ANATOMY of THE

ORAL CAVITY Dr. Abbas

 parasympathetic nerves
1973
 PHARYNGEAL ARCHES nerves
1975
 Small Ships Make Money, But My Brother Says
Big Boats Make More

2
 1973

Sensory motor
GVA GVE

GSA (pain, touch, thermal etc) SVE(1975)

SSA (TV) GSE

SVA (food)
Small Ships Make Money, But My Brother Says Big
Boats Make More
So4 Lr6 O3
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Lat. Pterygoid m.

Med. pterygoid m.
 1973

Sensory motor
GVA GVE

GSA (pain, touch, thermal etc) SVE(1975)

SSA (TV) GSE

SVA (food)
Small Ships Make Money, But My Brother Says Big
Boats Make More
So4 Lr6 O3
INTRODUCTION
 The oral cavity associated with many
pleasurable functions, but the most basic and
pleasurable perhaps, are eating and drinking
plus speech and alternate airway
 Extends from oral fissure to the palatoglossal
fold
 It is the commencement of the digestive tube
 Consist of 2 parts
A- Vestibule:- between lips, cheeks & teeth
B-Oral cavity proper:- behind the teeth
Human dentition
 Dentition:- is a term that describes all of the upper and lower
teeth collectively
 Anatomically Human dentition is diphyodont
 2 sets of dentitions
*Primary/deciduous
– 20 teeth in total
– 8Incisors/4canines/8molars
– Smaller size
*Secondary/permanent
– 32 teeth in total
– 8Incisors/4canines/8premolars/12molars
Bigger size
Clinically, there are 3 types of dentitions,
deciduous. Mixed or permanent
08/27/23 26
08/27/23 29
A – alveolar mucosa
B& C labial &buccal frena
 Boundaries
Anterior - the lips Posterior - the anterior tonsillar
pillars Roof - hard and soft palate Floor - mucosa
overlying sublingual and submandibular glands.
Walls - buccal mucosa
 Contents
Alveolar processes and teeth Anterior tongue to
circumvallate papilla, Orifice of parotid gland
(Stenson's duct) in buccal mucosa opposite upper
second molars, Orifice of submandibular duct
(Wharton's duct) & Orifices of sublingual glands in
anterior floor of mouth
A,vermilion B. Nasolabial fold c- oral commssure D-mental
groove E- philitrum F- vermolion border
 The Lips
 These are mobile muscular folds that surround the
mouth, the entrance of the oral cavity.
 The lips are covered externally by skin and internally
by mucous membrane.
 In between these are layers of muscles of facial
expressions, especially the orbicularis oris muscle.
 The upper and lower lips are attached to the gingivae
in the median plane by raised folds of mucous
membrane, called the labial frenula.
 Sensory Nerves of the Lips
 The sensory nerves of the upper and lower lips are
from the infraorbital and mental nerves, which are
branches of the maxillary (CN V2) and
mandibular (CN V3) nerves respectively.
A- skin B- MUCOUS MEMBRANE
C-vermilion D- Muscle orbicularis oris
E-labial salivary glands
Oral-facial clefts
 Due to failure fusion of the processes
Cleft Lip
 The Cheeks
 The cheeks form the lateral wall of the vestibule of the oral
cavity.
 They have essentially the same structure as the lips with which
they are continuous.
 The principal muscular component of the cheeks is the
buccinator muscle.
 Superficial to the fascia covering this muscle is the buccal
fatpad that gives cheeks their rounded contour, especially in
infants.
 The lips and cheeks act as a functional unit (e.g. during
sucking, blowing, eating, etc.).
 They act as an oral sphincter in pushing food from the
vestibule to the oral cavity proper.
 The tongue and buccinator muscle keep the food between the
molar teeth during chewing.
 Sensory Nerves of the Cheeks
 These are branches of the maxillary and mandibular nerves.
 They supply the skin of the cheeks and the mucous membrane
lining the cheeks.  
 Soft
palate

