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Fig 24. Ankyloglossia
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Ankyloglossia or “tongue tied”
(Figure 24) is a congenital condition characterized
by an abnormally short lingual frenum and the inability
to extend the tongue. The frenum may lengthen with
growth to produce normal function. If the extent of
the ankyloglossia is severe, speech may be affected,
necessitating speech therapy or surgical correction.
If the child is able to extend his or her tongue far
enough to moisten the lower lip, then a frenectomy
usually is not indicated.[6]
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Fig 25. Mucocele
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This retention of mucous in subepithelial
(below the surface) tissues most commonly occurs on
a child’s lower lip (Figure 25). The cause is
mechanical trauma to a minor salivary gland, with
pooling of mucous in an obstructed and dilated excretory
duct. The lesions are usually painless; they are smooth-surfaced
and bluish or translucent. Most mucoceles are less
than 1 centimeter in diameter. Treatment typically
involves surgical excision, with removal of associated
minor salivary glands to prevent recurrence. If a
mucocele is found on the floor of the mouth, it is
called a ranula and is associated with the submandibular
salivary glands.[6]
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Fig 26. Fibroma
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Fig 27. Papilloma
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Two common, tumor-like raised lesions
of the oral cavity are the fibroma (Figure 26) and
the papilloma (Figure 27), which result from reactive
connective tissue hyperplasia caused by a chronic
irritant. Most fibromas are less than 1 centimeter
in diameter; are pale pink, smooth, and firm; and
have a sessile
or pedunculated
base. Fibromas may be found on any area of the oral
mucosa but are most often located on the palate, tongue,
cheek, or lip. The papilloma has a soft, cauliflowerlike
surface; is pink to white in color; and is generally
a solitary lesion. It can be located anywhere in the
mouth. Treatment involves surgical excision and removal
of the source of the irritant. Recurrence is uncommon.[6]
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