesia, fluoride, recalls; ORN prevention is key |