Mouth Disorders

Mouth disorders are illnesses, infections, obstructions, and chronic conditions, related to the oral cavity.

A cleft palate is a congenital malformation causing an incomplete closure of the lip and palate. This results in functional (eating, speech) and cosmetic issues. Preventive measures include seeking proper prenatal care, for appropriate nutrition and health management. Prognosis is good with comprehensive therapy (surgical repair, orthodontics, prosthodontics, speech therapy), beginning in early childhood and through to adulthood.

Tongue inflammation with a red-surfaced tongue (glossitis) is sometimes associated with burning and pain of the tongue (glossodynia). Both appear to be benign and often secondary to other illnesses, medications, and smoking. Symptoms may cease with medication and smoking cessation.

Oral lichen planus is a chronic autoimmune disease causing inflammation, and has similar symptoms to other mouth disorders. Therapy is aimed at managing pain and discomfort using local or systemic steroids.

Chronic inflammation of the salivary gland with enlargement of the parotid glands may be due to a variety of disorders—Sjogren's and sarcoidosis, diabetes, alcoholism and vitamin deficiencies—or as a side effect of drugs stimulating salivary flow and more viscous saliva.

Sialolithiasis is calculus formation occurring most often in Wharton's duct (draining the submandibular), and occasionally in Stensen's duct (draining parotid glands), causing pain after eating and local swelling. The obstruction may be removed, or in severe cases, excision of the gland may be necessary.

Leukoplakia is a white lesion that cannot be removed by rubbing (most often it is benign), and is often caused by irritation. Erythroplakia is similar to leukoplakia but presents with redness. In many cases erythoplakia is dysplasia or carcinoma.

Squamous cell carcinoma of the oral mucosa accounts for the majority of oral cancers. Early detection is essential; lesions at 2 mm depth or less have the best prognosis. Treatment is by surgical excision, larger tumors require both excision and irradiation. Major risk factors include alcohol and tobacco use. Salivary gland tumors occur most often in the parotid glands and tend to be benign; tumors in the submandibular gland are less likely to be benign. Surgical excision if needed is sufficient treatment for most salivary gland tumors; post-surgical irradiation is indicated for large or high-grade tumors.