Terminology of Lesions & Conditions – Xerostomia, Abscess, Malocclusion & Related Terms

Overview

In dentistry, precise terminology is essential for accurate diagnosis, treatment planning, and interdisciplinary communication. Lesions and conditions affecting the oral cavity range from functional disorders such as dry mouth to infectious processes and developmental abnormalities.

This article explains commonly used clinical terms including xerostomia, abscess, malocclusion, and other frequently encountered oral pathologies and conditions.

1. Xerostomia

Xerostomia refers to the subjective sensation of oral dryness, typically resulting from reduced or altered saliva production. While not a disease itself, it is a symptom that may indicate underlying systemic conditions or medication side effects.

Causes

• Medication-induced salivary gland suppression (e.g., antihypertensives, antidepressants)
• Autoimmune disorders such as Sjögren's syndrome
• Radiation therapy to the head and neck
• Dehydration or systemic illness

Clinical Implications

Saliva plays a critical role in buffering acids, remineralizing enamel, and controlling oral microflora. Reduced salivary flow increases the risk of:

• Dental caries
• Erosion
• Oral infections (e.g., candidiasis)
• Difficulty swallowing or speaking

Management focuses on addressing underlying causes, stimulating salivary flow, and recommending saliva substitutes or topical fluoride.

2. Abscess

An abscess is a localized collection of pus caused by bacterial infection. In dentistry, abscesses are typically categorized as:

Periapical Abscess

Originates from infection of the dental pulp, usually due to untreated caries or trauma.

Periodontal Abscess

Arises from infection within periodontal tissues, often associated with deep periodontal pockets.

Clinical Features

• Localized swelling
• Pain and tenderness
• Possible fever or lymph node involvement
• Radiographic evidence of bone loss (in advanced cases)

Prompt treatment—often involving drainage, root canal therapy, or extraction—is required to prevent systemic spread.

3. Malocclusion

Malocclusion describes improper alignment of teeth and incorrect relationship between the upper and lower dental arches.

Classification

Malocclusions are commonly classified using Angle’s Classification, developed by Edward Angle:

• Class I: Normal molar relationship with crowding or spacing issues
• Class II: Retruded mandible ("overbite")
• Class III: Protruded mandible ("underbite")

Consequences

• Impaired mastication
• Speech difficulties
• Increased wear or trauma
• Aesthetic concerns

Orthodontic treatment aims to correct alignment and improve both function and appearance.

4. Ulcer

An oral ulcer is a break in the mucosal surface resulting in a painful lesion.

Common types include:

• Traumatic ulcers (mechanical irritation)
• Aphthous ulcers (recurrent, idiopathic lesions)
• Ulcers associated with systemic diseases

Persistent ulcers lasting more than two weeks require further clinical evaluation.

5. Caries

Dental caries is a multifactorial infectious disease characterized by demineralization of tooth structure due to acid production by plaque bacteria.

Risk factors include:

• High sugar intake
• Poor oral hygiene
• Reduced salivary flow
• Lack of fluoride exposure

Caries progression may lead to pulpal infection and abscess formation if untreated.

6. Gingivitis and Periodontitis

Gingivitis

A reversible inflammation of the gingiva caused primarily by plaque accumulation. Symptoms include redness, swelling, and bleeding on probing.

Periodontitis

An advanced inflammatory disease affecting supporting periodontal structures, leading to attachment loss and bone destruction. If untreated, it can result in tooth mobility and loss.

7. Cyst

An oral cyst is a pathological cavity lined by epithelium and typically filled with fluid or semi-solid material.

Examples include:

• Radicular cysts (associated with non-vital teeth)
• Dentigerous cysts (associated with impacted teeth)

Radiographic evaluation is essential for diagnosis and treatment planning.

8. Bruxism

Bruxism is the involuntary grinding or clenching of teeth, often occurring during sleep.

Clinical signs may include:

• Tooth wear (attrition)
• Jaw pain
• Headaches
• Temporomandibular joint discomfort

Management may involve occlusal splints and stress management strategies.

Clinical Relevance

Understanding lesion and condition terminology enables accurate documentation, diagnosis, and communication within dental teams. Early recognition of symptoms such as xerostomia or abscess formation can significantly improve patient outcomes through timely intervention.

Clear terminology also supports interdisciplinary collaboration between general dentistry, orthodontics, oral surgery, and periodontology.