Floor of the Mouth and palate hard

Floor of the Mouth (FOM)

• Lingual Frenum is a fold of tissue found in the midline near the base of the tongue’s inferior surface.
  • Ankyloglossia (tongue-tied) is a condition where the frenulum is too short and limits tongue movement.
• Sublingual Papillae are centrally positioned protrusions at the base of the tongue
  • The Submandibular and Sublingual Salivary Ducts open here.
  • The openings of the Rivinus Ducts are found on the sublingual folds.
• Mandibular Tori are bony swellings found sublingually to the premolar region, usually above the mylohyoid line.
  • They are often bilateral and visible on radiographs.
• Ventral Surface of the Tongue
  • Is covered in a thin, non-keratinized epithelium.
  • Has an irregular fringe fold of mucous membrane lateral to the lingual frenum.
• Changes of the FOM:
  • Can include salivary stones, piercings, and natural abnormalities like the presence of two lingual frenums.

The Palate

• Hard Palate:
  • Separates the oral cavity from the nasal cavity.
  • Composed of the palatine processes of the maxillae (anterior) and the horizontal plates of the palatine bones (posterior).
  • Function: aids in feeding and speech.
• Clinical Appearance of the Hard Palate:
  • Ortho-keratinized Stratified Squamous Epithelium
  • Pink in appearance.
  • Immobile.
  • More cushioned feeling laterally.
  • Firmer feeling medially.

Histology of the Hard Palate

• Lacks submucosa.
• Lamina Propria: directly attached to bone in the midline.
  • Anterior: contains adipose tissue & minor salivary glands.
  • Posterior: contains submucosa.
  • Lateral: more cushioned

Features of the Hard Palate

• Posterior border is concave where it meets the soft palate.
• High vaulted palate:
  • The degree of vaulting can vary between individuals.

Structures of the Hard Palate

• Incisive Papilla:
  • A dome-shaped structure located just behind the upper central incisors.
  • Covers the openings of the nasopalatine nerves which emerge through the incisive foramen.
• Palatine Rugae:
  • Irregular ridges of tissue that radiate transversally from the incisive papilla and the anterior part of the raphe.
• Median Palatine Raphe:
  • This is the midline of the hard palate, where the palatine bones fuse.
• Palatal Torus:
  • A bony overgrowth on the palate or floor of the mouth.
  • Can occur on the mandibular torus.

Changes of the Hard Palate

• Changes in Appearance
  • Color
  • Texture
  • Impact on function
• Examples of changes:
  • Cleft Palate
    • Develops during foetal development.
    • Impact on speech, eating, drinking, and nasal barrier for treatment delivery.
  • Smoker's Keratosis
    • White patches occur on the anterior 2/5 of the hard palate.
    • Lack of moisture causes a dry appearance.
• Self-inflicted changes:
  • Piercings
• Natural Abnormalities:
  • Double uvula

Nerve Innervation and Blood Supply of the Palate

• Nerve Innervation:
  • Supplied by branches of the maxillary nerve (a branch of the trigeminal nerve V).
  • Hard Palate:
    • Innervated by the greater palatine and nasopalatine nerves.
  • Soft Palate:
    • Innervated by the lesser palatine nerve.
• Blood Supply:
  • Hard Palate:
    • Supplied by the greater palatine artery.
  • Soft Palate:
    • Supplied by the lesser palatine arteries.

Test your knowledge on the floor of the mouth and its anatomical features. This quiz covers essential structures such as the lingual frenum, sublingual papillae, and conditions like ankyloglossia. Explore the changes and abnormalities that can occur in this region.