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Home , Abfraction, Dens invaginatus, Dentin dysplasia, Dilaceration, Gingival cyst, Hypercementosis

DH 248 General and Oral Pathology Spring 2014

Meeting Times: Tuesday & Thursday 10:00 - 11:50 a.m. CASA Mortuary Science Room 70

Credits: 4 credit hours

Faculty: Sherri Lukes, RDH, MS, Associate Professor, Room 129 Office: 453-7289 Cell: 521-3392 E-mail: [email protected]

Office Hours: Monday 1:00 p.m. - 4:00 p.m. Tuesday 1:00-4:00 Other office hours by appointment

COURSE DESCRIPTION: This course has been designed to integrate oral pathology and general pathology. Students will study principles of general pathology with emphasis on the relationships to oral diseases. Pathologic physiology is included such as tissue regeneration, the inflammatory process, immunology and wound healing. Clinical appearance, etiology, location and treatment options of general system diseases is presented, along with the oral manifestations. Special attention will be placed on common pathological conditions of the oral cavity and early recognition of these conditions.

DH Competencies addressed in the course: PC.1 Systematically collect analyze, and record data on the general, oral, and psychosocial health status of a variety of patients/clients using methods consistent with medico-legal principles.

PC.2 Use critical decision making skills to reach conclusions about the patient’s/client’s dental hygiene needs based on all available assessment data.

PC.3 Collaborate with the patient / client, and/or other health professionals, to formulate a com- prehensive dental hygiene care plan that is patient / client-centered and based on current scientific evidence.

PC.4 Provide specialized treatment that includes preventive and therapeutic services designed to achieve and maintain oral health. Assist in achieving oral health goals formulated in collaboration with the patient / client.

PC.5 Evaluate the effectiveness of the implemented clinical, preventive, and educational services and modify as needed.

HP.3 Refer patients/clients who may have a physiologic, psychological, and/or social problem for comprehensive patient/client evaluation.

Required Textbook:

DeLong, L. & Burkhart, N.W. (2013). General and Oral Pathology for the Dental Hygienist. 2nd Ed. Lippincott Williams & Wilkins, Philadelphia, PA.

We WILL be using the online resources that come with the text. Some resources will be posted on D2L

Recommended References/Resources:

Medical dictionary either in paper or online format

Oral pathology web site: http://www.usc.edu/hsc/dental/opath/ Go to the Disease Index http://www.dentalmedsoft.com/SampleCases/StartupPage.htm

OPERA Plus- Oral Pathology CD available for viewing in computer lab in CASA.

Langlais,R., & Miller, C. (1998). Color atlas of common oral diseases. Williams & Wilkins, Baltimore, MD.

Prerequisites: DH 226, DH 233

In order to pass the course, a final grade of “C” must be achieved as a course grade.

If any student needs special services, please contact the course instructor or Disability Support Services (453-5738, [email protected]). Tutoring is available for this course as a group or individually within the department. Tutors are DH juniors or seniors who received either an A or B in the course. This year’s tutors are Taylor Willer, [email protected], 636-577-2443 and Jordan Brown, [email protected], 217-213-4001.

COURSE OBJECTIVES:

At the completion of the course, the student will be able to: 1. Explain basic pathology terms and principles including: Definitions of key pathologic terms Description of radiographic findings Elements of a complete clinical Elements of the intra/extra oral exam Steps involved in the differential diagnosis description Steps involved in the definitive diagnosis Descriptive terms for lesions

2. Describe the integration and coordination of cell functions and response to as related to the following: Reversible Cell Injury Irreversible Cell Injury Atrophy Hypertrophy Metaplasia Dysplasia Cell Aging Cell Death Cell Necrosis

3. Explain the inflammatory process including: 5 Cardinal Signs of Circulatory Changes Vessel Wall Changes Mediators of Inflammation Emigration of Leukocytes Phagocytosis Cells of Inflammation Chemotaxis Granulation Tissue Purulent Exudate Wound Healing Forms of Inflammation Acute Inflammation Chronic Inflammation

