Oral Pathology

Pathology can be defined as the scientific study of the nature of disease and its causes, processes, development, and consequences. More simply put, however, it is the branch of health care that is concerned with diseases and abnion (history and physical examination), it will often enable the surgeon to narrow the diagnosis to two or three of the most likely possibilities. However, it is possible that your surgeon will ask you to undergo a biopsy to obtain a more definitive diagnosis. Biopsy (the removal of a small tissue specimen for microscopic examination) is the only way to be absolutely certain of a final diagnosis.

What Is A Biopsy?

lab tech peering into microscope

A biopsy is a surgical procedure that involves the removal of a piece of the suspicious tissue; usually part of the lining tissue (mucosa) of the mouth or the underlying bone that has demonstrated possible involvement through the examination process. Fortunately, most biopsies can be carried out in the office setting with Novocain or Lidocaine (local anesthesia). Upon completion of the biopsy, the harvested piece of tissue, or specimen, is sent to a pathology laboratory for examination where the tissue is handled by a qualified specialist in oral pathology.

The pathologist will need to process the tissue and then examine the specimen under a microscope. In the majority of cases this tissue processing and examination by the pathologist will require approximately ten days. Great care is taken to insure and provide an accurate diagnosis. Upon completing the tissue examination, the pathologist will send, fax or telephone a report to your surgeon for review. Any questions that the surgeon may have about the report is then discussed with the pathologist prior to the patient returning to the office.

The report provided to the surgeon by the pathologist not only helps in establishing a diagnosis, but enables him to develop a treatment plan that specifically addresses the type of lesion identified in the diagnosis. Small lesions may have been removed in their entirety during the biopsy while larger lesions may have had only a small portion removed, thereby, necessitating additional surgery. In addition, it may have been necessary to place sutures (stitches) at the biopsy site which will need to be removed at a future appointment. In any case, the patient is required to return to the office to review the results of the biopsy procedure and discuss the need for future treatment if that is deemed necessary.

Is There Anything I Can Do?

The simple answer is yes! Because the mouth is readily accessible, changes indicative of oral cancer or a pathological process can easily be detected in their early stages. But remember, we only find something if we are looking for it.

Performing a self examination regularly will help in the early recognition of disease. To complete a self examination of the mouth use a bright light and mirror (in front of the bathroom mirror is a good place) and perform the following:

Remove any dentures (if you have them).

Look at and feel the inside of the lips and the front of the gums around the teeth.

Tilt your head back to look at and feel the roof of your mouth.

Pull out the cheeks to see the insides and also see the back gums.

Stick your tongue out and look at all of its surfaces.

Feel for lumps or enlarged lymph nodes (glands) on both sides of the neck and under the lower jaw.

What Are The Risk Factors For Oral Cancer?

oral cancer rick checkboxes

Overall, cancer involving the head and neck region represents only about 5% of all malignancies (cancers) reported each year. According to the American Cancer Society, research has determined a number of factors that may contribute to the development of oral cancer.

By far the most common is the chronic use of tobacco and alcohol. Other factors include poor oral hygiene, irritation caused by ill fitting dentures and rough surfaces on teeth, poor nutrition and/or any combination of the above. Despite what you may hear to the contrary, studies have shown that the death rate from oral cancer is about four times greater for cigarette smokers than that for nonsmokers.

While it is widely held in the medical conormal conditions of the body. It follows logically then that oral pathology is the branch of the dental profession that deals with diseases and abnormal conditions of the oral cavity (mouth) as well as the adjacent areas of the head and neck. These maladies can range from a simple disease process such as an infected tooth and benign growth, to life threatening malignancy such as oral cancer.

Unlike some other less conspicuous locations in the body, we benefit significantly from the fact that the mouth is so easily accessible. This allows abnormalities to be easily detected in their early stage of development. To add to this good fortune, the majority of the disease processes in this region are benign, non-cancerous and are remedied by either medication or simple surgical procedures.

What Are The Warning Signs of Oral Pathology?

Reddish patches (erythroplasia)
Whitish patches (leukoplakia)
A sore that fails to heal and bleeds easily
A lump or thickening on the skin lining the inside of the mouth
Chronic sore throat or hoarseness
Difficulty in chewing or swallowing

Changes of the kinds listed above may be detected on the lips, cheeks, palate, gum tissue around the teeth, tongue, face, and/or neck. Pain is not always necessary to define a pathology and, curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer. When or if any of the above abnormalities are detected, you should be thoroughly evaluated by a trained dental professional. In most cases your regular dentist will perform a routine oral examination and take x-rays at least once a year in conjunction with your customary dental care. This is an additional safeguard provided by your regular dentist that you should understand and value during your routine checks with him.

When an abnormality is discovered either by the patient, dentist or other healthcare provider, a referral is often made to an oral and maxillofacial surgeon. As you have may have already learned by visiting our web site, an oral and maxillofacial surgeon is a dental professional that has completed extensive training in oral pathology and possesses the ability to recognize, diagnose and treat various conditions involving the mouth and related areas.

In any event, the oral and maxillofacial surgeon will need to obtain a complete medical history and conduct a thorough physical examination. In addition, he may request that additional imaging (x-rays, CT scan or MRI) be taken. Imaging is a useful adjunct in the diagnosis of problems related to the teeth and jaw bones. When combined with the aforementioned information commmunity that the heat generated by smoking pipes and cigars can irritate the mouth and lead to lip cancer, chronic exposure to sunlight is also an important factor in the development of cancer of the lip.

Those at an especially high risk of contracting oral cancer are males over the age of forty who participate in a combination of heavy drinking and smoking or are users of smokeless tobacco. Keep in mind that your mouth is one of your body’s most important early warning systems. Fortunately, most of the pathological processes associated with the mouth are benign and non-cancerous. However, do not be foolish to ignore any suspicious lumps or sores. The early detection and prompt treatment of any pathology may well be the key to a complete recovery.

For any additional questions regarding the use of imaging to acquire a diagnosis and to treatment plan your maxillofacial problem, please do not hesitate to contact one of our offices or ask your doctor during your consultation visit.

The information listed above is the opinion of the doctors of Connecticut Maxillofacial Surgeons, L.L.C. and does not necessarily reflect the opinion of the specialty as a whole.

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