Oral Mucosa Lecture Notes PDF

Oral Mucosa [Oral and Dental Sciences] Miss H Rogers GDC ILOs 1.1.5 Describe relevant and appropriate dental, oral, craniofacial and general anatomy and explain their applica;on to pa;ent management 1.1.6 Describe relevant and appropriate physiology and explain its applica;on to pa;ent management...

Oral Mucosa [Oral and Dental Sciences] Miss H Rogers GDC ILOs 1.1.5 Describe relevant and appropriate dental, oral, craniofacial and general anatomy and explain their applica;on to pa;ent management 1.1.6 Describe relevant and appropriate physiology and explain its applica;on to pa;ent management Related topics  Epithelium  Connec;ve Tissue  Intra-oral examina;on 3 Aim To gain an overview of the structure and func;on of the oral mucosa Learning Outcomes By the end of this lecture you should be able to: 1.Describe the diEerent types of mucosa and their histopathology in health 2.Iden;fy the areas of the oral cavity each type of mucosa is associated with 3.Iden;fy changes in the appearance of the oral mucosa 4 The soft tissue lining of the mouth What is it?. What do you understand by the term oral mucosa? · Lips mucos membrane ora Cheeks · unning as well. cavity. teeth. Except  underying trouacesis organs , ins recl and S & - proissues exernal from toa Barrier es iroment forces Barrier mechanical catting. sams Saliva nds receptors Sensory pain miner to not , cold, ↑ Lubricates a bra -Touch) mucos feel Reducing Trauma Links to protected. er reflexes sassing swallowing. 6 stratifiedSquamous epithelium Structure O 7 Have a look at your mouth in the mirror: What does the mucosa look like? How would you describe it- smooth/rough, pink/red, Nrm/soO? Does the appearance change depending on the area? Changes depending on the area, Pink in clar and Smooth firm - soft and mainly , depending Grea- on 8 ClassiAcaBon Based on their histological features, the oral mucosa can be divided into three main types: Lining mucosa Mas;catory mucosa Specialised mucosa Lining Mucosa 9 1 0 The structures covered by lining mucosa include: Can you iden;fy these areas in your own mouth? How would you describe the appearance of these areas? soft surface moise can be strecked. , , 1 1 In health, the lining mucosa’s clinical appearance generally - has: A soOer surface texture A moist surface An ability to be stretched and compressed (ac;ng like a cushion for the underlying structures) 1 2 FordyceSpots. needed normal · appearance - no investigation. Deposits Sebum of from · caused by Sebations glands , usally found in submucosa 1 3 Histology Think back to what you’ve learnt on epithelium… Can you remember the three types stra;Ned squamous epithelium? Out of these three, and based on what you could see, which do you think is most associated with the lining mucosa? Why? No Keritinized 1 4 Answer: NonkeraBnised - features elastic fibres based on histology layer - Large - Allows for compression of tissues above. 1 5 AddiBonal features Surgical incisions in these areas oOen requires sutures Local anaesthe;c injec;ons are easier in these areas with less discomfort. Infec;on can spread rapidly Why do you think these may be? MasBcatory Mucosa 16 1 7 The structures covered by mas;catory mucosa include: Can you iden;fy these areas in your own mouth? How would you describe the appearance of these areas? firm , Rubbery Surface. 1 8 In health, the mas;catory mucosa’s clinical appearance generally has: Rubbery surface texture Resiliency (Nrm base) 1 9 Histology as nonkera;nised or kera;nised epithelium? Why? Keratinized Strengression Which do you think is most associated with the mas;catory mucosa, 7 firmer base - eg. hard Pattet eg. Dorsum tounge attached Singvi attached gingvi 2 0 Addi;onal features Sutures are rarely needed in these areas following surgical procedures Local anaesthe;c injec;ons are more di\cult and cause more discomfort Swellings in these ;ssues caused by infec;ons cause greater discomfort Why do you think these may be? Specialised Mucosa 21 2 2 The structures associated with specialised mucosa include: e Loung -l urtace S tastebuds. not 2 3 Which do you think is most associated with the specialised mucosa, nonkera;nised or kera;nised epithelium? Why? Keratinised Changes in appearance: HyperkeraBnisaBon 24 2 5 Nonkera;nised epithelium may transform into a kera;nising type in response to fric;onal or chemical trauma. It has therefore become hyperkeraBnised. Histologically the ;ssue will resemble orthokera;nised epithelium with a kera;n and granular layer white. from appearance to Changes · pink It cause of Trauma's reversible · con be removed. 2 6 1. Can you iden;fy the hyperkera;nised area? O 2. How would you describe this area? on HardPallet S white area with irregular red border. a secent UL567 3. Which type of mucosa has it occurred on? masticatory mucosa 4. What do you think the possible cause may be and why? heat trauma. too not from eating something cheese. es. Pizza 2 7 1. Can you iden;fy the hyperkera;nised area? 2. How would you describe Bucch mucosa this area? adjacent 1745 crea O. White 3. Which type of mucosa has it occurred on? lining mucosa 4. What do you think the possible cause may be and why? Sharp/won down + eeth causing chemical trauma there. eg. asprin being placed 2 8 white line consistent with creek bitting. linea alba, ↳ 1. Can you iden;fy the hyperkera;nised area? 2. How would you describe this area? bucc mucosa lining mucosa 3. Which type of mucosa has it occurred on? mandibular ridge lining mucosa 4. What do you think the O possible cause may be and why? Frictio causing & Denture friction Changes in appearance: Oral PigmentaBon 29 3 0 3 1 As the ;ssue ages, these epithelial cells migrate to the surface of the oral mucosa and appear as localised _at pigmented areas, ranging from brown to brownish-black 3 2 Other colour changes may also occur to the oral mucosa, some of which may be covered in more detail in Dental Speciali;es in Year 2. Here are a few examples… 3 3 Drug Induced chemotherapy 3 4 InfecBon - carposioma of HEV to aids. Proggression 3 5 Tattoo Iatrogenic - Amalgam 1. 3 6 Self-inQicted Tattoos. 3 7 useful : AddiBonal resources YouTube watched very - Dental Educa;on Hub- Oral Mucosa Playlist hbps://www.youtube.com/playlist?list=PLjIUkW-fumBz9qmi_ 3pw_5uWVN6Rt-tb_ Website Geeky Medics- Pigmented lesions of the oral cavity hbps://geekymedics.com/pigmented-lesions-of-the-oral-cavi ty / 3 8 References Bath-Balogh, M. & Fehrenbach, M.J. Dental Embryology, Histology, and Anatomy. Elsevier 2006. Royal Berkshire NHS Founda;on Trust. Oral fric8onal hyperkeratosis (May 2022). Available at: hbps://www.royalberkshire.nhs.uk/media/jt0fzg2w/oral-fric ;onal-hyperkeratosis-n-_may22.pdf [Accessed 26th September 2022].