4. Recall and discuss the incredible role that the immune system plays in maintaining health and overcoming disease including: Natural Immunity Acquired Immunity Lymphocytes Plasma Cells Antibody Production Hypersensitivity Reactions Transplantation Blood Transfusion Rh factor Immunodeficiency Diseases Leukocytes Autoimmune Diseases

Explain the etiology, clinical features and possible treatment options of the following skin lesions and autoimmune disorder skin lesions when 5. presented on a written exam or projected on a slide: Lichenoid Drug Reactions Vulgaris Progressive Systemic Sclerosis Contact Glandularis Cheilitis Granulomatosa Basal and cell carcinoma Sarcoidosis Psoriasis Eczema Actinic keratosis Seborrheic Keratoses Ephelides Urticaria Nevi

Describe the clinical features and significance of the following genetic and developmental diseases when presented on a written exam or 6. projected on a slide: Fetal Alcohol Syndrome Trisomy 21 Klinefelter’s Syndrome Marfan Syndrome Cleft / Hypercholesterolemia Gingival fibromatosis Treacher Collins Syndrome Papillon-Lefevre syndrome Ehler’s Danlos Syndrome Cleidocranial dysplasia Turner’s Syndrome

Explain the etiology, clinical features and possible treatment options of the following abnormalities of the teeth when presented on a written 7. exam or projected on a slide:

Attrition Internal Resorption Fracture Avulsion External Resorption Ankylosis Impacted Teeth Erosion Cleidocranial Dysplasia Disturbances in Eruption Supernumerary Roots Dysplasia Conscresence Supernumerary Cusps Supernumerary Teeth Fusion Eruption Sequestrum Gemination Dentinogenesis Imperfecta Cervical Enamel Projections Ectodermal dysplasia Porphyria Rickets (hypophosphatemia) Cleidocranial dysplasia Fluorosis Hemolytic Anemia External resorption Tetracycline staining Gardner Syndrome Internal resorption Hypoplasia stones

Indicate the etiology, location, clinical features and significance, and possible treatment of the following endocrine disorders when presented on 8. a written exam or projected on a slide: Addison’s Disease(adrenal disorders) Dwarfism Hyperthyroidism Graves’ Disease Hypothyroidism Cretinism Myxedema Goiter Thyroid Diabetes Cushing’s Syndrome

Identify the cause, physiologic characteristics and manifestations, clinical significance, symptoms and possible treatment of the following 9. cardiovascular conditions when presented on a written exam:

Congenital Heart Diseases Tetralogy of Fallot Septal Defects Pulmonary Stenosis Mitral Valve Prolapse Atherosclerosis Myocardial Infarction Ischemia Angina Pectoris Hypertension Cor Pulmonale Congestive Heart Failure Cyanosis Patent Ductus Arteriosis Heart Murmurs Mitral Stenosis Aortic Stenosis Hypercholesterolemia Subacute Bacterial Endocarditis Tachycardia Atherosclerosis Ventricular Fibrillation Bradycardia Rheumatic Heart Disease

10. Discuss the epidemiology and possible causes of neoplasia/cancer. Neoplastic growth Diagosis-Tumor grading/staging Squamous Cell Carcinoma Breast Cancer Prostate Cancer Lung Cancer Melanoma Benign/malignant growth Basal Cell Carcinoma Oral Metastatic Cancer

Explain the etiology, clinical features and possible treatment options of the white oral lesions when presented on a written exam or projected on 11. a slide: Fordyce granules Parulis Frictional keratosis Smoker’s Melanosis Linea alba Hyperkeratosis Hairy tongue Cheek chewing() Lichen planus Nocotine Stomatitis Proliferative Verrucous Leukoplakia Carcinoma In Situ Candidiasis Squamous Cell Carcinoma Chemical/thermal burns Acanthosis

Explain the etiology, clinical features and possible treatment options of the following oral ulcers and ulcer like lesions when presented on a 12. written exam or projected on a slide:

