Some Disorders of the Oral Region by Predominant Site of Involvement
Site | Disorder or Lesion | Description |
|---|---|---|
Lips | Actinic atrophy | Thin atrophic mucosa with erosive areas; predisposes to neoplasia |
Acute swelling | ||
Angular cheilitis (cheilosis) | Fissuring at corners of mouth, often with maceration | |
Cheilitis glandularis | Enlarged, nodular labial glands with inflamed, dilated secretory ducts; sometimes everted, hypertrophic lips | |
Cheilitis granulomatosa | Diffusely swollen lips, primarily the lower | |
Multiple bullae that rupture quickly, leaving hemorrhagic ulcers; includes Stevens-Johnson syndrome | ||
Exfoliative cheilitis | Chronic desquamation of superficial mucosal cells | |
A locally destructive epithelial tumor thought to be a form of squamous cell carcinoma that usually regresses spontaneously | ||
Brownish black melanin spots, with GI polyposis | ||
Secondary herpes simplex (cold sore) | Short-lived vesicle (≤ 1 day) followed by small painful ulcer (≤ 10 days) at the vermillion border (common) | |
Verruca vulgaris (wart) | Pebbly surface | |
Buccal mucosa | Aspirin burn | Painful white area; when wiped off, exposes an inflamed area |
Fordyce granules | Cream-colored macules about 1 mm in diameter; benign; aberrant sebaceous glands | |
Small ulcerated vesicles; coxsackievirus strain infection in young children; mild | ||
Vesicles in posterior of mouth | ||
Irritation fibroma | Smooth-surfaced, dome-shaped, sessile | |
Koplik spots | Tiny, grayish white macules with red margins near orifice of parotid duct; measles precursor | |
Linea alba | Thin white line, typically bilateral, on the level of the occlusal plane; benign | |
Smokeless tobacco lesion | White or gray corrugated; usually behind lower lip; a risk factor for oral cancer | |
Verrucous carcinoma | Slow-growing, exophytic, usually well-differentiated; at site of snuff application; metastasis unusual, occurs late | |
White sponge nevus | Thick white folds over most of buccal mucosa except gingivae; benign | |
Palate | Granulomatosis with polyangiitis (formerly Wegener granulomatosis) | Lethal midline granuloma, with bone destruction, sequestration, and perforation |
Petechiae at junction of hard and soft palate | ||
Red to purple painless macules progressing to painful papules | ||
Necrotizing sialometaplasia | Large, rapidly developing ulcer, often painless; appears grossly malignant; heals spontaneously in 1–3 months | |
Papillary inflammatory hyperplasia | Red, spongy tissue, succeeded by fibrous tissue folds; velvety texture; benign; occurs under poorly fitting dentures | |
Red punctate areas are ducts of minor salivary glands, appearance is red spots surrounded by leukoplakia (often severe, usually benign) | ||
Secondary herpes simplex | Small papules quickly coalescing into series of ulcers (uncommon) | |
Overgrowth of bone in midline; benign | ||
Tongue and floor of mouth | Ankyloglossia | Tongue unable to protrude; speech difficulty Pulling away of the gingiva by the lingual frenulum |
Benign lymphoepithelial cyst | Yellowish nodule on ventral part of tongue or anterior floor of mouth | |
Benign migratory glossitis (geographic tongue, erythema migrans) | Changing patterns of hyperkeratosis and erythema on dorsum and edges; desquamated filiform papillae in irregular circinate pattern, often with an inflamed center and a white or yellow border | |
Dermoid cyst | Swelling in floor of mouth | |
Enlargement of tongue (macroglossia) | Localized or generalized depending on how many teeth are missing; adjacent teeth may indent tongue; posterior enlargement associated with obstructive sleep apnea and snoring | |
Fissured (scrotal) tongue | Deep furrows in lateral and dorsal areas | |
Glossitis | Red, painful tongue; often secondary to another condition, allergic, or idiopathic | |
Dark, elongated filiform papillae | ||
Linea alba | Thin white line on edges of tongue, usually bilateral | |
Lingual thyroid nodule | Smooth-surfaced nodular mass of thyroid tissue follicles, on the far posterior dorsum of tongue, usually at the midline | |
Painful, tender swelling under the tongue resulting from odontogenic infection; can compromise the airway by forcing the tongue superiorly and posteriorly | ||
Median rhomboid glossitis | Red (usually) patch in midline of tongue, without papillae; asymptomatic | |
Neurilemoma | Persistent swelling, sometimes at site of prior trauma; can be painful | |
Smooth, pale tongue, often with glossodynia or glossopyrosis | ||
Ranula | Large mucocele penetrating the mylohyoid muscle; may plunge deep into the neck; swollen floor of mouth | |
Thyroglossal duct cyst | Midline swelling that moves upward when tongue protrudes | |
Ulcers on dorsum (firm), cervical adenopathy | ||
Salivary glands | Benign lymphoepithelial lesion (Mikulicz disease) | Unilateral or bilateral enlargement of salivary glands; often with dry mouth and eyes |
Swelling, often painful; benign | ||
Swelling (eg, of floor of mouth) that increases at mealtime or with ingestion of sour or bitter foods | ||
Systemic disease causing dry mucous membranes | ||
Dry mouth; usually secondary to medications | ||
Various | Widespread ulcerating vesicular lesions; always present on gingiva; other locations may be involved; usually in young children | |
Multiple oral ulcers similar to those of aphthous stomatitis | ||
Canker sores, recurrent aphthous stomatitis | Small painful ulcers (canker sores) or large, painful scarring ulcers (recurrent aphthous stomatitis) | |
Bullae that rupture quickly, leaving ulcers; ocular lesions develop after oral lesions; found on alveolar mucosa and vestibules | ||
Sexually transmitted warts forming cauliflower-like clumps | ||
Dyskeratosis | Occurs with erythroplakia (red), leukoplakia (white patch on mucous membrane that does not rub off), and mixed red and white lesions; precancerous | |
Purple to dark-red lesions, similar to port wine stain; benign | ||
Localized dilated blood vessels | ||
Lacy pattern (Wickham striae), sometimes erosive; may become malignant; most common on buccal mucosa, lateral tongue | ||
Localized swelling or discoloration; benign; most common on tongue | ||
Mucocele (mucous retention cyst) | Soft nodule resulting from traumatized salivary gland; if superficial, covered by thin epithelium; appears bluish; most common on lips and floor of mouth | |
Noma | Small vesicle or ulcer that rapidly enlarges and becomes necrotic | |
Small yellow or hemorrhagic tense bullae; may last several days before rupture; most common on vestibules and alveolar mucosa | ||
Bullae that rupture quickly, leaving ulcers; can be fatal without treatment | ||
Chancre (red papule rapidly developing into a painless ulcer with a serosanguineous crust), mucous patch, gumma |