• Nutrition
• Stress
• Ischemia
• Enlarged tongue
• Alcohol and drug use
• Infections
• Cigarette smoking

Failure of the palatal shelves to fuse

• The medial nasal process merges to form the primary palate 
• The secondary palate is formed from the maxillary process

CL ± CP more common in males

Isolated CP more common in females

• Cleft palate
• Mandibular micrognathia
• Glossoptosis

• Double lip
• Blepharochalasis
• Non toxic thyroid enlargement

• Ectopic sebaceous glands
• Less than 2 mm yellow spots
• Usually found on skin
• Located on buccal mucosa and upper lip

• May prevent eruption of teeth
• Not painful or hemorrhagic
• Gingiva normal in color
• Localized more often than generalized

• Surgical removal or gingivectomy
• Most often recurs
• May need to extract in severe cases
• Fibrous hyperplasia not related to oral hygiene

• Paget's disease
• Acromegaly
• Fibrous dysplasia

• Relatively common in 12-20 % of population
• Not related to any syndrome
• Frequently hereditary

Commissural lip pits - about 1 or 2 mm in diameter

                               up to 4 mm in depth

Paramedian lip pits - may be 3 mm in diameter

                              and 2.5 cm in depth

• Oblique and lateral facial cleft
• Paramedian lip pits
• Hemihyperplastia
• Aglossia

• Double lip
• Romberg syndrome

• May be congenital or acquired
• Folds of excess tissue on inner mucosal aspect
• Usually upper lip

• May be confused with trauma
• Appears to be inherited
• No function

• All ages
• Occasionally on gingiva and retromolar pad
• Asymptomatic

• Epilepsy
• Mental retardation
• Hirsutism

• Vascular or lymphatic,
• Neurogenic
• Hormonal (endocrine) and
• Chromosomal abnormalities

• Malfunction of nervous system
• Trauma
• Infection (viral or borrelia)
• Hereditary
• Form of scleroderma

• More common in females
• May have pigmentation of skin

• Premolar(s) missing
• Bone more radiodense
• Remains stable

• Vascular malformation such as hemangioma, lymphangioma
• Hemihypertrophy
• Down syndrome
• Neurofibromatosis

• Edentulous patients
• Myxedema
• Acromegaly
• Angioedema

• May restrict movement
• May exhibit speech difficulties
• May cause slight clefting at tip of tongue

• Majority treated surgically by clipping frenum
• But not until 4 or 5 years to evaluate
• Some self correcting

• Common
• Usually painless
• Overall incidence about 2-5 %

• Hereditary
• May be associated with some extrinsic factor such as chronic trauma
• Increases as age increases

• May persist for weeks or months
• Border may show hyperparakeratosis

• Unknown
• Emotional stress
• Hypersensitivity to environmental factors
• Chronic irritation

• None
• Patient should be reassured at the beginning
• Topical steroids in severe cases
• May recur

• Brown or black pigment on dorsal tongue
• Elongated hair like projections
• Usually asymptomatic
• Not hairy leukoplakia in HIV

• Antibiotic therapy
• Poor oral hygiene
• Oxidizing mouthwashes or antacids
• Fungal and bacterial overgrowth
• General debilitation
• Smoking
• Food

• Brush tongue or use tongue scraper
• Podophyllum resin in rare cases

• Increases with age
• Solitary varices seen in other parts of mouth

• Located posterior to the foramen cecum
• May cause dysphagia or feeling of fullness in throat

• Thyroid scan using iodine isotope
• Not thyroglossal duct cyst

• Incisional biopsy only (not excisional)
• After careful diagnosis

• Palatine tonsils
• Pharyngeal tonsils
• Lingual tonsils
• May also include foliate papillae

• May be site of malignant lymphoma
• Biopsy indicated if lesion does not regress

• Often bilateral
• Not bony hard tori
• Surface may be keratinized
• 4 mm

• The only serous minor salivary gland
• Referred to as von Ebner's glands