General and Oral Pathology

Course Description

DEH2400 – General and Oral Pathology is a lecture course covering disease processes as they affect the body generally and the oral cavity specifically. Broward College carries it at 2 credits / 32 contact hours, and that configuration is typical — it is a compact, dense course rather than a survey.

Its purpose is precise and it is the reason dental hygienists matter to general health: a hygienist sees patients more often than most physicians do, and examines a region where systemic disease, infection, and malignancy frequently first appear. The hygienist does not diagnose — but the hygienist is the person who has to notice, describe accurately, and refer.

Content covers general pathology — cell injury, inflammation, repair, immunity, and neoplasia; the descriptive vocabulary of oral lesions — macule, papule, vesicle, ulcer, plaque, nodule — and how to describe a finding in terms a dentist can act on; developmental disorders of the teeth and oral structures; infections — bacterial, viral, and fungal, including candidiasis and herpetic lesions; immune and autoimmune conditions such as lichen planus and pemphigus; oral manifestations of systemic disease — diabetes, HIV, blood dyscrasias, and nutritional deficiency; oral cancer — risk factors, presentation, screening, and referral; salivary gland disorders; cysts and odontogenic tumors; the effects of medications on oral tissue; and biopsy and diagnostic procedures.

Offered at approximately 13 Florida institutions with CODA-accredited dental hygiene programs.

Learning Outcomes

Required Outcomes

• Describe general disease processes including cell injury, inflammation, and repair.
• Describe immune function and hypersensitivity reactions.
• Describe neoplasia and distinguish benign from malignant characteristics.
• Distinguish normal oral variation from pathology.
• Describe an oral lesion accurately using standard descriptive terminology.
• Document oral findings in a form that supports referral and diagnosis.
• Recognize developmental abnormalities of teeth and oral structures.
• Recognize bacterial, viral, and fungal infections of the oral cavity.
• Recognize immune-mediated and autoimmune oral conditions.
• Describe oral manifestations of systemic diseases including diabetes and HIV.
• Describe oral effects of medications, radiation, and chemotherapy.
• Perform an oral cancer screening examination and describe its components.
• Identify oral cancer risk factors and clinical presentations warranting referral.
• Describe salivary gland disorders and their oral consequences.
• Describe cysts, odontogenic tumors, and common radiographic pathology.
• Determine when a finding requires referral and describe the referral process.

Optional Outcomes

• Describe biopsy techniques and specimen handling.
• Describe the role of HPV in oropharyngeal cancer.
• Describe adjunctive oral cancer screening technologies and their limitations.
• Describe forensic and age-estimation applications of oral pathology.
• Describe genetic and syndromic conditions with oral findings.
• Describe tobacco and vaping effects on oral tissue and cessation counseling.

Major Topics

Required Topics

• Cell injury and adaptation — atrophy, hypertrophy, hyperplasia, metaplasia, and necrosis.
• Inflammation and repair — acute and chronic, healing, and complications.
• Immunity — immune response, hypersensitivity, and immunodeficiency.
• Neoplasia — terminology, benign versus malignant, and carcinogenesis.
• Descriptive terminology — lesion morphology, color, surface, and distribution.
• Normal variation — Fordyce granules, tori, geographic tongue, and linea alba.
• Developmental disorders — tooth number, size, shape, and structure anomalies.
• Bacterial infections — including necrotizing periodontal disease and syphilis.
• Viral infections — herpes simplex, varicella-zoster, HPV, and coxsackievirus.
• Fungal infections — candidiasis and its clinical forms.
• Immune-mediated conditions — aphthous ulcers, lichen planus, pemphigus, and pemphigoid.
• Oral manifestations of systemic disease — diabetes, HIV/AIDS, anemia, leukemia, and nutritional deficiency.
• Medication and treatment effects — xerostomia, gingival enlargement, osteonecrosis, and mucositis.
• Oral cancer — epidemiology, risk factors, presentation, screening, and referral.
• Premalignant lesions — leukoplakia and erythroplakia.
• Salivary gland pathology — xerostomia, sialolithiasis, mucocele, and Sjögren syndrome.
• Cysts and odontogenic tumors — clinical and radiographic features.
• Diagnostic process — history, examination, referral, and biopsy.

