1. A 39-year-old man with tooth displacement
A 39-year-old man with tooth displacement. All images courtesy of Dr. Juan Yepes, MPH, DrPH.
A 39-year-old man visited the dentist’s office for a recall exam. His last dental exam was five years ago. The patient was asymptomatic with no complaints.
His past medical history was unremarkable, and he had no history of surgeries or allergies. He was not taking any medication. The extraoral and intraoral exams were within normal limits.
2. A 6-year-old boy with an abscess and discolored anterior teeth
A 6-year-old boy presented to the pediatric dentist, referred by a family dentist, because of unusual discoloration of the anterior teeth.
The boy’s past medical history was remarkable for a genetic condition, the name of which the parents couldn’t recall. The parents also mentioned the presence of kidney stones (diagnosed one year prior), spinal cord “issues,” and occasional knee pain. The extraoral exam revealed frontal bossing. The intraoral exam revealed a clinical abscess apical to tooth #I.
3. An 8-year-old boy with two small “growths”
An 8-year-old boy with two small “growths.”
The patient was an 8-year-old boy who presented to a pediatric dentist for evaluation. The boy was referred by his pediatrician, who noted two small “growths” in the anterior maxilla.
The boy had no other symptoms. His parents told the dentist that the “bumps” had been there for approximately one year and that there had been no significant changes in the size of the growths during that time. The patient’s past medical history was unremarkable.
4. A 46-year-old man with painful lesions
A 46-year-old man presented at the emergency department with painful lesions on his lips and fingers that had developed within the past 24 hours. The patient told the physician that it was the first time he had developed such lesions. He had been eating and drinking normally but with pain.
His past medical history was unremarkable. He reported no allergies.
The extraoral exam revealed erythema and ulcers over the upper and lower lip and lesions on his fingers. The ED physician consulted with the on-call dentist.
5. A 22-year-old man with an unusual radiographic finding
A 22-year-old man with an unusual radiographic finding.
A 22-year-old man was referred to the oral surgeon by a family dentist because of an unusual finding on a panoramic film. The suspicious finding was located over the right anterior maxilla.
The patient was asymptomatic. His past medical history was unremarkable. The extraoral and intraoral exam were within normal limits. The dentist ordered a cone-beam computed tomography scan, which was sent to the oral surgeon.
6. An 8-year-old girl with a lip mass
An 8-year-old girl visited the pediatric dentist to evaluate a mass located on her inferior lip. The patient was asymptomatic. The girl’s parents told the pediatric dentist that the mass had been there for about one year but had increased in size in the last three months.
The girl’s past medical history was unremarkable. The extraoral exam was within normal limits except for the soft-tissue lesion, which was pedunculated, mobile, painless, soft, and located over the ventral aspect of the tongue.
7. A 65-year-old man with mandibular growths
A 65-year-old man with mandibular growths.
A 65-year-old man presented to the family dentist for a regular checkup visit. He last visited a dentist more than 10 years ago. The patient had no complaints except that something was slowly growing on the floor of the mouth. His past medical history was unremarkable. The patient had no known allergies, nor was he currently taking any medications.
The extraoral exam was within normal limits. The intraoral exam revealed several bony protuberances that were hard on palpation and painless in the lingual and labial aspects of the mandible.
8. A 16-year-old girl with swelling, pain in the floor of her mouth
A 16-year-old girl presented to the oral surgeon with a history of experiencing pain in the floor of her mouth for the past six months. The patient told the surgeon that for at least one year, she had episodes of swelling that resolved after a few days without any specific treatment.
The girl’s past medical history was unremarkable. She reported that she had no known drug allergies.
The physical exam revealed mild swelling of the floor of the mouth and mild discomfort with palpation. The intraoral exam revealed a “yellow” area in the floor of the mouth. No caries lesions or periodontal disease was noted.
9. A 21-year-old man with an unusual third molar
A 21-year-old man with an unusual third molar.
A 21-year-old asymptomatic man presented to the dentist for a regular recall exam. The patient’s past medical history included frequent upper respiratory infections and congenital hip dysplasia.
The intraoral and extraoral exams were within normal limits. As part of the recall exam, the dentist ordered imaging, including a panoramic film and cone-beam computed tomography imaging.
10. A 28-year-old man with a radiographic finding
A 28-year-old man presented to the oral surgeon’s office, referred by a family dentist because of a “lesion” on the left mandible that was noted in a panoramic film. The patient was asymptomatic. There was no paresthesia or swelling associated with the lesion.
The man’s past medical history was significant for seasonal allergies. The intraoral and extraoral exams were within normal limits.
