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Oral Pathology

All areas of the body may form pathological conditions; the facial region and the mouth are no different. Examples of some pathological lesions include: ulcers (sores), areas of pigmentation, lumps and bumps of the gums and cheek, and swellings of the jaws.

Biopsy

Luckily, most of these lesions are benign but may still require further treatment to resolve. Dr. Nickel or Dr. Steinberg may recommend a biopsy in order to be able to tell what is causing the problem. A biopsy is a minor surgical procedure, during which a small sample of tissue is surgically removed. This can usually be done under local anesthesia although some patients may prefer to have some IV sedation. The specimen is then sent to a pathologist, a specialist who looks at the tissue under a microscope to help make a diagnosis. Once the diagnosis is established, treatment can be more specifically directed for that particular entity.

Jaw Cysts and Tumors

Some swellings of the jaws are due to cysts and tumors. Cysts are fluid filled sacs of pathologic tissue. Tumors are solid growths. Many of these develop in the jaws from tissue that helped to form the teeth during their developmental stage. Remnants of this tissue can "overgrow" to form cysts and tumors.

These lesions can range from a small size to a very large size. Again, luckily most jaw cysts and tumors are benign. Treatment depends on what the diagnosis is and the size and location of the cyst or tumor. Both Dr. Nickel and Dr. Steinberg have extensive experience in treating these types of problems.

After removal of a larger cyst or tumor, Dr. Nickel and Dr. Steinberg are able to reconstruct the area involved so that missing bone structure and any lost teeth may be replaced. Our goal is to restore normal facial form and function.

Infection

Some other swellings around the jaws are caused by infections. Infections can be small and localized to one tooth or be large like an abscess involving a large area around the jaw.

Infections are usually caused by teeth that have cavities (dental caries), broken or fractured teeth. Some infections are caused by gum disease (periodontal disease).

In general, treatment will involve addressing the source of the infection, by either doing root canal treatment, or extraction of the infected tooth. Additionally, treatment of periodontal disease is usually required to treat gum infections. When an abscess (a collection of pus) is present, drainage may also be needed at the same time as treating the infected tooth. Dr. Nickel and Dr. Steinberg are very experienced in treating abscesses and infections.

Diseases of the oral tissues

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

  • Reddish patches (erythroplasia) or whitish patches (leukoplakia) 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

These changes can be detected on the lips, cheeks, palate, gum tissue around the teeth, tongue, face and/or neck. Pain does not always occur with pathology, and curiously, is not often associated with oral cancer.

Some of these lesions can be diagnosed by examination and some may need a biopsy.

Do not ignore suspicious lumps or sores. Please contact us so we may help.

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