Sore throat

Pharyngeal Pouch

Mouth lesions

2 week wait referrals to oral surgery should be done in all of the following cases:

• Unexplained oral ulceration or mass persisting for greater than 3 weeks
• Unexplained red, or red and white patches that are painful, swollen or bleeding
• Unexplained one-sided pain in the head and neck area for greater than 4 weeks, which is associated with ear ache, but does not result in any abnormal findings on otoscopy
• Unexplained recent neck lump, or a previously undiagnosed lump that has changed over a period of 3 to 6 weeks
• Unexplained persistent sore or painful throat
• Signs and symptoms in the oral cavity persisting for more than 6 weeks, that cannot be definitively diagnosed as a benign lesion

The level of suspicion should be higher in patients who are over 40, smokers, heavy drinkers and those who chew tobacco or betel nut (areca nut).

Black hairy tongue

Black hairy tongue is relatively common condition which results from defective desquamation of the filiform papillae. Despite the name the tongue may be brown, green, pink or another colour.

Predisposing factors

• poor oral hygiene
• antibiotics
• head and neck radiation
• HIV
• intravenous drug use