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Oral Cancers

Understanding the Anatomy4de Vries N, Van der Waal I, Snow GB. Multiple primary tumours in oral cancer. International journal of oral and maxillofacial surgery. Feb 1986;15(1):85-87.

When discussing oral cancer, you should start by understanding the anatomy. This illustration shows different parts of the oral cavity, or the mouth. Basically, the mouth goes from the pink part of the lips back to the bony roof of your mouth and to the part of the tongue you can see when you open your mouth.

02a_mouthsites (1)

Oral cancers can start in one of seven different areas within the mouth, called subsites. Keep in mind that the soft palate, uvula (dangly bit of tissue in the back of the mouth) and the base of the tongue are actually part of the oropharynx, not the oral cavity.

The different subsites of the mouth include:

Mucosal lips: The upper mucosal lip and lower mucosal lip start at the vermillion border (the junction of facial skin and pink lip) and extend to where the lips contact each other.

Buccal mucosa: This is the pink lining inside your lips and cheek. It goes from the inside part of the lips that you can’t see when the mouth is closed to the gums and along the inner part of your cheek.

Oral tongue: This is the front two-thirds of the tongue. It is the part of the tongue that moves around easily. When describing a tumor of the oral tongue, doctors will say it is either on the tip, lateral border (the side), the dorsum (the top of the tongue) or the ventral surface (undersurface).

Floor of mouth: This is the part in the front or side of the mouth that you can see if you lift your tongue up to the roof of your mouth. It goes from the gingiva (gums) on the inside of the mandible (lower jawbone) just to the undersurface of the tongue. The lingual frenulum separates the floor of the mouth into a left and right side.

Upper and lower alveolar ridge: This is the gums, or the pink mucosa that is attached to the upper jawbone (maxilla) and lower jawbone (mandible).

Retromolar trigone: This is the lining on each side of the mouth. It is attached to bone in the back corner of the mouth behind the very last lower tooth and forms a triangle between the upper and lower jawbones. It is a thin piece of mucosa that sits over part of the lower jawbone.

Hard palate: This is the bony part of the roof of the mouth. The soft palate is located behind the hard palate and is actually considered part of the oropharynx (throat).

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22 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed November 9, 2016. To view the most recent and complete version of the guideline, go online to www.NCCN.org. The NCCN Guidelines are a work in progress that may be refined as often as new significant data becomes available. The NCCN Guidelines are a statement of consensus of its authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult any NCCN Guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient’s care or treatment. The National Comprehensive Cancer Network makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.

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