Optional Topics

• Biopsy technique and specimen handling.
• HPV-associated oropharyngeal cancer.
• Adjunctive screening technologies.
• Forensic odontology.
• Genetic and syndromic conditions.
• Tobacco, vaping, and cessation counseling.

Resources & Tools

• General and Oral Pathology for the Dental Hygienist (Ibsen & Phelan), Elsevier — written specifically for this course and the most common adoption.
• Oral Pathology for the Dental Hygienist (DeLong & Burkhart), Wolters Kluwer.
• Color Atlas of Common Oral Diseases (Langlais) — image-based; pathology is a visual discipline and an atlas is close to essential.
• American Academy of Oral and Maxillofacial Pathology — case material and professional resources.
• Oral Cancer Foundation and NIDCR — screening guidance and patient education materials.
• Florida Department of Health — oral health program data and tobacco cessation resources including Tobacco Free Florida.
• Clinical photographs and slide banks — institution-supplied; recognition improves with volume of images seen.
• Joint Commission on National Dental Examinations — NBDHE content outline; pathology is well represented.

Career Pathways

• Dental Hygienist (SOC 29-1292) — where oral cancer screening is a routine, expected part of every appointment.
• Public Health Dental Hygienist — screening programs in county health departments and community settings.
• Oral and Maxillofacial Surgery or Periodontal Practice Hygienist — specialty settings with higher pathology exposure.
• Dental Hygiene Educator — with further education.
• Dental Sales and Clinical Education — roles requiring clinical credibility.
• Pathway to dentistry — some hygienists continue to dental school, where this material is foundational.

Special Information

Notice, describe, refer — the hygienist does not diagnose

The scope boundary is the organizing principle of the course. A dental hygienist is not licensed to diagnose pathology or to tell a patient what a lesion is. What the hygienist does — and what nobody else in the practice is positioned to do as often — is perform a thorough examination, describe a finding precisely enough to be actionable, document it, and bring it to the dentist. "White patch on the left lateral border of the tongue, roughly 8 mm, non-wipeable, present at the last visit six months ago" is clinically useful. "Something looked odd" is not. The descriptive vocabulary taught here is the professional skill.

Oral cancer screening is the highest-stakes routine thing a hygienist does

Oral and oropharyngeal cancer has a poor survival rate largely because it is usually found late, and survival improves dramatically with early detection. A hygienist performing a complete extraoral and intraoral examination at every recall appointment is the most reliable screening mechanism most adults encounter. Two current points the course should make: HPV-associated oropharyngeal cancer has changed the risk profile — patients with no tobacco or alcohol history are affected, so screening cannot be limited to traditional risk groups — and any lesion persisting beyond two weeks warrants referral rather than watchful waiting.

Systemic disease shows up in the mouth first, and that matters in Florida

Diabetes, HIV, blood disorders, autoimmune disease, and nutritional deficiency all produce oral findings, sometimes before diagnosis elsewhere. Florida's demographics make several of these unusually relevant: a large older population with polypharmacy and consequent xerostomia, high diabetes prevalence, and substantial populations with limited access to primary care for whom a dental visit may be their only regular contact with a health professional. That gives the hygienist's observation real weight.

Medication effects are a large and growing part of the content

Xerostomia from hundreds of common drugs, gingival enlargement from certain anticonvulsants and calcium channel blockers, and medication-related osteonecrosis of the jaw associated with bisphosphonates and antiresorptives all require the hygienist to take an accurate and current medication history and understand what it implies. In an older patient population this is routine, not exceptional.

Position in the program and examination relevance

Normally taken mid-program, after dental anatomy and histology and alongside or before the clinical sequence. Broward lists DEH1002, DEH1002L, and DEH2840L (minimum grade C) as pre- or corequisites; verify locally. Pathology is well represented on the National Board Dental Hygiene Examination, and it appears in case-based items rather than as isolated recall — which is a reason to learn it as clinical reasoning rather than as a list.

It is a memorization-heavy course with a visual component

Students consistently report this as one of the denser courses in the curriculum: many conditions, similar appearances, and precise names. The methods that work are spaced repetition, and looking at many images of each condition rather than the single textbook photograph — real lesions vary far more than textbook exemplars, and recognition is built by volume.