Traumatic Ulcers Necrotizing sialometaplasia Syphilis Gonorrha Necrotizing Ulcerative Deep fungal Aphthous ulcers Behcet syndrome Reiter syndrome Erythema multiforme Hypersensitivity reactions Lupus erythematosus Crohn disease Squamous cell carcinoma

Explain the etiology, clinical features and possible treatment options of the following oral lesions that have a vesicular appearance when 13. presented on a written exam or projected on a slide: Virus infections Varicella-Zoster Virus infections Epstein-Barr Virus Cytomegalovirus Hand, Foot, and Mouth Disease Acute Lymphonodular Pharyngitis Rubella Measles Pemphigus Vulgaris Epidermolysis bullosa Mucous membrane pemphigoid

Explain the etiology, clinical features and possible treatment options of the following oral lesions in shades of red and purple when presented on 14. a written exam or projected on a slide: Pyogenic Hypersensitivity reactions Kapsosi sarcoma Peripheral giant cell granuloma Candidosis(candidiasis) Lichen planus Hemangioma Varicosity(varix) Lymphangioma Hereditary Hemorrhagic Telangiectasia Petechiae Purpura Ecchymoses

Explain the etiology, clinical features and possible treatment options of the following oral pigmented lesions when presented on a written exam 15. or projected on a slide:

Physiologic pigmentation Titanium Implants Intentional tattooing Heavy metal pigmentation Minocycline tissue staining AZT pigmentation Smoking-associated melanosis Betel quid use Nevus Melanotic macule Disease associated pigmentation

Explain the etiology, clinical features and possible treatment options of the following oral Raised Lesions with a Rough or Papillary Surface 16. when presented on a written exam or projected on a slide: Oral squamous papilloma Verruca vulgaris Condyloma acuminatum Focal epithelial hyperplasia Inflammatory papillary hyperplasia Keratoacanthoma

Explain the etiology, clinical features and possible treatment options of the following oral Oral Soft Tissue enlargements when presented on a 17. written exam or projected on a slide: Mucocele Mucus Retention Viral / Chronic Sclerosing Acute Parotitis Benign Lymphoepithelial Lesion Traumatic neuroma Monomorphic Adenoma Neurilemmoma Mucepidermoid Carcinoma Peripheral ossifying fibroma Neurofibroma Gingival hyperplasia Neurofibromatosis Lymphoid hyperplasia Bacterial Sialadenitis Rhabdomyosarcoma Sarcoidosis Thyroglossal duct cyst Sjogren Syndrome Cervical lymphoepithelial cyst Dermoid Cyst Papillary Cystadenoma Lymphomatosum Granular cell tumor

Explain the etiology, clinical features and possible treatment options of the following oral Oral Hard Tissue enlargements when presented on a 18. written exam or projected on a slide: Torus Calcifying Epithelial Osteosarcoma Exostosis Ossifying fibroma Chondrosarcoma Central giant cell granuloma Ewing Sarcoma Garre’s osteomyelitis

Identify the cause, physiologic characteristics and manifestations, oral manifestations, prognosis and possible treatment of HIV and AIDS when 19. presented on a written exam or projected on a slide:

HIV virus/ Pathogenesis Therapy Oral manifestations Candidiasis Hairy Leukoplakia HPV lesions Malignancies/neoplastic lesions Oral Ulcerations Periodontal diseases disease Identify the cause, physiologic characteristics and manifestations, prognosis and possible treatment of the following Blood Diseases when 20. presented on a written exam or projected on a slide: Iron Deficiency Anemia Pernicious Anemia Sickle Cell Anemia Thalassemia Fetal Erythroblastosis Leukopenia Agranulocytosis Leukocytosis Leukemia Hodgkin Lymphoma Non-Hodgkin Lymphoma Burkitt Lymphoma Multiple Myeloma Thrombocytopenia Vitamin C Deficiency Hereditary Hemorrhagic Telangiectasia

Explain the etiology, clinical features and possible treatment options of the following oral Oral Radiopaque Lesions when presented on a written 21. exam or projected on a slide: Focal Sclerosing Osteomyelitis Gardner Syndrome Osteopetrosis

