Oral Mucosa - Tagged.pdf.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 Not teeth What is it? - What do you understand by the term oral mucosa? tinual con oral mucous membraceoral h throug cavity the living tissues cavity all inside  tissues underlying + organs mucous Barrier to external environment membrane Traume - Mastication seices mechanica forces - swallowing - Surfacerasions - to infection/Baberie miner Salivary glands rep temp , pain , touch - lubrication trauma - reduces Reflective in oral reflexes carity , - gagging -Swallowing 6 Oral mocosa = stratified squares epithelium Structure 7 Pink Smooth 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? compressable malvable 8 ClassiAcaBon Based on their histological features, the oral mucosa can be divided into three main types: Lining mucosa Mas;catory mucosa -hard palate , tounge 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? 1 1 Lining mucosa 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 small yellowish Fordyce's spots elevations on ↑ normal Mucosa surface. Deposits of from sebum misplaced savations slands submoloss. 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? 1 4 Lining mucosa Answer: NonkeraBnised elastic fibres - Stretchy -recoil - swalloing/ speech submucosa large compression of overlying tissues. 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. - more fleshy 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: Rubbery base Firm Can you iden;fy these areas in your own mouth? How would you describe the appearance of these areas? resilience 1 8 In health, the mas;catory mucosa’s clinical appearance generally has: Rubbery surface texture Resiliency (Nrm base)  masticatory 1 needed palate Firm base submucosa 9 mucosa ward Histology for speaking chewing , = - no Which do you think is most associated with the mas;catory mucosa, nonkera;nised or kera;nised epithelium? Why? -Firmer refe rigdes Firm base - - -hard palate (thin submucosal Hong - Dorsum of attached gingival (o mocosal -attached gingival 2 0 Masticatory Mocosa 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: (taste bods/ bumps on + darsun lingual border. 2 3 Which do you think is most associated with the specialised mucosa, nonkera;nised or kera;nised epithelium? Why? Lingual Papillae- - (taste buds)  Nonkeratinised epithelium into can transform Keratinised Changes in appearance: 2 HyperkeraBnisaBon to a in responsechemical or frictional trauma. 24 2 5 Nonkeratinised > - > to hyperberatinised 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 on top. top [ can be reversible but takes time for beratinised , shed lay to away. even Keratinised epithelium can become hyperberatinised e. g. hard palate traumatised and can be epithelium becomes whiter. 2 6 1. Can you iden-fy the hyperkera-nised area? hard palate~ 2. How would you describe this area? pace pink/white- Legion irres boards Adjacent , , 3. Which type of mucosa has it occurred on? Muncosa- masticatory 4. What do you think the possible cause may be and why? burn hard food- Trauma 1.e. temperature , vlcerated Keratinised area. 2 7 1. Can you iden-fy the hyperkera-nised area? - to Local sulcus/Bod mocos 2. How would you describe this area? beratinised uneven appearance , striction 3. Which type of mucosa has it occurred on? living mucosa- 4. What do you think the possible cause may be and why? chemical burn in bocal mocoss. 2 consistent Buccal 8 plane = occulsal mucosa (Cheek) Frictim lining Mocosa write i horizontal linear alba 1. Can you iden-fy the where teeth meet hyperkera-nised area?. 2. How would you describe this area? gingiva-missingtook 3. Which type of mucosa has (27456) it occurred on? 4. What do you think the possible cause may be and why? cheek biting living mocosa Denture friction Changes in appearance: Oral Pigmenta3on 29 3 0 · /Melanieed neurocrest alls Basal layer of epithelium 3 1 into areas migratesGmented pl flat as tissua As the -ssue ages, these epithelial cells migrate to the surface of the oral mucosa and appear as localised Cat 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 medications S chemotherapy 3 4 Infec3on Kaposi sarcoma Progressio of HIL to aid 3 5 Iatrogenic Amalgum tattoo (at in mocosa) 3 6 Self-in