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. Oral mucosa changes can be detected on the lips, cheeks, palate, and 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. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer.

Perform a Self-Exam Monthly

Historically the death rate associated with this cancer is particularly high, not because it is hard to detect or diagnose, but because the cancer is often discovered late in its development.

The National Cancer Institute’s SEER data indicate that when oral cancer is detected early, survival outcomes are improved and treatment-related health problems are reduced. Among healthcare professionals, your family dentist or oral and maxillofacial surgeon is in the best position to detect oral cancer during your routine dental examinations. If you are at high risk for oral cancer, you should see your general dentist or oral and maxillofacial surgeon for an annual exam.

In addition, oral and maxillofacial surgeons recommend that everyone perform an oral cancer self-exam each month. 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

Examples of Oral Pathology

These are examples of conditions that would require an exam and follow-up from an oral surgeon.

Thin White Patches in the Mouth

Thin White Patches in the Mouth

Non-Healing Ulcers

Non-Healing Ulcers

Thick White Patches in the Mouth

Thick White Patches in the Mouth

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Early Detection and Treatment Provide a Better Chance for Cure

When performing an oral cancer self-examination, look for the following:

  • white patches of the oral tissues — leukoplakia
  • red patches — erythroplakia
  • red and white patches — erythroleukoplakia
  • a sore that fails to heal and bleeds easily
  • an abnormal lump or thickening of the tissues of the mouth
  • chronic sore throat or hoarseness
  • difficulty in chewing or swallowing
  • a mass or lump in the neck

See your oral and maxillofacial surgeon if you have any of these signs. If the oral and maxillofacial surgeon agrees that something looks suspicious, a biopsy may be recommended. A biopsy involves the removal of a piece of the suspicious tissue, which is then sent to a pathology laboratory for a microscopic examination that will accurately diagnose the problem. The biopsy report not only helps establish a diagnosis, but also enables the doctor to develop a specific plan of treatment.

A Word About Oral Care

Keep in mind that your mouth is one of your body’s most important early warning systems. Don’t ignore any suspicious lumps or sores. Should you discover something, make an appointment for a prompt examination. Early treatment may well be the key to complete recovery.