Explain the etiology, clinical features and possible treatment options of the following oral Oral Radiolucent Lesions when presented on a written 22. exam or projected on a slide: Periapical/Radicular Cyst Nasopalatine canal cyst Adenomatoid Odontogenic tumor Periapical Granuloma Aneurysmal of the newborn Ameloblastic fibroma Langerhans cell diseaser Cementoosseous dysplasia Eruption cyst Static Bone Cyst Odontogenic Nevoid Basal Cell Carcinoma Syndrome Calcifying

Identify the cause, physiologic characteristics and manifestations, prognosis and possible treatment of the following conditions of Respiratory, 23. Gastrointestinal, Neurologic and Skeletal disorders when presented on a written exam or projected on a slide: Pneumonia Pulmonary Tuberculosis Common cold/influenza Lung Abscess Chronic Bronchitis Asthma Emphysema Chronic obstructive pulmonary disease Cystic Fibrosis Legionnaires’ Disease Dysphagia Gastroesophageal reflux disease Peutz Jeghers Syndrome Gastritis Meningitis and encephalitisc Inflammatory Bowel Disease/polyps Peritonitis Parkinson disease Crohn’s Disease Celiac disease Bell Palsy Gastroenteritis Diverticulosis Trigeminal Neuralgia Osteoarthritis Peptic Ulcer Rheumatoid arthritis Ulcerative Colitis TMJ disorder Osteoporosis Paget disease Fibrous dysplasia

Grading:

Exam 1 60 points Exam 2 50 points Exam 3 60 points Exam 4 60 points Exam 5 50 points Final Exam 150 points Quizzes/Assignments 90 points (approx)

The point values for exams and quizzes are approximate, due to changing textbooks in spring 2014, which will require compiling new exams. The primary value that could change is the quiz value. There may be less than 9 quizzes which would make the final total less. To figure your grade at any point, however, the points earned up to that point are simply divided by the points possible up to that point. The calculation will yield a percentage. The university follows the grading scale listed below. Grades will be posted on D2L throughout the semester for the student to stay abreast of academic standing in the course. Grading Scale: A 90 - 100% B 80 - 89% C 70 - 79% D 60 - 69% F 59% or below

*Note* The instructor reserves the right to amend the number of points possible if need be; however, students will receive notification of changes in sufficient time to comply with the changes and complete required coursework.

Attendance: Attendance is mandatory and will be recorded. Students are expected to attend all lectures and be on time for class. Those missing more than two class periods will be dropped a letter grade for the course. Late arrivals and/or leaving class early will count as half of an absence. There are no make-ups on quizzes. The lowest quiz score is dropped during final grade calculations so in the event of an absence on a day that a quiz is given, that quiz score of 0 will be the score dropped. If an additional quiz is missed, a zero will be entered as that quiz score. Quizzes may be unannounced. Though highly discouraged, missed exams may be made up, but must be taken within one week of the actual date the exam was missed. It is the student’s responsibility to contact the instructor and schedule a time to take the missed exam. Students MUST contact the instructor before the exam if the student will not be taking the exam at the regularly scheduled time. Failure to do so will result in drop of a letter grade when the exam is made up.

Cell phones: Cell phone use of any kind is strictly prohibited during class time. They must be put away and out of sight during class. If a student is observed texting or reading a text, if their cell phone rings, etc. the student will be penalized 3 points on the next quiz.

EMERGENCY PROCEDURES:

Southern Illinois University Carbondale is committed to providing a safe and healthy environment for study and work. Because some health and safety circumstances are beyond our control, we ask that you become familiar with the SIUC Emergency Response Plan and Building Emergency Response Team (BERT) program. Emergency response information is available on posters in buildings on campus,

available on the BERT’s website at www.bert.siu.edu, Department of Public Safety’s website www.dps.siu.edu (disaster drop down) and in the Emergency Response Guidelines pamphlet. Know how to respond to each type of emergency.