Anterior & palatoglossal

lateral – teeth fold
& gums

palatine tonsil
Posterior –
oropharyngeal
isthmus

Floor – tongue, mucous

Roof – hard &
membrane, mylohyoid &
soft palate
geniohyoid muscles

Oral cavity proper – Boundaries

 Sagittal Section

Soft
Hard palate palate

Palatoglossal
fold
Palatopharyngeal
fold

Floor occupied
by the tongue

Palatine tonsil
 The Palate
 The palate forms the arched roof of the
mouth and the floor of the nasal cavities.
 The palate consists of two regions: the
anterior 2/3 or bony part, called the
hard palate, and the mobile posterior 1/3 or
fibromuscular part, known as the soft palate.
 
 The Hard Palate
 The anterior bony part of the palate is formed by the palatine process of
the maxillae and the horizontal plates of the palatine bones.
 Anteriorly and laterally, the hard palate is bounded by the alveolar
processes and the gingivae.
 Posteriorly, the hard palate is continuous with the soft palate.
 The incisive foramen is the mouth of the incisive canal.
 This foramen is located posterior to the maxillary central incisor
teeth.
 This foramen is the common opening for the right and left incisive canals.
 The incisive canal and foramen transmit the nasopalatine nerve and the
terminal branches of the sphenopalatine artery.
 Medial to the third molar tooth, the greater palatine foramen pierces
the lateral border of the bony palate.
 The greater palatine vessels and nerve emerge from this foramen and run
anteriorly into two grooves on the palate.
 The lesser palatine foramen transmits the lesser palatine nerve and
vessels.
 This runs to the soft palate and adjacent structures.
  The Soft Palate
This is the posterior curtain-like part, and has no bony support. It
does, however, contain a membranous aponeurosis.
The soft palate, or velum palatinum , is a movable,
fibromuscular fold that is attached to the posterior edge of
the hard palate.
It extends posteroinferiorly to a curved free margin from which
hangs a conical process, the uvula .
The soft palate separates the nasopharynx superiorly and the
oropharynx inferiorly.
During swallowing the soft palate moves posteriorly against the
wall of the pharynx, preventing the regurgitation of food into
the nasal cavity.
Laterally, the soft palate is continuous with the wall of the
pharynx and is joined to the tongue and pharynx by the
palatoglossal and palatopharyngeal folds.
The soft palate is strengthened by the palatine aponeurosis,
formed by the expanded tendon of the tensor veli palatini
muscle.
This aponeurosis attaches to the posterior margin of the hard
palate.
 Muscles of the Soft Palate
1-The Levator Veli Palatini (Levator Palati)
2-The Tensor Veli Palatini (Tensor Palati))
3- The Palatoglossus Muscle (palatoglossal arch)
4-The Palatopharyngeus Muscle
(palatopharyngeal arch).
5-The Musculus Uvulae (uvular muscle)
When the muscle contracts, it shortens the uvula
and pulls it superiorly to close the passage
between the oral cavity and nasal cavity
 Nerves of the Palate
 The sensory nerves of the palate, which are branches
of the pterygopalatine ganglion, are the greater and
lesser palatine nerves.
 They accompany the arteries through the greater and
lesser palatine foramina, respectively.
 The greater palatine nerve supplies the gingivae,
mucous membrane, and glands of the hard palate.
 The lesser palatine nerve supplies the soft palate.
 Another branch of the pterygopalatine ganglion, the
nasopalatine nerve, emerges from the incisive
foramen and supplies the mucous membrane of the
anterior part of the hard palate.
 
