Introduction to Oral Pathology

The head and neck and especially the oral cavity have more complex anatomy than any other area of the body. Likewise it is susceptible to more pathology. The variety of pathologic conditions that occur in this area is astounding.

The types of lesions that can occur can be grouped in many ways. One important way to think about these is in 3 groups:

  • Benign
  • Benign but locally destructive
  • Malignant

90% or more of the lesions that occur in the head and neck are benign. This includes skin, deep soft tissues and bone lesions. These require only minor procedures or none at all. The other small percentage that represents the destructive, aggressive and malignant lesions, however, guides much of what we do when evaluating and treating all lesions. This is because we want to make sure the lesion is benign. We want to “rule out” one of the dangerous ones. So whenever a patient finds something like a lump, a bump, an ulcer or notice any kind of change in sensation, voice, etc., it should be investigated.

One important modality of evaluation or screening for lesions is a panoramic x-ray. Every child should have a panoramic x-ray around the age of 10 and another one around the age of 15 and then every five years thereafter. Age 6 – 18 years is a critical time in the development of the teeth and jaws.

A panoramic x-ray allows evaluation for proper eruption of teeth, for impacted teeth and to look for bone pathology in the jaws. Because the teeth form in the jaws and because of the way the face forms embryonically the jaws and facial bones are more likely to have pathologic lesions than any other bone in the body. It is important to note that most of the time lesions in the bone are not able to be felt by the patient. That is why an x-ray is important.

It is a good idea to do a self exam by looking in the mirror at your mouth. Look at all the teeth and gums and soft tissues. Anything unusual should be evaluated by your dentist or our doctors. Don’t be surprised if your dentist sends you for further evaluation by our team for something that seems innocuous. Most likely it is innocuous. In spite of this, it is not worth taking the risk of it being something harmful.

Soft Tissue Oral Pathology

The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer. The following can be signs at the beginning of a pathologic process or cancerous growth:

  • Whitish patches (leukoplakia) in the mouth
  • Reddish patches (erythroplasia) in the mouth
  • 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
  • A lump in the neck or under the chin

These changes can be detected on the lips, cheeks, palate, gum tissue around the teeth, tongue, floor of mouth, face and/or neck. Pain does not always occur with 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.

It is recommended to perform an oral cancer self-examination monthly and remember that your mouth is one of your body’s most important warning systems. Do not ignore suspicious lumps or sores or patches. Please contact us so we may help.

Hard Tissue Oral Pathology (Tumors and Cysts of the Jaws and Facial Bones)

Of all the bones in the body, the jaws are more likely to develop tumors or cysts. This is due to the complex embryonic development of the facial and jaw bones and because the teeth develop within the jaw bones.

Cysts and tumors of the jaws are not always evident on physical exam. Most cysts and tumors are diagnosed from x-rays.

Our facility is equipped with high tech radiographic imaging machines that can produce many different x-ray images to help diagnose such lesions.

It is advisable to have an orthopantomogram (Panoramic jaw x-ray) to view the jaws in the teen years and then again in each decade of life.

Our team  is specially trained to remove hard and soft tissue lesions of the face and to reconstruct the area if needed.

  • Oral CDX
  • Scalpel Biopsy
  • Oral Cancer
  • Pre-Cancer Surgical Dental Evaluation and Pre-Bisphosphonate Treatment Dental Evaluation