Mouth

Mouth

The mouth (from Latin bucca, “cheek”) is the opening through which food enters the body. It forms the first segment of the digestive tract in humans and in some animals and also allows breathing and phonation.

Mouth anatomy

The mouth, or oral cavity, is made up of several structures. It is lined on the inside with a protective mucous membrane. It opens with the lips. It is bounded laterally by the cheeks, at the top by the roof of the mouth which is formed by the bony palate and the soft palate that lead to the back of the tongue and to the tonsils (two symmetrical masses of lymphatic tissue that are part of the system immune system). At the bottom, it is limited by the floor of the mouth on which the tongue rests. It is connected to the floor by the frenulum of the tongue, a small fold of the mucous membrane that limits its movement backwards. The mouth contains the lower and upper jaws, on which the gums and teeth sit.

The space limited on the outside by the cheeks and lips and on the inside by the teeth and gums forms the vestibule of the mouth. We can also distinguish the proper cavity of the mouth, which is limited in front and on the sides by the teeth.

Physiology of the mouth

The primary function of the mouth is to be the gateway to food in order to begin the process of digestion. The food is crushed and chewed by the teeth and mixed with saliva which contains digestive juices. The tongue participates in this mixing and pushes the food into the pharynx: this is swallowing.

The tongue is also covered on its surface with taste buds which are involved in taste. The oral cavity allows social interactions through speech or practices like kissing. Part of breathing is also permitted through the mouth.

Oral pathologies

Ankyloglossie : congenital malformation of the frenulum of the tongue which is too short or too rigid. Tongue movements are restricted, which can interfere with the baby’s breastfeeding and later speech. The treatment is surgical: incision (frenotomy) or section of the frenulum (frenectomy).

Mouth ulcers : these are small superficial ulcers that most often form on the mucous membranes inside the mouth: on the inside of the cheeks, the tongue, the inside of the lips, the palate or the gums.

Halitosis (bad breath): most often, it is the bacteria present on the tongue or teeth that produce unpleasant odors. Although halitosis is a minor health problem, it can still be a source of stress and a social handicap. It can be caused by certain foods, such as poor hygiene or an infection.

Genital herpes : Known by the popular names of “cold sore” or “cold sore”, cold sores are manifested by the appearance of a cluster of painful blisters, most often on and around the lips. It is an infection caused by a virus called herpes simplex virus type 1 (HSV-1).

Gingivitis : inflammation of the gums. These become red, irritated, swollen when they are normally firm and pale pink. They can bleed easily, especially when brushing teeth.

Periodontite: inflammation of the tissues that surround and support the teeth, called the “periodontium”. These tissues include the gum, supporting fibers called the periodontium, and the bone in which the teeth are anchored. Disease of bacterial origin, it occurs most often when the immune mechanisms are weakened.

Oral candidiasis : yeast infection of the mouth due to the proliferation of a naturally occurring fungus, candida albicans. The causes are multiple: pregnancy, dry mouth, inflammation, diabetes … It can be manifested by the appearance of a white “muget”: the tongue and cheeks become red, dry up and become covered with plaques. white.

Lichen plan buccal : lichen planus is a skin disease of unknown origin that can affect the oral cavity. Skin lesions are usually found on both sides of the mouth. The lining of the cheeks, back of the tongue, and gums are often affected by lesions that appear as purple itchy (itchy sensation) papules that may be covered with a whitish substance. Chronic disease without treatment, it manifests itself by periods of relapses and remission.

Dry mouth (xerostomia) : It is characterized by a deficit in the secretion of saliva, which indicates an attack of the salivary glands. The most suggestive signs are sticky lips or the absence of saliva under the tongue. The diagnosis is made by the doctor to adapt the treatment.

Mouth cancer : malignant tumor which originates in the cells of the mouth.

It develops on the floor of the mouth, tongue, tonsils, palate, cheeks, gums and lips. According to the National Cancer Institute (7), 70% of oral cancers are diagnosed too late, which reduces the chances of recovery. The earlier oral cancer is detected, the more effective the treatments.

