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 infiltration of the mucosa is often found in cancerous lesions.

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 and is often grooved by dense fissures. 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. Rarely, it is pre-cancerous.

(inflammation of the mouth) arises from the same causes as inflammation elsewhere, but among the main causes are sharp or broken teeth, Herpes simplex infection, 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 sufficient.

(see TEETH, DISEASES OF) is inflammation 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.

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.

A salivary calculus is a stone in one of the major salivary-gland ducts. This may result in a blockage which will cause the gland to swell and be painful, particularly before a meal and then slowly subsides. It may be passed spontaneously 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. Dental calculus, also called TARTAR, is calcified material adherent to teeth. It often starts as the soft debris found on teeth which have not been well cleaned when 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.)

This is a cyst-like swelling found in the floor 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.

is an acute infective disorder of the major salivary glands. It causes a painful enlargement of the glands which lasts for about two weeks. (See also main entry for MUMPS.)

may occur in all parts of the mouth, and 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 the UK around 7,500 people are diagnosed annually as having cancer of the mouth and PHARYNX.

Cancer of the mouth is less common below the age of 60 years and is more common in men. About two-thirds of cases are probably caused by smoking; alcohol and betel leaf chewing are also risk factors. LEUKOPLAKIA may be a precursor of cancer. Spread is by way of the lymph nodes in the neck. Early treatment by surgery, radiotherapy or chemotherapy will often be effective, 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 patients.