Instructors will provide guidance and direction to students in the classroom in the event of an emergency affecting your location. It is important that you follow these instructions and stay with your instructor during an evacuation or sheltering emergency. The Building Emergency Response Team will provide assistance to your instructor in evacuating the building or sheltering within the facility.

ACADEMIC HONESTY:

All students are expected to adhere to a strict code of academic honesty. Academic dishonesty will be addressed according to the “Policies and Procedures Applicable to Academic Dishonesty” as stated in the “Important Information for Students, Faculty, & Staff” booklet.

From the “Student Conduct Code”, section II, article A:

Acts of Academic Dishonesty:

1. Plagiarism, representing the work of another as one’s own work; 2. Preparing work for another that is to be used as that person’s own work; 3. Cheating by any method or means; 4. Knowingly and willfully falsifying or manufacturing scientific or educational data and representing the same to be the result of scientific or scholarly experiment or research; 5. Knowingly furnishing false information to a university official relative to academic matters; 6. Soliciting, aiding, abetting, concealing, or attempting conduct in violation of this code.

Sanctions will be imposed for violations of this policy in accordance with the Student Conduct Code. A copy of the “Important Information for Students, Faculty & Staff” booklet can be obtained from the Office of the Vice Chancellor for Student Affairs, Mailcode 4308, Southern Illinois University, Carbondale, IL 62901-4308.

ADA Accommodations:

In keeping with the goal of the implementation of the Americans with Disabilities Act (ADA), all students for whom this act applies should notify the instructor no later than the second session of the course so that arrangements can be made for accommodations to meet your educational needs and maximize learning.

DH 248-General and Oral Pathology-Tentative Schedule/topical outline The instructor reserves the right to modify the schedule if needed Spring 2014

Week Date Reading Assignment Reading for the assigned class period is to be done prior to class 1 T 1/14 Syllabus Chapter 1 Intro to General and Oral Pathology Th 1/16 Chapter 2 Basic Pathology 2 T 1/21 Chapter 3 Inflammation and repair Th 1/23 Chapter 4 The Immune System and Immunity 3 T 1/28 Chapter 23 Skin lesions Th 1/30 Finish chapter 23 4 T 2/4 Exam 1 (begin chap 6) Th 2/6 Chapter 6 Developmental, Genetic and Congenital Disorders 5 T 2/11 Chapter 21 Abnormalities of the teeth Th 2/13 Chapter 7 Endocrine Disorders 6 T 2/18 Chapter 8 Cardiovascular Disorders Th/ 2/20 Exam 2 (begin chap 5 ??) 7 T 2/25 Chapter 5 Neoplasia Th 2/27 Chapter 14 White Lesions 8 T 3/4 Chapter 12 Ulcers and Ulcer-Like Lesions Th 3/6 Chapter 11 Lesions That Have a Vesicular Appearance 3/10-3/14 Spring Break NO CLASS RELAX!!!!! 9 T 3/18 Chapter 13 Lesions in Shades of Red and Purple Th 3/20 Exam 3 (begin chap 15) 10 T 3/25 Chapter 15 Pigmented lesions Th 3/27 Chapter 16 Raised Lesions with a Rough of Papillary Surface 11 T 4/1 Chapter 17 Soft Tissue Enlargements Th 4/3 Chapter 18 Hard Tissue Enlargements 12 T 4/8 Chapter 22 HIV and AIDS Th 4/10 Exam 4 (Begin Chap 9) 13 T 4/15 Chapter 9 Bood Diseases Th 4/17 Chapter 19 Radiopaque lesions 14 T 4/22 Chapter 20 Radiolucent lesions Th 4/24 Chapter 10 Respiratory, Gastrointestinal, Neurologic and Skeletal Disorders 15 T 4/29 Exam 5 Th 5/1 Review for Final 16 5/5-5/9 Final Exam Week Final exam-Thursday, May 8, 10:10-12:10

Tutors for Spring 2014, Taylor Willer and Jordan Brown (Junior students)