 Vessels of the Palate
 The palate has a rich blood supply from branches of
the maxillary artery.
tongue drop ,then shelves grow horizontal &
fuse with each other & nasal septum by
medial edge epithelium which is designed to
die &repaced by mesenchymal cells to
ossify.posteriorly develops soft palate
Cleft Palate
THE TONGUE
 Tongue
 Inspection of the tongue

 Mainly composed of striated

muscles, covered by
mucous membrane
Base
 Organ of taste, deglutition,
mastication & speech Body

 Oral & pharyngeal in

position Apex

 Apex / tip, body & base;

dorsal & ventral surfaces
Palatoglossal fold
 Tongue – External features
Dorsal surface – 2 parts by
Foramen the terminal sulcus
Epiglottis
cecum
 embryonic site of attachment of the
thyroglossal duct [lingual thyroid may be
Pharyngeal present]
part
Dorsal surface

Terminal
sulcus Oral part
anterior two thirds
Shows lingual papillae

Inferior / ventral surface

Apex / Tip
Posterior one third [Pharyngeal part] - Posterior to the sulcus
terminalis

Lateral Median – glossoepiglottic folds palatoglossal folds - side of the

tongue between oral &
pharyngeal parts
Vallecula
Lingual Connected to the epiglottis by a
median and two lateral
tonsil glossoepiglottic folds

devoid of papillae but shows

low elevations of lymphoid
nodules - collectively form
lingual tonsil

Circumvallate papillae anterior to

Palatine
the terminal sulcus
tonsil
 The Tongue
The tongue (L. lingua; G. glossa) is a highly
mobile muscular organ that can vary greatly in
shape.
 It consists of three parts, a root, body, and
tip.
 The tongue is concerned with mastication,
taste, deglutition (swallowing), articulation
(speech), and oral cleansing.
 Its main functions are squeezing food into
the pharynx when swallowing, and forming
words during speech.
 
 Gross Features of the Tongue
 The dorsum of the tongue is divided by a V-
shaped sulcus terminalis into anterior oral
(presulcal) and posterior pharyngeal
(postsulcal) parts.
 The apex of the V is posterior and the two
limbs diverge anteriorly.
 The oral part forms about 2/3 of the tongue
and the pharyngeal part forms about 1/3.
Dorsum of the tongue
On the dorsum of the oral part of the tongue is a median
groove.
 This groove represents the site of fusion of the distal tongue
buds during embryonic development.
The Lingual Papillae and Taste Buds (p. 746)
 The filiform papillae (L. filum, thread) are numerous, rough,
and thread-like.
 They are arranged in rows parallel to the sulcus terminalis.
 The fungiform papillae are small and mushroom-shaped.
 They usually appear are pink or red spots.
 The vallate (circumvallate) papillae are surrounded by a
deep, circular trench (trough), the walls of which are studded
with taste buds.
 The foliate papillae are small lateral folds of lingual mucosa
that are poorly formed in humans.
 The vallate, foliate and most of the fungiform papillae contain
taste receptors, which are located in the taste buds.
 The Pharyngeal Part of the Tongue
 This part lies posterior to the sulcus terminalis
and palatoglossal arches.
 Its mucous membrane has no papillae.
 The underlying nodules of lymphoid tissue give
this part of the tongue a cobblestone
appearance.
 The lymphoid nodules (lingual follicles) are
collectively known as the lingual tonsil.
The Tongue – Dorsal Side
Venteral aspect of Oral Part of the Tongue
 This part is freely movable, but it is loosely
attached to the floor of the mouth by the
lingual frenulum.
 On each side of the frenulum is a deep lingual
vein, visible as a blue line.
 It begins at the tip of the tongue and runs
posteriorly.
 All the veins on one side of the tongue unite at
the posterior border of the hyoglossus
muscle to form the lingual vein, which joins
the facial vein or the internal jugular vein.
The Tongue – Ventral Side
 Muscles of the Tongue
 Intrinsic – superior longitudinal, inferior longitudinal,
transverse & vertical change shape of the tongue

 Extrinsic – genioglossus, hyoglossus, styloglossus and

palatoglossus change position of the tongue

 All are paired, separated by a median fibrous septum

 Intrinsic muscles are within the tongue [no bony attachments]
and alter the shape of the tongue
 Extrinsic muscles are attached to mandible [genial tubercles] /
hyoid / styloid process / palate
 Extrinsic muscles move the tongue

