Oral pathology is a specialty of dentistry that focuses on the diagnosis and treatment of oral diseases, including oral cancer. Pathologists are involved in all areas of disease management including research, diagnosis, examination and treatment.
Role of the Oral Pathologist
When patients have a suspicious growth or condition of the mouth, it's essential to determine the cause. Symptoms such as lesions can be indicative of more serious problems down the road. To ensure accurate diagnosis and speedy care, we will enlist the expertise of an oral pathologist, an oral disease specialist.
Oral pathologists can help diagnose examine and diagnose oral conditions - both malignant and benign. Oral pathologists deal with conditions such as:
- Oral cancer
- Salivary problems
- Canker sores
- Fungal infections
- Herpes of the mouth
- Bad breath
Because many people do not realize they have oral cancer, a diagnosis may not be made until the problem has become more advanced, making treatment more difficult. With early detection of oral cancer and pre-cancerous oral conditions there is a higher probability of cure. Regular dental examinations are an invaluable part of early cancer detection and treatment.
Oral cancer often appears unnoticed in the mouth as a tiny white or red spot or a sore.
Other signs to watch out for include:
- A sore that bleeds easily or does not heal
- Red or white patches
- A change in color of any parts of the mouth
- A lump, thickening, rough spot, crust or small eroded area
- Pain, tenderness, or numbness anywhere in the mouth or on the lips
- Difficulty chewing, swallowing, speaking or moving the jaw or tongue
- Sore throat or hoarseness
- A change in the way the teeth fit together
Oral Evaluation / Oral Cancer Screening
An oral exam is your best defense against dental problems, and it's the best opportunity to detect oral diseases. While there is may be no way to prevent cancer, early detection is essential in successfully treating the disease. Regular oral cancer screenings can help spot any abnormalities or changes before symptoms appear.
As dental specialists, we perform various cancer screening tests to reduce the potential damage of these diseases. Oral cancer screenings can include visual examination, biopsies and more. These tests can be successful in detecting early indicators of cancer that increase the effectiveness of treatment.
All patients should be screened for oral cancer at least once a year, especially those at a higher risk of developing the disease. Patients at a higher risk include those who:
- Are over the age of 40
- Consume excess amounts of alcohol
- Have a history of oral cancer
- Have an oral HPV infection
Treatment for oral cancer can be effective as long as the disease is detected early. In fact, more than 90 percent of cases are treated successfully when oral cancer is found at its earliest stage.
Cancer Screening Technologies
Modern oral pathology provides some cutting-edge tools for diagnosing oral diseases.
Here are two of those vital technologies:
Toluidine blue: Also knows as "T-Blue," toluidine blue is a dye that helps identify potential oral cancers. During this "chair side" procedure, the dye is swabbed onto suspicious lesions. The reaction of the lesion to the dye helps determine whether or not we a biopsy should be performed.
ViziLite® Plus: ViziLite Plus is an oral cancer screening exam that detects early signs of the disease through a simple procedure. During the screening, the patient first rinses with a special solution. A light is shined in the mouth to illuminate potential problem areas. ViziLite Plus uses a specially designed light source to highlight any abnormalities within the mouth and make detection of oral cancer easier.
When a growth or sore, of a questionable nature, is detected in the mouth a biopsy is often required. A biopsy is a diagnostic test involving the removal of a tissue sample and examining it under a microscope. This test is used to identify abnormal cells and screen for cancer and other issues. An oral biopsy will take one of two forms:
Incisional oral biopsy: An incisional biopsy is performed to remove part of a larger mass to be sampled and screened. This will be used to determine if the mass is malignant or benign.
Excisional oral biopsy: An excisional biopsy is a biopsy where the entire lump or suspicious growth is removed rather than only a part of it. Excisional biopsies are usually performed when the lump is small.
Salivary Gland Tumors
The salivary glands are found in and around the mouth and throat. These glands secrete saliva near the upper teeth, from under the tongue through the floor of the mouth. Many other minor salivary glands are located in the lips, inner cheeks and throat. In some patients, a rare salivary gland tumor may occur.
These tumors can be either malignant or benign, and they are often removed with surgical means. Common symptoms of salivary gland tumors include pain, numbness, a lump or fluid draining from the ear.
Oral Pathology of Benign Conditions
While the diagnosis and treatment of oral cancers represents a large part of oral pathology, it's certainly not the only part. There are a host of non-cancerous irregularities and conditions that oral pathology can address.
Here are a few common oral lesions:
Cold sores: also known as "fever blisters", cold sores are among the most common oral lesions patients experience. The sores are caused by the herpes simplex virus and are manifested as small blisters on the lip. The virus can be passed from person to person, and while there is no cure, treatment often includes the use of creams, ointments or pills.
Canker sores: are small lesions that form at the base of the gums or the soft tissues of the mouth. They can cause pain as well as difficulty with eating and speaking. Unlike cold sores, canker sores are not contagious. While the exact cause of canker sores remains unknown, several factors have been associated with their occurrence, including oral injury, allergic reactions and emotional stress. Most canker sores are oval shaped, measure less than half an inch in diameter and heal within two weeks.
Oral thrush: also known as candidiasis, oral thrush is a yeast infection that develops in the mouth, causing white patches that become red and sore if irritated. This condition is common in babies and in older adults due to the weaker immune system that both of these groups possess. This condition occurs when small amounts of candida fungus develop within the mouth, digestive tract or skin and then grows uncontrollably, causing a fungal infection.
Oral Problems Associated with Certain Medications
Prescription medication can contribute to some oral conditions. Below are a few oral issues that have been linked to certain medications:
Osteonecrosis of the jaw: also known as avascular necrosis, this occurs when the blood supply to a specific bone is lost, causing the bone tissue to die and collapse. This condition may develop as a result of previous trauma, such as a displaced fracture. Medications known as bisphosphonates have also been known to contribute to osteonecrosis of the jaw. Bisphosphonates are sometimes used in the treatment of certain cancers.
Dry mouth: also known as xerostomia, dry mouth is characterized by an insufficient amount of saliva. Saliva, which is crucial to your oral health and function, serves many purposes by moistening and lubricating the mouth, promoting digestion and killing certain bacteria. There are a great number of medications that can cause dry mouth. These include certain antidepressants, antihistamines, anti-nausea drugs and more.
Soft tissue sores: some medications cause the gums and soft tissue of your mouth to become inflamed or develop sores. These medications include some oral contraceptives and certain blood pressure medications.