Oral Pathology

An oral exam is routinely performed by the dentist during the course of an initial comprehensive exam and regular check-up.  An oral cancer exam refers to the identification and management of diseases pertaining to the maxillofacial and oral regions.

The soft tissue of the mouth is normally lined with mucosa, which is a special type of skin that should appear smooth in texture and pink in color.  Any alteration of the color or texture of the mucosa may signal the beginning of a pathological process.  These changes may occur on the face, neck and areas of the mouth (e.g., gums, tongue, lips, etc.).  The most serious of these pathology changes (which may or may not be painful) is oral cancer, but there are also many other common pathology problems.  If your dentist finds any areas that look suspicious you will be referred to Dr. Eisner.

Our office specializes in the treatment of oral pathology.  In some cases you are able to have the procedure done with our dental laser to expedite the recovery time.

Geographic Tongue – Also known as Benign Migratory Glossitis or Erythema Migrans, is a condition where the tongue is missing papillae (small bumps) in different areas, and a map-like appearance can develop.  This condition is usually seen as red well defined areas on or around the sides of the tongue.  The red patched (which can look like an unsightly rash) may come and go from hours to months at a time and cause increased sensitivity to certain substances.

Median Palatal Cyst – This cyst is of developmental origin and is essentially a fluid filled skin sac.  Is usually appears in the middle of the palate and may cause substantial discomfort.

Hairy Tongue – An overgrowth of bacteria or a yeast infection in the mouth which can cause the tongue to appear hairy and black.  This condition is usually a result of poor hygiene, chronic or extensive use of antibiotics, or radiation treatments to the head or neck.  It is often also seen in HIV positive patients and  who are intravenous drug users.  Hairy Tongue may or may not require treatment.

 

TREATMENT OF PATHOLOGICAL DISEASE

In the majority of cases, the pathological changes experienced in the oral region are uncomfortable and disfiguring,, but not life threatening.  However, oral cancer is on the rise (especially amongst men)  and the chances of survival are around 80% if an immediate diagnosis is made.

Oral cancer is a general term used when referring to any type of cancer affecting the tongue, jaw and lower cheek area.  Since it is impossible for the dentist to decisively diagnose a pathological disease without taking a biopsy sample of the affected area, seeking immediate treatment when changes are first noticed might be a life and death decision.  For less serious problems, there are several options available, such as:

Antibiotics – In the case of a bacterial infection or persistent soreness, the dentist may prescribe a dose of antibiotics to return the mucosa to its natural state.  This will alleviate soreness and discomfort.

Chlorehexidine mouth rinse – When poor oral hygiene is causing changes to the soft tissue, the dentist may prescribe a Chlorehexidine mouth rinse.  This will kill more bacteria than regular mouthwash, assist with calculus/tartar build up as well as improving halitosis (bad breath).

Oral Surgery – If the patient has cysts or abnormal non-cancerous growths, Dr. Eisner may decide to completely remove them.  This can improve comfort levels, alleviate breathing problems and make speech substantially easier depending on the location of the cyst.

 

ORAL EXAMINATIONS BY AN ORAL SURGEON

During the course of your consultation, Dr. Eisner will thoroughly inspect the soft tissue of the mouth.  If there are abnormal cells present, you will then be scheduled for a biopsy of the affected area and it will be sent away to be analyzed by laboratory specialists.  When definite results are obtained, Dr. Eisner can decide on the best course of treatment.

 

ORAL CANCER SCREENINGS

An oral cancer screening is usually performed during a comprehensive or recall (check-up) exam.  Screening is painless and only takes a few minutes.  In some practices the dentist or hygienist will use a light to assess the soft tissue for cell changes that might be indicative of oral cancer.  If such cell changes are present, at that time you would be referred to our practice for an oral surgery consultation.

if you are experiencing any pain or symptoms that cause you concern, we encourage you to contact us today to schedule an appointment.

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 a cure.

 

FACTORS THAT MAY CAUSE CANCER

Research has intentified 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 the 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

Dr. Eisner recommends that everyone perform an oral cancer self-exam each month.  If you are at high risk for oral cancer ; smokers, consumer of alcohol, user of smokeless tobacco, or snuff, you should see your general dentist or Dr. Eisner for an annual exam.

An oral examination is performed using a bright light and a mirror.

  1. Remove any dentures
  2. Look and feel inside the lips and the front gums
  3. Tilt head back to inspect and feel the roof of your mouth
  4. Pull the cheek out to see its inside surface as well as the back of the gums
  5. Pull out you tongue and look at all if its surfaces
  6. 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

  1. White patches of the oral tissues  – leukoplakia
  2. Red patches – erythroplakia
  3. Red and white patches – reythroleukoplakia
  4. A sore that fails to heal and bleeds easily
  5. An abnormal lump or thickening of the tissues of the mouth
  6. Chronic sore throat or hoarseness
  7. Difficulty in chewing or swallowing
  8. A mass or lump in the neck
See Dr. Eisner if you have any of these signs.  If he feels that something looks suspicious, biopsy may be recommended.  A biopsy involves the removal of a piece of that 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.  Do not 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.


Ask Dr. Eisner if your treatment would benefit from the use of our state of the art laser to minimize pain and post operative