Structure of the Oral Mucosa

The oral mucosa is a highly permeable tissue, with regional variations, as the type and keratinization status of the epithelial cell layer varies in different locations of the oral cavity. The oral cavity is lined by at least four different types of mucosa (Squier and Finkelstein, 2003). While nonkeratinized epithelium lines the majority of the oral cavity, covering the hard palate and gingiva is the masticatory mucosa, which receives the most severe mechanical forces and has stratified keratinized epithelium. The dorsal surface of the tongue is covered by specialized mucosa and is also lined by keratinized epithelium, which specializes in taste and other neurophysiologic functions. Junct-ional epithelium is a relatively undifferenti-ated and nonkeratinized epithelium, which forms the junction between the oral mucosa and the teeth. Another unique structural feature of the oral cavity is the localized presence of submucosa containing adipose tissue and minor salivary glands (Squier and Finkelstein, 2003).

The most common form of Candida stomatitis affects the palatal and dorsal tongue mucosa (Samaranayake and Mac-Farlane, 1990), and therefore this infection mostly relates to oral stratified keratinized squamous epithelium. In general, stratified squamous epithelia are thought to protect the underlying tissues by the process of ker-atinization, which decreases the mucosal permeability, and also by the process of desquamation of keratinized cells, which is thought to play an important role in the clearance of adherent bacteria and fungi (Samaranayake and Samaranayake, 2001).

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