An approach to the diagnosis and management of oral mucosal abnormalities. I. Introduction

It is customary in traditional textbooks on oral pathology to classify and discuss diseases according to etiology. While this is a convenient and logical method to present basic material it does not always lend itself to the clinical situation. When a patient is examined, the clinician is most concerned with appearances, i.e. colour, shape, and size. These are some of the parameters which become a part of the thought process that is utilised in the diagnosis of lesions. In this approach oral diseases are to be classified according to their clinical appearance rather than by cause. Each grouping of lesions listed under a particular heading can be looked at then, as forming a basis for a differential diagnosis. It is important to remember that some redundancy exists in this type of approach, since there are lesions which characteristically have different clinical appearances. Squamous cell carcinoma is an excellent example of such a condition. The lesion may be red or white, exophytic or flat and ulcerated or non-ulcerated, which necessitates its consideration in a number of clinical categories.