Amygdalite : inflammation and infection of the tonsils following contact with a virus or bacteria. They increase in size and become painful, often interfering with swallowing. Taking medication (anti-inflammatory drugs and antibiotics if needed) is usually sufficient to eradicate the symptoms.

Fente palatine lip : Known as the improper cleft lip, it is a congenital malformation caused by improper fusion of the upper lip and / or palate of the embryo during its development (6). It is treated by surgery.

Treatments and oral care

In general, it is important to observe good oral hygiene and to have your mouth monitored during consultations with the doctor or dentist. Lesions can appear and are not easy to spot, which may be the case with oral cancer. Early detection increases the chances of recovery. This is all the more advisable for smokers and regular alcohol users for whom the development of cancer is favored (7).

Regarding benign conditions, certain drugs are known to promote the occurrence of candidiasis. Broad-spectrum antibiotics (8), that is to say effective against a large number of families of bacteria (amoxicillin or penicillin for example), corticosteroids, antacid drugs (to reduce the acidity of the stomach) or neuroleptics (which decrease the production of saliva) are examples.

Examinations and exploration of the mouth

Oral examination : visual examination performed by the doctor or dental surgeon who assesses the teeth, gums, tongue, soft tissues under the tongue, the palate and the inside of the cheeks. It aims to prevent any dental problem or ailment of the oral cavity. In some cases, an early diagnosis is made allowing a rapid management of the pathology (9).

Medical imaging exams:

These techniques help to determine the extent to other structures of oral cancer.

  • Radiography: medical imaging technique that uses X-rays. It is the standard reference examination, the first compulsory step and sometimes sufficient for diagnosis.
  • Scanner: diagnostic imaging technique which consists of “scanning” a given region of the body in order to create cross-sectional images, thanks to the use of an X-ray beam. The term “scanner” is actually the name of the medical device, but it is commonly used to name the exam. We also speak of computed tomography or computed tomography.
  • MRI (magnetic resonance imaging): medical examination for diagnostic purposes carried out using a large cylindrical device in which a magnetic field and radio waves are produced to generate very precise images, in 2D or 3D, of the mouth. MRI is a very powerful examination for studying tumors (shape and appearance).
  • PET Scan: also called positron emission tomography (PET or “positron emission tomography” in English) is an imaging test that allows you to visualize the functioning of organs (functional imaging). It combines the injection of a radioactive product visible in imaging and the taking of images by a scanner.

Endoscopy / Fibroscopy: reference examination which makes it possible to visualize the internal structures of the body thanks to the introduction of a flexible tube called a fiberscope or endoscope which is equipped with small cameras. This technique is used to identify suspicious areas and direct a cancer diagnosis.

Biopsy: examination which consists in removing a fragment of tissue or organ. The removed piece is subjected to a microscopic examination and / or a biochemical analysis to confirm the cancerous nature of a tumor, for example.

Amygdalectomy : surgical operation which consists of the removal of the tonsils. It is performed in 80% of cases following hypertrophy (excessively large tonsils) which block the airways and thus obstruct breathing. In 20% of cases, it follows repeated tonsillitis accompanied by pain and fever. Contrary to popular belief, this is not a trivial operation: it requires consideration on a case-by-case basis and significant monitoring after the operation (11).

Frenotomy : incision of the frenum of the tongue. Intervention indicated in the case of ankyloglossia. It allows the lengthening of the frenulum to restore the functions of the tongue. It can be carried out locally using a laser.

Phenectomy : removal of the frenulum of the tongue. Intervention indicated in the case of ankyloglossia. It allows the removal of the frenulum which has the effect of restoring the functions of the tongue. It can be carried out locally using a laser.

History and symbolism of the mouth

The mouth is an erogenous zone, both in men and in women, from adolescence. It is a symbol of sensuality and seduction.

The mouth can be likened to a door, letting in or out words and sounds. We find this notion of door when the word mouth is used to designate the estuary of a river (13).

In ancient Egypt, it was customary to open the mouth of the deceased so that his soul returned to his body. The soul was thus preserved in the hereafter.

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