Oral Pathology

The oral cavity is a specialized environment of soft and hard tissues that is unique and one of the most dynamic regions in the body.  It is the only area of the body  that houses teeth (and the specialized structures that form teeth), contains bone, blood vessels, nerves, mucosa (the specialized type of skin that lines the oral cavity, nose, and GI tract), salivary glands, taste buds, and muscle tissue.  Any of these structures can manifest either benign or malignant pathology, as well as manifest the signs of many systemic diseases and general health of a patient.  Oral and maxillofacial surgeons must be vigilant in their examination and knowledge of the types of pathology that can present in the oral cavity.

There are a number of developmental cysts and tumors that are related to the jaws and the specialized organs that lead to the development of teeth (odontogenic cysts and tumors) that are often asymptomatic.  Many times these types of pathology are detected by the careful clinical and radiographic (x-ray) examination that is performed routinely by your dentist and dental hygienist.  These can also be detected by patients because of growth of the jaws, changes in the bite, loosening of teeth, pain in the jaws or any other number of symptoms that should prompt patients to seek evaluation by a dental specialist.  Once there is suspicion of an odontogenic cyst or tumor and after careful clinical and radiographic examination, a biopsy is often performed and sent to a pathologist that specializes in oral diseases.  Depending on the diagnosis, we will review the pathology with you and tailor your treatment to your specific needs.  The majority of these cysts or tumors are benign and treatment can range from simple removal to more extensive surgeries requiring reconstruction.

Often, people will have different changes that are noticed themselves or by their dentist or physician.  These can range from bumps, white spots, growths, or swellings on the gum tissue, cheeks, or lips.  Although these things are often benign, they should not be ignored and should be promptly evaluated by surgeons at our office.  With the evaluation, we will often recommend biopsy, or close follow up with the patient with the assistance of the dentist.

The most serious type of oral  pathology is oral cancer and because early detection is critical to successful treatment, we will often biopsy lesions of the soft tissues of the mouth.  The most common presentation of oral cancer is a red or red-white patch in the mouth, a sore or ulceration that fails to heal, a hard lump in the soft tissues of the mouth or neck, or changes in sensation in the soft tissues of the mouth, lip, chin, or tongue.  These lesions are typically not painful but this does not mean that they should be ignored.  Patients should perform self-examination monthly and attend routine dental visits for a more thorough examination.  Again, with evaluation of these lesions, we may recommend biopsy and will review the results with you and are able to deliver state of the art treatment.

How to Perform a Monthly Self-Examination

Our oral and maxillofacial surgeons recommend that everyone perform an oral cancer self-exam each month. If you are at high risk for oral cancer — smoker, consumer of alcohol, or family history — you should see your general dentist or oral and maxillofacial surgeon for an annual exam.

An oral examination is performed using a bright light and a mirror:

  • remove any dentures
  • look and feel inside the lips and the front of gums
  • tilt head back to inspect and feel the roof of your mouth
  • pull the cheek out to see its inside surface as well as the back of the gums
  • pull out your tongue and look at all of its surfaces
  • feel for lumps or enlarged lymph nodes (glands) in both sides of the neck, including under the lower jaw
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