From the Guidelines
The six most common buccal mucosa physical exam findings include linea alba, fordyce granules, leukoedema, traumatic lesions, aphthous ulcers, and oral candidiasis. These findings are crucial in the assessment of the buccal mucosa, as they can indicate various conditions, from benign to potentially malignant.
Key Features of Each Finding:
- Linea alba presents as a horizontal white line along the buccal mucosa at the occlusal plane, caused by chronic cheek biting or pressure 1.
- Fordyce granules appear as small yellowish-white spots representing sebaceous glands, are completely normal, and require no treatment 1.
- Leukoedema manifests as a diffuse, filmy white appearance that disappears when the mucosa is stretched, commonly seen in smokers but considered a normal variant 1.
- Traumatic lesions present as ulcerations or erythematous areas resulting from mechanical injury like cheek biting or sharp tooth edges, typically healing within 7-10 days unless the source of trauma persists 1.
- Aphthous ulcers (canker sores) appear as painful, round, shallow ulcers with a yellow-gray center and erythematous border, often triggered by stress or minor trauma, and usually resolve within 1-2 weeks with symptomatic treatment using topical anesthetics or corticosteroids 1.
- Oral candidiasis presents as removable white plaques on an erythematous base, often in immunocompromised patients or those on antibiotics, requiring antifungal treatment such as nystatin oral suspension 400,000-600,000 units four times daily or fluconazole 100-200mg daily for 7-14 days 1. When examining the buccal mucosa, it is essential to wear gloves, use good lighting, and thoroughly inspect both sides while looking for asymmetry, color changes, and texture abnormalities 1. This comprehensive approach ensures the detection of potential abnormalities and facilitates early intervention, which is critical in improving morbidity, mortality, and quality of life outcomes.
From the Research
Common Buccal Mucosa Physical Exam Findings
The following are common findings in a buccal mucosa physical exam:
- Mucosal ulcers
- White lesions
- Red lesions
- Pigmented lesions
- Lichen planus, which can present with a reticular pattern 2, 3
- Leukoplakia, which can be differentiated from lichen planus using digital texture analysis in intraoral photography 4
Key Features of Buccal Mucosa Lesions
Key features of buccal mucosa lesions include:
- Appearance: white, red, pigmented, or ulcerated
- Location: buccal mucosa, tongue, gingiva 2
- Pattern: reticular, as seen in lichen planus 2, 3
- Presence of dysplasia or candidiasis, as seen in some cases of lichen planus 2
Clinical Presentation and Diagnosis
Clinical presentation and diagnosis of buccal mucosa lesions involve: