A cyst in the floor of the mouth, which produces a translucent bluish swelling. Ranulas probably arise from damage to a salivary gland. They are removed surgically.
Retention cysts In these, in consequence of irritation or another cause, some cavity which ought naturally to contain a little ?uid becomes distended, or the natural outlet from the cavity becomes blocked. Wens are caused by the blockage of the outlet from sebaceous glands in the skin, so that an accumulation of fatty matter takes place. RANULA is a clear swelling under the tongue, due to a collection of saliva in consequence of an obstruction to a salivary duct. Cysts in the breasts are, in many cases, the result of blockage in milk ducts, due to in?ammation; they should be assessed to exclude cancer (see BREASTS, DISEASES OF). Cysts also form in the kidney as a result of obstruction to the free out?ow of the urine.
Developmental cysts Of these, the most important are the huge cysts that originate in the OVARIES. The cause is doubtful, but the cyst probably begins at a very early period of life, gradually enlarges, and buds o? smaller cysts from its wall. The contents are usually a clear gelatinous ?uid. Very often both ovaries are affected, and the cysts may slowly reach a great size – often, however, taking a lifetime to do so.
A similar condition sometimes occurs in the KIDNEYS, and the tumour may have reached a great size in an infant even before birth (congenital cystic kidney).
Dermoid cysts are small cavities, which also originate probably early in life, but do not reach any great size until fairly late in life. They appear about parts of the body where clefts occur in the embryo and close up before birth, such as the corner of the eyes, the side of the neck, and the middle line of the body. They contain hair, fatty matter, fragments of bone, scraps of skin, even numerous teeth.
Hydatid cysts are produced in many organs, particularly in the liver, by a parasite which is the larval stage of a tapeworm found in dogs. They occur in people who keep dogs and allow them to contaminate their food. (See TAENIASIS.)... cysts
Thrush is characterised by the presence of white patches on the mucous membrane which bleeds if the patch is gently removed. It is caused by the growth of a parasitic mould known as Candida albicans. Antifungal agents usually suppress the growth of candida. Candidal in?ltration of the mucosa is often found in cancerous lesions.
Leukoplakia literally means a white patch. In the mouth it is often due to an area of thickened cells from the horny layer of the epithelium. It appears as a white patch of varying density and is often grooved by dense ?ssures. There are many causes, most of them of minor importance. It may be associated with smoking, SYPHILIS, chronic SEPSIS or trauma from a sharp tooth. Cancer must be excluded.
Stomatitis (in?ammation of the mouth) arises from the same causes as in?ammation elsewhere, but among the main causes are the cutting of teeth in children, sharp or broken teeth, excess alcohol, tobacco smoking and general ill-health. The mucous membrane becomes red, swollen and tender and ulcers may appear. Treatment consists mainly of preventing secondary infection supervening before the stomatitis has resolved. Antiseptic mouthwashes are usually su?cient.
Gingivitis (see TEETH, DISEASES OF) is in?ammation of the gum where it touches the tooth. It is caused by poor oral hygiene and is often associated with the production of calculus or tartar on the teeth. If it is neglected it will proceed to periodontal disease.
Ulcers of the mouth These are usually small and arise from a variety of causes. Aphthous ulcers are the most common; they last about ten days and usually heal without scarring. They may be associated with STRESS or DYSPEPSIA. There is no ideal treatment.
Herpetic ulcers (see HERPES SIMPLEX) are similar but usually there are many ulcers and the patient appears feverish and unwell. This condition is more common in children.
Calculus (a) Salivary: a calculus (stone) may develop in one of the major salivary-gland ducts. This may result in a blockage which will cause the gland to swell and be painful. It usually swells before a meal and then slowly subsides. The stone may be passed but often has to be removed in a minor operation. If the gland behind the calculus becomes infected, then an ABSCESS forms and, if this persists, the removal of the gland may be indicated. (b) Dental, also called TARTAR: this is a calci?ed material which adheres to the teeth; it often starts as the soft debris found on teeth which have not been well cleaned and is called plaque. If not removed, it will gradually destroy the periodontal membrane and result in the loss of the tooth. (See TEETH, DISORDERS OF.)
Ranula This is a cyst-like swelling found in the ?oor of the mouth. It is often caused by mild trauma to the salivary glands with the result that saliva collects in the cyst instead of discharging into the mouth. Surgery may be required.
Mumps is an acute infective disorder of the major salivary glands. It causes painful enlargement of the glands which lasts for about two weeks. (See also main entry for MUMPS.)
Tumours may occur in all parts of the mouth, and may be BENIGN or MALIGNANT. Benign tumours are common and may follow mild trauma or be an exaggerated response to irritation. Polyps are found in the cheeks and on the tongue and become a nuisance as they may be bitten frequently. They are easily excised.
A MUCOCOELE is found mainly in the lower lip.
An exostosis or bone outgrowth is often found in the mid line of the palate and on the inside of the mandible (bone of the lower jaw). This only requires removal if it becomes unduly large or pointed and easily ulcerated.
Malignant tumours within the mouth are often large before they are noticed, whereas those on the lips are usually seen early and are more easily treated. The cancer may arise from any of the tissues found in the mouth including epithelium, bone, salivary tissue and tooth-forming tissue remnants. Oral cancers represent about 5 per cent of all reported malignancies, and in England and Wales around 3,300 people are diagnosed annually as having cancer of the mouth and PHARYNX.
Cancer of the mouth is less common below the age of 40 years and is more common in men. It is often associated with chronic irritation from a broken tooth or ill-?tting denture. It is also more common in those who smoke and those who chew betel leaves. Leukoplakia (see above) may be a precursor of cancer. Spread of the cancer is by way of the lymph nodes in the neck. Early treatment by surgery, radiotherapy or chemotherapy will often be e?ective, except for the posterior of the tongue where the prognosis is very poor. Although surgery may be extensive and potentially mutilating, recent advances in repairing defects and grafting tissues from elsewhere have made treatment more acceptable to the patient.... mouth, diseases of
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