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Due to this, dark pigmentation may be visible on the oral mucosa or skin. [10] 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]
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]
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.
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]
Inflammatory papillary hyperplasia almost exclusively involves the hard palate, specifically the vault of the palate. Extension of the lesion to the mucosa of the residual ridges have also been observed. 11% to 13.9% of patients who wear maxillary complete dentures with complete palatal coverage has been reported to have IPH. [22]
Stomatitis nicotina is a diffuse white patch on the hard palate, usually caused by tobacco smoking, usually pipe or cigar smoking. [2] It is painless, [4] and it is caused by a response of the palatal oral mucosa to chronic heat.
Amalgam tattoo is a grey, blue or black area of discoloration on the mucous membranes of the mouth, typically on the gums of the lower jaw. It is a healthcare caused lesion, due to entry of dental amalgam into the soft tissues. It is common, painless, and benign, but it can be mistaken for melanoma
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 ...