Palate / Roof of Mouth July 7, 2023 by Palate / Roof of Mouth Hard palate ridges - Normal anatomy The hard palate (roof of the mouth) is not smooth, but has ridges, called plicae. These can be shallow or deep and are more noticeable just behind the teeth in the front of the mouth. Palatal torus with ulceration - Benign change Tori (plural) are normal bony growths that often come from the jaw but may also be on the palate (top of the mouth). They are not usually painful and are often symmetric (same on both sides). In some cases, the lining of the mouth may wear away, leaving an ulcer over the torus, which can be painful. In these cases, evaluation is needed, and the torus may need to be removed to help with symptoms and to rule out other problems. Palatal melanosis - Benign change This picture shows a dark spot along the hard palate (top of the mouth). This is an oral melanocytic macule, or in other words, a small dark spot in the mouth. These are common on the lips, gums, cheeks, and the palate. They can occur in any patient but are more common in women and people with darker skin tones. Usually, these are small ( Cutaneous horn - Benign change Excessive thickening of the surface of the palate can be seen. While usually benign, the area should be evaluated by a medical professional. Leukoplakia - Benign change This persistent area on roof of the mouth should be evaluated by a medical professional as it may be cancer or precancer. Maxillary pleomorphic adenoma - Benign tumor This is a photo of a salivary gland tumor of the roof of the mouth. These may present as a lump growing under the surface or as a progressive non-healing sore. In either instance, they should be assessed by a medical professional. Submucosal myxoma - Benign tumor This is a tumor of the palate (top of the mouth) that grows from the teeth. It is benign (not cancerous) but may form in multiple locations. This usually does not come with an ulcer of the lining of the mouth and may not show any pain. This is often treated with a simple surgery, but if multiple tumors are present or this comes back after treatment, then more advanced surgery may be needed. Ameloblastoma - Benign tumor This is a tumor in the left part of the jaw that grows from enamel of the teeth. It is usually benign (not cancerous) but is often treated more like a cancer with surgical removal and jaw reconstruction. Ameloblastoma - Benign tumor This is a tumor in the right part of the maxilla (upper jaw) that grows from enamel of the teeth. It is usually benign (not cancerous) but is often treated more like a cancer with surgical removal and jaw reconstruction. This usually does not come with an ulcer of the lining of mouth and may not show any pain. Instead, it expands gradually within the jaw. Peripheral giant cell tumor - Benign tumor This is an uncommon benign (not cancerous) tumor in the maxilla (upper jaw). This tumor may be confused with other tumor types and needs to be evaluated by a professional. These tumors are generally treated with surgery. Lichen planus - Precancer These white patches can be benign, precancer or cancer and should be evaluated by a medical professional. Erythroplakia - Precancer Erythroplakia is a red spot in the mouth. This particular patch is on the undersurface of the palate (roof of the mouth). The lining of the mouth is red, so this can be difficult to distinguish from normal tissue, but it generally looks different than its surroundings. Sometimes the red spot can be mixed with white spots as well. If the red spot is present for more than two weeks and is not going away or is painful, it generally should be biopsied to rule out cancer. Left maxillary adenocarcinoma - Cancer Left maxillary adenocarcinomaThis is an example of a cancer of the back of the hard palate. Such a tumor would often present with pain or cause the denture not to fit anymore. Adenoid cystic carcinoma - Cancer This is a photo of the roof of the mouth showing a salivary gland cancer. The area is hard to see and is only seen due to the increased blood vessels over top of it. Adenoid cystic cancer is known for slow growth and also traveling along nerves. If you develop unexplained weakness of the face or numbness in your mouth, face or throat, you should seek medical attention. Malignant salivary gland tumor - Cancer This is a photo showing a salivary cancer of the back part of this person’s upper gum. It presented as a non-healing sore that became noticeable when their denture would not fit well. Polymorphous low-grade adenocarcinoma - Cancer This is a photo of a large salivary tumor of the roof to the mouth. Any progressive sore or swelling that lasts longer than 2 weeks should be assessed by a medical provider. Squamous cell carcinoma - Cancer This is a squamous cell cancer of the roof of the mouth. Squamous cell carcinoma - Cancer This is a cancer of the roof of the mouth. If the destruction is extensive enough, patients may present with nasal regurgitation (fluids or foods through the nose) due to the defect. Squamous cell carcinoma - Cancer This is an example of cancer involving the upper jaw. Maxillary lymphoma - Cancer This is a lymphoma of the right upper jaw. Note the enlarged blood vessels and the enlargement of the upper jaw. Maxillary squamous cell carcinoma - Cancer This is a cancer of the left side of the roof of the mouth. These cancers show up as a nonhealing sore or loose/bad teeth.
