Fall, September 29-30, 2023

Distinguishing the Benign from the Deadly: Oral Pathology Update

Friday Morning 

Fasten your seatbelts! This lecture will be heavy on pictures with the goal of illustrating a variety of conditions that can be encountered frequently in the dental office. Growths that can be seen in a wide spectrum of ages from children to the elderly will be reviewed. The signs and symptoms of oropharyngeal carcinoma and the role HPV plays will be discussed.

Educational Objectives:

1. How to develop a differential diagnosis for common oral growths.

2. Understand how color, shape and size can aid in identifying growth.

3. Learn which lesions are normal variations and when to refer for biopsy.

4. Be familiar with the terminology of leukoplakia and erythroplakia and how to distinguish the entities frommasqueraders.

5. How to develop an organized approach to oral examinations and recognize the most common areas for oralcancer development.

6. Understand the role of HPV in cancer.

"Red, White, Brown, and Ulcerative Lesions of the Oral Cavity. What are they?"

Friday Afternoon 

This course is designed to guide the health care provider through the differential diagnosis, treatment, and management of commonly encountered oral soft tissue growths and ulcers. Differentiating oral ulcers based on the clinical presentation, duration and location is imperative for appropriate management. Subjects include the differential diagnoses of white lesions including leukoplakia and lichen planus and red lesions including erythroplakia and geographic tongue. Particular emphasis on the clinical presentation of oral dysplasias or early cancer will be illustrated. Diagnosis and treatment algorithms of lichen planus and other vesiculo-erosive conditions that can affect the oral mucosa will be presented. Biopsy techniques including biopsies for direct immunofluorescence will be reviewed. Differentiating oral ulcers based on clinical presentation, duration and location will be discussed, with special reference to oral herpes and aphthous ulcers. Diagnosis and treatment options for Burning Mouth/Tongue Syndrome will be discussed and tips on separating this entity from other causes of burning, including candidiasis and reactions to topical agents such as cinnamon, mints, and other agents

Educational Objectives:

Education:

1. Be able to identify common oral soft tissue lesions and develop a differential diagnosis.

2. Be familiar with various therapeutic treatment options.

3. Learn when and what to biopsy for diagnosis.

4. Develop proficiency in identifying oral precancerous lesions.

Susan Muller, DMD, MS retired from Emory University October 2013 and is Professor Emeritus, currently in private practice with Atlanta Oral Pathology. She has held joint appointments in the Department of Pathology, Department of Otolaryngology Head and Neck Surgery, and the Winship Cancer Institute beginning in 1995. Dr. Muller is Past President of the American Academy of Oral and Maxillofacial Pathology, Past President of the North American Society of Head and Neck and Past President of the American Board of Oral and Maxillofacial Pathology. Dr. Muller was Editor-in-Chief of Head and Neck Pathology from 2008-2019. Currently Dr. Muller serves on the Test Development and Construction Committee for the American Board of Pathology. She is an Editor on the 2022 WHO Classification of Head and Neck Tumors and co-editor of the 3rd edition of Diagnostic Pathology: Head and Neck. Dr. Muller enjoys lecturing on Oral Pathology and has lectured throughout the world.

DRUG-RELATED PROBLEMS IN DENTAL PRACTICE: IT’S A MINEFIELD OUR THERE!

Saturday:

Increasing numbers of dental patients are uncontrolled hypertensives or on multiple medications with complex oral health problems. Many new cardiovascular and central nervous system drugs can interact with dental drugs or affect bleeding or wound healing. Patient self-medication with supplements and over-the –counter drugs has recently been recognized as potentially risky in dentistry. Consequently, more and more patients report chemical and drug allergies and intolerances. Dental professionals are frequently faced with medically complex and chemically challenged patients and need practical strategies for providing safe and appropriate care. The purpose of this course is to identify new drug-related problems encountered in dental practice and to outline practical management solutions. Extensive handouts will supplement discussion of intra-oral drug effects, new premed guidelines, and treatment modifications involving medicated, xerostomic, or allergic patients. Throughout the program, primary emphasis will be placed on developing consistent strategies for treating medically complex dental patients. An extensive and current handout will greatly enhance the chair-side value of this fast-paced and practical course.

• Recognize the specific dental treatment modifications necessary to prevent complications in patients with major cardiovascular or central nervous system disorders. 

• Modify dental treatment for patients on new chronic medications for diabetes, osteoporosis, and collagen vascular diseases such as rheumatoid arthritis. 

• Identify which new biologics or targeted therapies can predispose to MRONJ. 

• Recognize and manage drug-induced oral problems and harmful drug-drug interactions.

Karen Baker, RPH, MS: Professor Baker has been on the Dental College faculty at the University of Iowa for 40 years and occupies a unique role in dental practice and education. She is a clinical pharmacist with a Master’s degree in clinical pharmacology and therapeutics and is focused on patient-specific dental drug therapy. She has given over 1000 invited programs nationally and internationally and holds memberships in many dental and clinical pharmacology and therapeutics organizations. Her dental education-based pharmacy and drug therapy consultation center is the only one in the United States. She has authored many articles and abstracts and lectures extensively in pre-doctoral and graduate courses at the University of Iowa.