The oral cavity includes the lips, the gingival, or gums, the floor of the mouth, and the buccal mucosa, which is the soft lining of the inner lips and cheeks.
The oropharynx includes the soft palate, which is the quiet part of the roof of the mouth right behind the hard palate, the tonsils, the walls of the throat, and the posterior or back one-third of the tongue.
Oral Cancer and Tumours in The Mouth, Lips and Tongue
Oral Canceror oral tumours can affect various structures in the mouth, such as the mucosa palate floor of the mouth, tongue, lips, gums and, bones.
There are various triggers or carcinogenic agents, such as tobacco, alcohol, radiation, human papillomavirus etc.
Oral cancer occurs when carcinogenic agents act on cells altering their genetic material producing a mutation.
These damaged cells can divide and multiply excessively in the body normally. The body controls the division and growth of cells. But if the balance of cell division and, cell death is disturbed a tumour can form tumour can be cancerous malignant or non-cancerous benign a cancerous area can spread to another organ different from the one in which it started by blood or lymphatic roots this process is called metastasis you.
The oral cavity and oropharynx are lined by epithelium – and there are a few different types.
- The first type of epithelium is called keratinized stratified squamous epithelium. These epithelial cells produce keratin, a protein that makes the layer tough, and protects against normal wear and tear from food and drinks. Beneath the epithelium, there’s another layer called the basement membrane made of tough connective tissue, and below that is the lamina propria which yet more connective tissue that houses blood vessels, lymphatics, nerves, and immune cells. The oral surfaces covered in keratinized epithelium include the hard palate, the dorsal surface, or top, of the tongue, and the gingival.
- The second type of epithelium is the non-keratinized stratified squamous epithelium, and it contains cells that don’t produce much keratin, making this layer less tough. The oral surfaces covered by non-keratinized stratified squamous epithelium include the buccal mucosa, the floor of the mouth, the lateral and ventral, or bottom, surfaces of the tongue, the soft palate, and the retromolar trigone.
The Mucosal Tissue in The Oral Cavity
Now the mucosal tissue in the oral cavity can undergo several premalignant pathological changes.
The first one of these is leukoplakia, where leuko- means white and – Lakia means a flat, raised patch or plaque. And leukoplakia specifically relates to a white plaque with no clear underlying cause.
These leukoplakias are usually painless but can’t be easily scraped away.
Now, the exact cause for leukoplakia is unknown, but a known risk factor is tobacco use. Early on, these lesions are usually pretty thin, so it’s called thin leukoplakia. These can either go away on their own, remain unchanged, or grow and become thicker, at which point it’s called thick leukoplakia. If it becomes bumpy it’s called nodular leukoplakia, and if it becomes wart-like it’s called verrucous leukoplakia.
Now a more serious form of leukoplakia is called proliferative verrucous leukoplakia, which usually affects women, with no risk factors and has a predilection for gingiva and causes multiple rough white lesions that grow and spread, and in most cases, eventually develop into squamous cell carcinoma. At the cellular level, leukoplakia typically shows a thickened keratin layer.
Since keratin absorbs water, a thick keratin layer looks white when it’s wet. At a cellular level, leukoplakia may show cells that have undergone some degree of dysplasia, meaning they look abnormal in some way, but are not cancerous, or malignant, yet.
However, leukoplakia is considered a precancerous condition, meaning that compared to normal tissue, it’s more likely to develop into oral cancer in the future.
And that change could happen at the microscopic level, meaning that the lesion might look the same on the outside, even though the cells have become cancerous. Generally speaking, the transition from dysplastic cells to malignant cells occurs gradually.
And as cells become more and more dysplastic the lesions sometimes develop red spots, and at that point, it’s called erythro leukoplakia. Cells in these red areas have suffered serious damage to their DNA and don’t mature normally and therefore can’t produce keratin. And as they become more and more atypical, the more immature becomes the epithelium and it will start becoming thinner or atrophic and allow more of the underlying blood vessels to be seen through the mucosa.
At that point, the lesion will be completely red and will be called erythroplakia. Erythroplakias are more serious than leukoplakia because almost always when they are removed
and examined under the microscope they will show severe dysplasia or early oral cancer.
Squamous Cell Cancers
There are several types of orthodontic appliances. Movable and fixed orthodontics helps to change the position of the teeth and jaw. The orthodontic appliance gently puts pressure on the teeth and jaw, creating the desired change over time.
The severity of the deformity of the teeth and the age and physiological characteristics of the patient determine which type of orthodontics is better for treatment. It is the orthodontist who determines and performs the orthodontic treatment method at each stage by examining the patient’s condition.
Orthodontics is one of the dental specialties that is used to arrange and align teeth and align jaws. One of the main tasks of orthodontics is the diagnosis, prevention and treatment of dental malformations.
This can be done by fixed or mobile treatments, orthodontics with Brackets of the same colour (ceramic) (composite), or by invisible orthodontics by the lingual system (placing the Brackets behind the teeth) or invisible orthodontics with transparent plaque (Invisalign), Etc. to be done.
Fixed orthodontics can be done by Straight, Edgewise, Roth or Damon methods and so on. Also, new techniques such as Mini Screw can be used to treat abnormalities
The oral cavity and oropharynx are lined by epithelium – and there are a few different types.
- The first type of epithelium is called keratinized stratified squamous epithelium. These epithelial cells produce keratin, a protein that makes the layer tough, and protects against normal wear and tear from food and drinks. Beneath the epithelium, there’s another layer called the basement membrane made of tough connective tissue, and below that is the lamina propria which yet more connective tissue that houses blood vessels, lymphatics, nerves, and immune cells. The oral surfaces covered in keratinized epithelium include the hard palate, the dorsal surface, or top, of the tongue, and the gingival.
- The second type of epithelium is the non-keratinized stratified squamous epithelium, and it contains cells that don’t produce much keratin, making this layer less tough. The oral surfaces covered by non-keratinized stratified squamous epithelium include the buccal mucosa, the floor of the mouth, the lateral and ventral, or bottom, surfaces of the tongue, the soft palate, and the retromolar trigone.