 All extrinsic & intrinsic muscles of the tongue are

innervated by the hypoglossal nerve (CN XII), except for
palatoglossus – vagus [cranial accessory]
Extrinsic muscles
Palatoglossus [elevates the
tongue & approximates the
palatoglossal folds]
Genioglossus – protrusion &
depression; prevents the tongue from
sinking back / obstructing
respiratory passage

Styloglosssus [draws the tongue

up & backwards]

Hyoglossus
[depression]

Genioglossus Geniohyoid
 Coronal Section – Intrinsic muscles
Superior longitudinal

Median Vertical &

fibrous transverse
septum

Inferior
H M longitudinal
Genioglossus

Lingual artery

Hyoid bone Lingual

nerve

Hypoglossal nerve
 Innervation of the Tongue
1-MOTOR
  Motor InnervationAll muscles by hypoglossal
nerve (CN XII) except palatoglossus muscle (by
the pharyngeal plexus)
2-SENSORY
 General Sensory InnervationLingual nerve
(branch of mandibular nerve CN
V3)Glossopharyngeal nerve (CN IX)
 Special Sensory InnervationChorda tympani
nerve (branch of facial nerve)Glossopharyngeal
nerve (CN IX)
Nerve Supply – general Epiglottis
sensory, taste and muscles Posterior most area –
Internal laryngeal
branch of vagus
Posterior third
including the vallate
papillae [General &
special sensory] –
glossopharyngeal

Anterior two thirds excluding

vallate papillae Vallate papilla

General sensory – lingual

Taste – chorda tympani

Motor – hypoglossal except palatoglossus [vagus through pharyngeal plexus]

Muscles are derived from the occipital myotomes
08/27/23 86
 Tongue arterial supply – lingual arteries

Branches – dorsal lingual,

sublingual & deep lingual

Injury to the tongue – accidental, during recovery from anesthesia, epileptic attack
etc. bleeding is arrested by grasping the tongue posterior to the wound
Ventral surface
Sublingual drug administration – in angina
pectoris vasodilators may be given;
absorption through veins

fimbriated fold

Deep lingual vessels

Frenulum

Base of the frenulum – submandibular duct

opens at the summit of the sublingual
papilla

Sublingual fold - mucous fold raised by

the sublingual gland
 Ankyloglossia (tongue tie)

Frenulum

fenulum too short or extends far anteriorly –

interferes with tongue movements [breast
feeding & speech are affected]
Lingual nerve is at risk during removal of the lower third molar or
during operations of the submandibular gland / duct

Paralysis

Normal
Damage to the hypoglossal nerve – tongue
deviates to the paralyzed side; longstanding
paralysis wasting of the muscles

Normal genioglossus pulls the same side forwards leaving the paralyzed side
stationary
DENTAL ANAESTHESIA
 MAXILLARY TEETH
 Infiltraton:- maxilla is porous
 For fillings &RCT only buccal or labial injection is
needed for SANs
 Extraction:-buccal &palatal
(G.palatine+nasoplatine) injections
 MANDIBULAR TEETH
 Inferior alveolar block:- mandible is dense
compact.
 For filling &RCT only IAN in the mandibular
foramen
 Extraction :lingual with IAN& long buccal on the
buccal side
08/27/23 94
 *infiltration can be at the lower anterior teeth
 ADMINISTERING
LOCAL ANAESTHETIC
Maxilla Mandible

Blue - Areas where

Buccal region local anaesthetic Buccal region
can be delivered

Palatal region Lingual region

 Lymphatic drainage Medial area of anterior part –
jugulo-omohyoid

Posterior part – jugulo-

digastric

Apex – submental
nodes

Margins of anterior part

– submandibular nodes
jugulo-omohyoid
[inferior deep cervical]
Carcinoma – can spread to
bilateral nodes