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Oral Health Solutions | Oral Pathology in Dallas

Oral Health Solutions

Dr. Sammar Razaq
General Dentistry

5340 Belt Line Rd
Dallas, TX 75254
(469) 547-2250
Oral Pathology
 

What is Oral Pathology?

Oral pathology is the specialty of dentistry and a discipline of pathology which focuses on the diagnosis and treatment of diseases affecting the oral and maxillofacial regions (areas of the mouth, jaw, face, head, neck and associated structures).

Diagnosis

Diagnosis is completed through radiographic, microscopic, biochemical and other in office examinations. Oral pathologists provide biopsy services for dentists and their diagnosis is based on their findings.

Some of the diseases that oral pathologists diagnose include:

  • mouth and throat cancer
  • salivary gland disorders and dry mouth conditions
  • ulcers
  • benign swellings
  • odontogenic infection

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:

  • Reddish patches (erythroplakia) 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 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.

Oral Cancer

Close to 40,000 Americans will be diagnosed with oral or pharyngeal cancer this year. It will kill roughly 1 person per hour, 24 hours per day. The survival rate at 5 years is approximately 57% -a number which has not significantly improved in decades. The death rate for oral cancer is higher than that of cancers which we hear about routinely such as cervical cancer, Hodgkin's lymphoma, laryngeal cancer, cancer of the testes, and endocrine system cancers such as thyroid, or skin cancer (malignant melanoma).

Historically the death rate associated with this cancer is particularly high not because it is hard to discover or diagnose, but due to the cancer being routinely discovered late in its development. Today, (2012) that statement is still true, as there is not a comprehensive program in the US to opportunistically screen for the disease, and without that; late stage discovery is more common. Another obstacle to early discovery (and resulting better outcomes) is the advent of a virus, HPV16, contributing more to the incidence rate of oral cancers, particularly in the posterior part of the mouth (the oropharynx, the tonsils, the base of tongue areas) which many times does not produce visible lesions or discolorations that have historically been the early warning signs of the disease process.

Often oral cancer is only discovered when the cancer has metastasized to another location, most likely the lymph nodes of the neck. Prognosis at this stage of discovery is significantly worse than when it is caught in a localized intra oral area. Besides the metastasis, at these later stages, the primary tumor has had time to invade deep into local structures. Oral cancer is particularly dangerous because in its early stages it may not be noticed by the patient, as it can frequently prosper without producing pain or symptoms they might readily recognize, and because it has a high risk of producing second, primary tumors. This means that patients’ who survive a first encounter with the disease, have up to a 20 times higher risk of developing a second cancer. This heightened risk factor can last for 5 to 10 years after the first occurrence. There are several types of oral cancers, but around 90% are squamous cell carcinomas.

Pre-cancerous oral lesions are abnormal cell growths in or around the mouth. They may become cancer. Cancerous oral lesions are life-threatening cell changes in the mouth. These lesions need to be detected early to give you a better chance for a cure.

Screening for early changes in the oral tissue can help detect cancer at an earlier stage when it can be more successfully treated.

What procedures do oral pathologists perform?

Once properly diagnosed, the oral pathologist can perform numerous procedures on patients including biopsies, radiographs, X-rays, dental imaging, and oral cancer screening.

1.Oral Cancer screening

2.Biopsy

A biopsy is often recommended following a consultation and comprehensive oral health examination. It is a simple procedure that provides tissue for the histopathologists to discover the presence, cause or extent of a disease.

A biopsy is the best way to find out if a lesion is precancerous or cancerous. During a biopsy, the area around the lesion will be numbed. A part of the lesion will then be removed, and sent to a lab to be examined under a microscope.

There are two types of biopsy:

Excisional Biopsy
This is usually only appropriate for small lumps or swellings where the biopsy aims to remove an area completely

Incisional Biopsy.
This usually involves only a small piece of an abnormal area that is removed to confirm a diagnosis.

Links

Pictures

FIBROMA-benign reactive swelling Pyostomatitis gingivans Pyogenic granuloma- benign reactive swelling Peripheral ossifying fibroma

Swelling on gingival diagnosed as squamous cell carcinoma (oral cancer) Candidia infection under a full upper denture Ulcer diagnosed as squamous cell carcinoma (oral cancer) Post inflammatory pigmentation
 
 
Dallas Dentist | Oral Pathology. Sammar Razaq is a Dallas Dentist.