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Smoker's melanosis is seen with the naked eye as a brown to black pigmentation of the oral tissue i.e. the gums, [1] cheeks or palate [2] as well as in larynx. [3] [4] It is most often seen in the lower labial gingiva of tobacco users. Most easily it is found in Caucasians, due to their lack of a genetically caused melanin pigmentation. [5] [6]
Most common oral sites include: buccal mucosa, lips, gums, hard palate or tongue. Intraoral sites are usually seen as the first sign and they usually develop prior to the skin lesions. [ 11 ] In developing countries, this disease is often associated with tuberculosis, where the infection can lead to destruction of the adrenal gland.
To check the uvula, a tongue blade is pressed down on the patient's tongue and the patient is asked to say "ah"; the uvula should look like a pendant in the midline and rise along the soft palate. Abnormal findings include deviation of the uvula from the midline, an asymmetrical rise of the soft palate or uvula and redness of either.
A cleft lip is an opening of the upper lip, mainly due to the failure of fusion of the medial nasal processes with the palatal processes; a cleft palate is the opening of the soft and hard palate in the mouth, which is due to the failure of the palatal shelves to fuse together. [10]
Nicotinic stomatitis is whitening of the hard palate by hyperkeratosis caused by the heat from smoking or from drinking hot liquids. This irritation also causes inflammation of the duct openings of the minor salivary glands of the palate, and they become dilated. This manifests as red patches or spots on a white background. [12]
Fordyce spots on scrotum Fordyce spots on lips. On the shaft of the penis, Fordyce spots are more visible when the skin is stretched, and may only be noticeable during an erection. [8] The spots can also appear on the skin of the scrotum. [8] Oral Fordyce granules appear as rice-like granules, white or yellow-white in color.
In regions such as the gingiva and parts of the hard palate, oral mucosa is attached directly to the periosteum of underlying bone, with no intervening submucosa. This arrangement is called a mucoperiosteum and provides a firm, inelastic attachment. [12] A variable number of Fordyce spots or granules are scattered throughout the nonkeratinized ...
Tongue posture plays an important role in swallowing and dentofacial growth. In case of tongue thrust swallowing, the tip of the tongue can come against or between the dentition; the midpoint may be collapsed or extended unilaterally or bilaterally; or the posterior part of the hard palate. In these conditions, there are chances of abnormal ...