Oral Pathology

There are wide range of diseases that affect the hard and soft tissues of the head and neck region. Head and neck pathology can include both malignant and benign diseases. They can be treated surgically and non-surgically. Many of these conditions can have a significant effect on a person’s well being. Oral and maxillofacial surgeons are well trained in the diagnosis and treatment of oral pathology. They received specialized training to treat these lesions both surgically and with medical treatment. They are also often involved in the secondary surgical procedures after the pathologic lesion has been treated. There can be a significant defect after removing the tumour. With their extensive knowledge in head and neck anatomy and dental occlusion, they are able to carry out the reconstruction procedures to restore the patient’s functions. The surgeons at Pacific Coast Oral and Maxillofacial Solutions are also consultants for the Fraser Valley Cancer Agency. They treat many cancer patients and work closely with the oncology doctors to provide treatment for these patients. They also have the capacity to perform the more extensive surgeries either under general anesthesia at the office setting or in the operating room at the hospital.

Early Detection

When you look in the inside of your mouth, you can see that it is lined with a special type of skin (oral mucosa) that is smooth and coral pink in color. An early warning sign of a possible pathology is change in this appearance. The most serious of these is oral cancer. These changes may be observed on the lips, cheeks, palate, tongue, and gum tissue around the teeth. The following may be warning signs of the beginning of a pathologic process or cancerous growth.

  • white patches (leukoplakia) and/or reddish patches (erythroplakia) in the mouth
  • a sore or ulcer that fails to heal or bleeds easily
  • a lump on the lining of the inside of the mouth
  • thickening of the tissues inside the mouth
  • a swelling growing from the gums
  • difficulty chewing or swallowing
  • chronic sore throat or hoarseness

We recommend a monthly self-examination performed to screen for oral cancer. Keep in mind that your mouth can be one of your body’s most important warning systems. Do not ignore suspicious lumps or sores. Please contact us so we may help.

Other sign and symptoms

Other sign and symptoms of a pathology in the mouth may include but are not limited to:

  • facial swelling
  • altered sensation
  • bleeding
  • loose teeth
  • changes in bite
  • lumps and bumps

 

Other pathologic processes can occur in your jaws. These include cysts and tumours that are often asymptomatic until they have damaged adjacent structures such as your teeth and your bone. A panoramic xray may be needed to evaluate the presence and extent of these lesions. These cysts and tumours are often related to impacted teeth such as your wisdom tooth and are termed odontogenic (tooth-related). If these pathologies are not evaluated and treated promptly, there can be significant damage to your teeth such as loosening, destruction of bone causing a fracture, or nerve problems. They can readily grow in size and can affect a significant portion of your jaw bone. We also have the state-of-the-art 3D cone beam CT machine to further evaluate the lesion and plan the surgery accordingly.

Reconstruction

After surgery to remove the tumour or cyst, there is often a significant defect of the hard tissue (bone) or soft tissue (gums or mucosa) and possible loss of teeth. Therefore, many patients require secondary reconstruction to regain what was lost. Our oral and maxillofacial surgeons are able to perform the complex bone grafting surgeries and soft tissue augmentation to reconstruct the defect so that you may receive implants or dentures in the future.

 

VELSCOPE

The VELscope is a powerful tool available for assisting in the discovery of oral abnormalities. The VELscope’s distinctive blue-spectrum light causes the soft tissues of the mouth to naturally fluoresce. Healthy tissues fluoresce in distinctive patterns — patterns that are visibly disrupted by trauma or disease. Using the VELscope, a wide variety of oral abnormalities can be discovered — often before they’re visible to the unassisted eye.

Discovering soft tissue abnormalities is particularly important in the fight against oral cancer. Because the VELscope Vx assists in early detection, cancer can be caught before it has time to spread, potentially saving lives through less invasive, more effective treatment.

BIOPSY

A consultation appointment is required for all cases involving a pathology. During the consultation, the oral surgeon will conduct a thorough head, neck, and intraoral examination and take necessary imaging studies if required. Our surgeon will give you a list of differential diagnosis of what the pathology may be and expected course of treatment. Often, before definitive surgery can be performed, we need to find out what the pathology is and this is called the biopsy procedure. It may involve taking a piece of the tissue and sending it off to the oral biopsy service and we will know the results in about 7-14 days. It is a simple procedure performed in the office setting.

Oral Cancer

Because the mouth is a region where changes can be easily seen, oral cancer can be detected in its early stages. Performing a self examination regularly will help in the early recognition and detection of oral cancer, and increase the chance for cure.

Factors That May Cause Cancer

Research has identified a number of factors that may contribute to the development of oral cancer.The most common are the use of tobacco and alcohol. Others include poor oral hygiene, irritation caused by ill-fitting dentures and rough surfaces on teeth, poor nutrition, some chronic infections and combinations of these factors.

Studies have shown that the death rate from oral cancer is about four times higher for cigarette smokers than for nonsmokers. It is also widely believed in the medical field that the heat generated by smoking pipes and cigars irritates the mouth and can lead to lip cancer.

Those at an especially high risk of developing oral cancer are over 40 years of age, heavy drinkers and smokers, or users of smokeless tobacco, including snuff.

Perform a Self-Exam Monthly

Oral and maxillofacial surgeons recommend that everyone perform an oral cancer self-exam each month. If you are at high risk for oral cancer — smoker, consumer of alcohol, user of smokeless tobacco, or snuff — you should see your general dentist or oral and maxillofacial surgeon for an annual exam.

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

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.

 

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