If you look in an open mouth, you see many structures. We have already treated the teeth.
The mouth consists of two parts:
- The vestibulum oris, "porch of the mouth". With this porch is meant the space between the teeth and the cheeks / lips.
- The cavum oris, the actual oral cavity. The oral cavity is therefore that part of the mouth that lies within the row of teeth. The oral cavity is for the most part filled by the tongue.
The mouth is surrounded by the lips and cheeks. Labium (plural labia) is the Latin word for lip. Bucca (plural buccae) is Latin for cheek.
When we use the drawing (see image below) as a guide to further explore the mouth, you come across a lip band or frenulum under the upper lip. After the mucous membrane of the lip and the gingiva you see the row of teeth of the upper jaw. Behind the upper elements the palate or palatum begins. The first part of the palate is bone coated with mucosa. This hard palate is called the palatum durum. The posterior part of the palate has no bone under the mucosa. This soft palate is called the palatum molle. The transition from the hard to the soft palate is called the A-line (also called H-line). Namely, when someone makes an a-sound, the palatum molle pulls up and you see the transition from hard to soft palate as a line.
The uvula hangs in the middle of the soft palate. The pharynx or pharynx starts behind the uvula. Left and right between the palate arches is the throat almond or tonsilla palatina.
At the bottom of the mouth, the tongue or lingua fills the entire space within the row of sub-elements. When we have passed the lower elements, we come across another frenulum at the lower lip. After the lower lip we had the entire mouth.
The dentist is one of the few who regularly inspect the mouth. When periodically examining a patient's mouth, it is wise to inspect all other structures as well as the teeth and their mutual relationship. Such an entire mouth inspection does not have to be time consuming. Sometimes a simple inspection can reveal issues that do not bother a patient (now), but which can later give rise to complaints.
The oral mucosa
For the sake of convenience we speak of "the oral mucosa". But the oral mucosa or the oral mucosa is not the same everywhere. The mucous membrane in the mouth does have the characteristics of mucous membrane everywhere:
- It is unchanged multilayer epithelium.
- It is well blooded.
- It is pink / red in color.
However, the structure of the mucous membrane varies from place to place (see image below):
- Mucous membrane of the mouth and bottom of the mouth. The mucous membrane of the cheeks, lips and mouth has the same structure. It consists of unchanged epithelium. There are mucous glands in this epithelium and some connective tissue. The mucous membrane is fairly loose on the surface and is fairly elastic.
- Attached gingiva. The gums sit like a cuff around the teeth. The gingiva is attached to the alveolar bone and root cement with fibers. The gingiva is non-sliding on that surface.
- Palatal mucosa. The mucous membrane on the palate is very stiff; it contains a lot of connective tissue. Just like the gingiva, it is non-sliding on the surface. There are many mucous glands in it.
- Tongue mucosa. There are a number of typical elevations, the papillae, on the tongue mucosa in the multilayer unchipped epithelium. These papillae are discussed during the discussion of the tongue.
- Lips. The lips form the transition from the mucous membrane of the mouth to the skin. That transition is not abrupt; the red lip forms that transition.
The unchanged multilayer epithelium is located in the mouth. The lip red consists of transparent multi-layered epithelium with very little watering. The skin on the outside consists of horned multi-layer epithelium.
The lips are very sensitive. They contain many nerve fibers, with which our food is scanned, among other things. This sensing consists, for example, of feeling the temperature.
The tongue is one of the largest organs in the mouth. He helps with the following tasks:
- To speak. The sounds of the voice box are formed by the movements of the tongue into intelligible language.
- Chew. The tongue, together with cheeks and lips, distributes the food in the mouth during the chewing process in such a way that it is well ground.
- To swallow. When swallowing, the tongue makes the movements that cause the food product to end up in the throat.
- Taste. Seeing food already gives a certain idea about taste. The taste senses of the tongue, which are in the papilla, warn if the food clearly tastes different than it should taste.
- Touch. There are many probe organs especially at the tip of the tongue. With this you scan food. The fact that the sense of touch of the tongue is very large, is evident from the fact that small children put everything in their mouth to be able to scan it properly.
There are a number of elevations on the mucous membrane of the tongue, which we call the papillae (see image below).
- The papillae fungiformes are mushroom-shaped. They are mainly found on the tip and on the sides of the tongue. Taste senses are found in the epithelium of these papillae. They can distinguish three flavors, namely sweet, salty and sour.
- The papillae filiformes are thread-shaped and are located in large numbers in the middle of the tongue. These papillae have no taste senses.
- The papillae circumvallatae are papillae around which a kind of canal is visible. They are found on the back of the tongue, on the transition to the so-called tongue root. The epithelium of the papillae circumvallatae contains taste senses that taste mainly bitter.
- In the tongue root, behind the papillae circumvallatae, there is lymphatic tissue, the tonsilla lingualis. The tonsilla lingualis together with the tonsilla palatina and the tonsilla pharyngea form a kind of ring around the passage from the throat to the windpipe and the esophagus (the so-called Waldeyer ring). Lymphatic tissue has a task in defending the body.