What are Foliate Papilla?
Foliate papilla are crescent-shaped nodules or ridges
that exist along the sides of the rear of the tongue.
They occur normally and are not associated with any localized
or systemic disease. Foliate papilla often occur in clusters
of tissue, usually symmetrical on each side of the tongue.
However, they can also exist on only one side of the tongue.
Their shape, size, location, and number vary greatly between
individuals.
Foliate papilla are comprised of lymphatic
tissue, and they are similar in composition to your tonsils.
Because of this, they may swell in
response to oral or upper-respiratory infections, but
then subside when the infection clears. One of the most
common sites for oral cancer is the foliate papilla site
on the rear sides of the tongue. For this reason, it's
crucial that we check this portion of your mouth thoroughly
and carefully during the exam portion of your visit.
Treatment Options
• Since these are normal structures, no treatment
is usually necessary.
• If there is abnormal color change, ulceration,
or any other abnormality, a tissue sample (biopsy) may
be indicated.
What are Fordyce Granules?
Fordyce granules are yellow or yellowish-white clusters
of pimplelike formations just beneath the mucosa (the
pink tissue covering the
inside of the oral cavity). They usually occur on the
inside of the lips and cheeks or in the corners of the
mouth. They are not symptomatic of a disease, but a normal
variation in the appearance of the inside of the lips
or cheek.
Fordyce granules are actually sebaceous glands, which
are oilproducing glands that normally exist under your
skin beneath the hair
follicles. However, they have no function within the mouth;
their existence is therefore said to be ectopic, or abnormal.
The surface of the mouth's lining (called the mucosa)
may have a slightly rough feel to it where the glands
are clustered, but such change in the texture of the mucosa
is of no consequence.
Treatment Options
Since Fordyce granules are merely a variation in appearance
within your mouth, treatment is not required. It may be
frightening to see
these clusters beneath the mucosa within your mouth, but
rest assured they are harmless sebaceous glands that are
simply out of place.
What is Granulation Tissue?
of a wound as it heals. This tissue is usually firm, or
even hard, andhas a red, velvety, 'beefy' appearance because
of the large number of small blood vessels within it. It
may be seen on the skin as well as the mucosa (the inner
lining of the mouth). Granulation tissue can take nearly
any shape or form. Its growth pattern is also unpredictable;
it can increase in size, remain stable or regress. There
is occasionally some pain or discomfort associated with
granulation tissue, but it can also be present with no symptoms
whatsoever, as it contains no nerves.
Treatment Options
Unless the granulation tissue is excessive, there is
seldom any need for treatment.
• It is important to protect granulation tissue
until the area is completely covered by a normal layer
of epithelium (outer skin or mucosa).
• Since this tissue contains many small blood vessels,
it can bleed very easily if irritated or injured; these
injuries can then become infected.
What is Hairy Tongue?
Hairy tongue is a chronic condition in which the tiny bumps
on the tongue's surface (called filiform papillae) enlarge
and elongate to
form hair-like projections. Normally, the surface cells
of the papillae are shed on a regular basis, keeping the
size of the papillae uniform in appearance. With hairy tongue,
the surface cells are shed less frequently, which results
in the overly long projections. The color can vary from
yellowish white to brown or black. Even though it is unsightly,
hairy tongue is a painless condition. Hairy tongue can occur
at any age, but it is most common in adults, especially
those who are heavy smokers or who use mouthwashes regularly.
The condition can also be brought on by antibiotic therapy
or by the use of metronidazole (Flagyl), an antiprotozoal
medication. Additionally, using antacid medications will
cause pre-existing hairy tongue to turn black. Some cases
of hairy tongue are associated with extensive radiation
of the head and neck for treatment of a tumor. This invariably
affects the salivary glands and their secretions, but we
do not yet understand why radiation seems to frequently
cause hairy tongue.
Treatment Options
• In some cases, hairy tongue may be associated with
a systemic disturbance, such as anemia or gastric upset;
often, treatment of these conditions will result in the
regression of the hairy tongue.
• Hairy tongue not associated with a condition elsewhere
in the body requires no treatment other than meticulous
oral hygiene and regular brushing of the tongue. These
will promote shedding of the surface cells and prevent
food particles from collecting between the filiform papillae.
• In some cases, we may apply a medication to the
surface of the tongue that hastens the shedding of excess
cells. Such
medications can be caustic and should never be self-administered.
What is Hypercementosis?
Enamel covers the portion of the tooth above the gumline.
Cementum covers the portion below the gumline (the root
surface).
Hypercementosis is the thickening or increased deposit
of cementum on the root surface. It may involve the entire
root surface, but more commonly it appears as a bulbous
mass involving the root end (called the apex).
No pain or other signs or symptoms of hypercementosis
are usually present; typically we will discover that you
have the condition during your routine dental x-rays.
The characteristic x-ray appearance when hypercementosis
is present includes a thickening of the cementum layer
as well as blunting or rounding of the root's tip.
Causes of Hypercementosis
• The extension of a tooth from its normal position
due to the loss of the opposing tooth from the opposite
arch
• An abscess or low-grade inflammation at the tip
of the root (most often caused by an infection of the
pulp, or nerve, of a tooth)
• A tooth that hits first when chewing (called hyperocclusion)
• A broken or fractured root Hypercementosis can
also be present with none of the above causes. If multiple
teeth are involved, we will need to rule out other conditions,
such as Paget’s disease and hyperpituitarism.
Treatment Options
Usually, no treatment of hypercementosis is necessary,
but it’s important to diagnose the condition in order
to rule out the other treatable conditions listed above.
The other significant reason to diagnose hypercementosis
occurs when we need to extract a tooth
with this condition. Frequently, these teeth require surgical
extraction in order not to fracture the supporting bone
or disturb the healthy adjacent tooth.
