CE WEBINAR: I Found an Ulcer During My Oral Exam, Now What?

The webinar link will be sent out at 1:00pm on the day of the presentation. Please be sure to register with the email address you'd like the link sent to. 

If you'd like the recording of this webinar (available to view 10 days after the live program), please email info@vicdds.ca. 

Program Description 

A critical aspect of every patient intraoral examination is the observation of all the oral mucosae. The goal is to identify any changes that would not normally be expected. Once a change is identified a process should be initiated to achieve a final diagnosis. One change that is commonly seen in the oral mucosa is an ulceration. There are many different etiologies that can lead to the appearance of an oral ulcer and identifying the etiology is critical to instituting the appropriate course of clinical intervention. The objective of this presentation is to review different causes of an oral ulceration, the diagnostic steps to identify the etiology, the clinical course typically seen with ulcers of different etiology and recommendations for procedures to definitively diagnose and treat the ulcer. The outcome of the material should help to provide a more comprehensive strategy to evaluate an oral ulcer and develop a differential diagnosis.

The course will review the different causes of oral ulcerations and the changes that occur in the oral mucosa. Images from actual clinical cases will be used to present examples and discuss the mechanism of ulceration. Specific diagnoses that are linked to oral ulcerations will be discussed and different clinical features associated with the specific diagnoses presented. The approaches that can be used in questioning the patient’s Chief Complaint and History of Present Illness will be presented to assist in the assignment of potential etiologies and generate a differential diagnosis. Specific diagnostic procedures will be presented to achieve a final diagnosis for the ulcer leading to a specific recommendation for definitive treatment. There will be an emphasis on the normal physiology of the tissue and the changes that contribute to the signs and symptoms seen in the patient. The importance of developing a process to assess changes in the oral mucosa will be stressed and based on the clinical examination strengths of the oral health professional.

Learning Objectives

1. To recognize changes oral mucosa associated with an oral ulceration.
2. To evaluate the clinical history of the oral ulceration and identify factors that contribute to either the etiology or prognosis.
3. To develop a differential diagnosis based on the normal anatomy, histology and physiology of the oral mucosa.
4. To establish a process to achieve a definitive diagnosis for an oral ulceration and develop a plan for treatment.

Bio

Dr. Shuler was the Dean of the Faculty of Dentistry of the University of British Columbia for ten years, finishing his second five-year term June 30, 2017.  He is now a professor of oral pathology in the Department of Oral Biological and Medical Sciences at UBC Dentistry engaged in active research on education outcomes and teaching oral pathology/medicine.  Prior to being appointed at UBC he was a faculty member at the University of Southern California for 18 years. At USC he served as the Director of the University of Southern California Center for Craniofacial Molecular Biology holding an endowed chair position as the George and Mary Lou Boone Chair Professor of Craniofacial Molecular Biology. He also served as the Director of the Graduate Program in Craniofacial Biology and the Associate Dean for Student and Academic Affairs at the USC School of Dentistry. Dr. Shuler received his B.S. in Biochemistry from the University of Wisconsin, his D.M.D. from Harvard School of Dental Medicine, his Ph.D. in Pathology from the University of Chicago and his Oral Pathology education at the University of Minnesota and the Royal Dental College Copenhagen Denmark.  He has been active in assessing and managing clinical oral pathology patients with soft and hard tissue lesions.   He has had an active research program funded by national granting agencies that focused on evaluating the molecular regulation of the soft and hard tissues of the secondary palate to better understand the etiology of craniofacial birth defects and pathologic changes of the tissues. He currently mentors a Study Club on Clinical Oral Pathology that reviews cases recognized by general dentists in British Columbia.