Kahn Michael A. Hall J. Michael - The ADA Practical Guide to Soft Tissue Oral Disease

This edition first published 2014 2014 by John Wiley & Sons, Inc.

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Library of Congress Cataloging-in-Publication Data

Kahn, Michael A., author.

The ADA practical guide to soft tissue oral disease / Michael A. Kahn and J. Michael Hall.

1 online resource.

American Dental Association practical guide to soft tissue oral disease

Practical guide to soft tissue oral disease

Includes bibliographical references and index.

Description based on print version record and CIP data provided by publisher; resource not viewed.

ISBN 978-1-118-27798-0 (Adobe PDF) ISBN 978-1-118-27800-0 (ePub) ISBN 978-1-118-27797-3 (pbk.)

I. Hall, J. Michael, author. II. American Dental Association. III. Title. IV. Title: American Dental Association practical guide to soft tissue oral disease. V. Title: Practical guide to soft tissue oral disease.

[DNLM: 1. Mouth Diseases. 2. Diagnosis, Oral. 3. Soft Tissue Neoplasms. WU 140]

RK307

617.522dc23

2014001140

A catalogue record for this book is available from the British Library.

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Cover image: iStock/ Tjerrie

Cover design by Nicole Teut

To our families and mentors for their support, patience, dedication, and lessons taught.

This textbook is intended to be a practical guide and reference source for the basic clinical aspects of soft tissue oral and maxillofacial disease. It is not intended to be an all-encompassing tome of oral pathology but rather to include those aspects of this dental specialty that are its most important foundational information and the most frequently encountered orofacial soft tissue diseases. The book is intended for health-care practitioners whose occupation involves encountering a variety of conditions and diseases of the oral cavity and its contiguous anatomic structures; it is not intended to be a reference source for oral medicine (i.e., details of the medical aspects of a particular disease within the oral cavity).

We envision this book not as one to reside on a clinician's library shelf gathering dust and rarely referred to, but rather one used regularly within the dental operatory to help the clinician's decision making: that is, deciding what is the best thing to do for the patient when a pathologic condition is initially discovered, how to determine its most likely provisional diagnosis or differential diagnosis, whether to biopsy or refer for consultation by a dental or medical specialist, and how to most accurately and effectively communicate that information to the patient so the patient can give informed consent about his or her treatment course and management.

Since 1984, when we began our residency training in oral pathology at Emory University's School of Dentistry (Atlanta, GA), we have increasingly recognized specific essentials of oral pathology that need to be learned, understood, and used by all dentists; furthermore, we have witnessed common diagnostic pitfalls and management mistakes. This book is the culmination of our cumulative and collective experiential wisdom gained during our training as well as our subsequent years of being in teaching institutions. By interacting with dentists, with dental and dental hygiene students, and with physicians and patients in clinical and educational settings as well as by participation in active oral pathology biopsy services and clinical consultation clinics, we have become aware of the lesions commonly encountered but misunderstood by them or unknown to them.

Michael A. Kahn

J. Michael Hall

I would like to recognize the many professionals who helped guide me in my quest to find my niche in health care, first as a general dentist and then an oral pathologist. Anyone who has graduated from dental school can attest to its trials and tribulations and I was fortunate to have a big brother, Dr. Barry Kennedy, who as an upperclassman helped guide me over the many hurdles encountered. One of the Emory dental school faculty, Dr. Patricia Moultin, also offered words of encouragement when most needed to persevere and I am forever indebted to her. During my early general dentistry career, in the U.S. Army, yet another individual, Dr. Jack Edge (Lt. Col., retired), stepped up and taught me the real-world dental tricks of the trade and guided me into correct and wise decisions. I decided to return to Emory for my postgraduate training in oral pathology and am especially indebted to my two primary mentors, Dr. D. R. (Ronnie) Weathers and Dr. Steven Budnick, as well as two of my fellow residents, Dr. Craig Fowler and Dr. J. Michael Hall (the coauthor of this textbook). Dr. John Kalmar, at that time a Young Dental Scientist Award winner, also helped and taught me more than I can now remember. Following my stint at Emory, I did a one-year postdoctoral fellowship at Temple University, where Drs. J.C. Chen, Arthur (Art) Miller, and John Fantasia fine-tuned my 3-year postdoctoral training and helped my early transformation into a dedicated faculty member. A seminal moment in my career occurred near the completion of my fellowship when Dr. James Turner asked me to interview for an assistant professor position at UTMemphis College of Dentistry. He took a chance on me and I am forever grateful as he, Dr. Harry Mincer, and Dr. Marjorie Woods gave me every opportunity to maximize my potentialI couldn't have been luckier and I am forever grateful. Soon after my arrival in Memphis I challenged the American Board of Oral Pathology examination and I am indebted to the oral pathologists of the AFIP, Dr. Fowler, and Dr. Robert Brannon for their willingness to share their education material and expertise. Approximately 11 years ago, my latest career phase began when Dr. Robert (Bob) Goode strongly supported my move to Tufts University School of Dental Medicine. Bob was a wonderful mentor who served his country admirably in the U.S. Air Force as an oral pathologist, including a stint as a forensic odontologist. When our country experienced military mass disasters Bob was there to provide closure to the families of the deceased. Unfortunately, poor health forced Bob into early retirement. At Tufts, I learned much with Dr. Eleni Gagari, subsequently with Dr. Lynn Solomon, and most recently with Dr. Hall. A special tip of the hat to Drs. Solomon and Hall for the extra workload they endured as I became more and more active in organized dentistry, particularly within our specialty. Finally, through all these years, the love and support of my deceased parents (Sylvia and Leo) and my current nuclear family (Sandy, Greg, Matt, David), and most especially the time they allowed me to be preoccupied with my professional duties, is appreciated beyond description.