Oral medicine, oral pathology and recognition of abnormalities
What this domain tests
Oral medicine and pathology questions test recognition of normal variation, common mucosal disease and red flags that require referral.
Core rules
- Take a focused history: onset, duration, site, size, pain, change, habits, medications and systemic disease.
- Red flags include an ulcer persisting beyond two weeks, induration, fixation, spontaneous bleeding, a painless lump, dysphagia, otalgia, hoarseness or unexplained weight loss.
- Leukoplakia is a clinical diagnosis of a white patch that cannot be characterised; erythroplakia is red and higher risk. Both need referral.
- Common conditions include candidiasis, lichen planus, recurrent aphthae and traumatic lesions, but persist without diagnosis is unsafe.
- Do not prescribe topical steroids or antifungals without a working diagnosis and review plan.
Worked example
A 62-year-old smoker has a 3-week ulcer on the lateral tongue. It is indurated and fixed. This is a red flag for oral squamous cell carcinoma; refer urgently through the local pathway and document the finding.
Traps
Reassuring a patient because the lesion is painless; treating with mouthwash and reviewing later; ignoring pigmented lesions; stepping outside your scope by diagnosing definitively.