Our Board-certified Oral and Maxillofacial Surgeons use oral pathology to diagnose and treat mouth lesions
The mouth, or oral cavity, is lined by mucosa that is smooth and pink in color. Any change in the lining or mucosa such as a growth, ulceration or development of a white or red patch may be a sign to an underlying disease process. Many times these lesions are treated with medications in the same way we would treat an affected region of our skin. A growth or abnormality of the oral cavity that does not respond to medication or resolve in ten to fourteen days should be further evaluated.
A lesion or growth that is present for more than ten to fourteen days is generally biopsied. A biopsy is a surgical procedure in which a section or the entire growth is removed depending on the size, location and nature of the growth. Growths in the oral cavity are typically benign in nature. A malignant lesion, or oral cancer, is rare in the general population; however, due to the innocuous appearance of some oral cancer, all suspicious lesions should be biopsied.
Most biopsies are performed in the office using only a local anesthetic. For those patients who prefer, a light sedation or general anesthesia can be administered. In many cases a laser can be used to simplify the surgical procedure and eliminate the need for sutures. Following removal of the lesion the specimen or biopsy is sent to an oral pathologist for a final diagnosis. The diagnosis would dictate the need for possible further treatment.
Why a Biopsy?
Biopsies are actually simple procedures, involving the removal of oral tissue for examination by a pathologist. And although the word ‘biopsy’ may cause anxiety due to its inherent link to cancer evaluation, you need not jump to conclusions: the majority of biopsies do not result in a cancer diagnosis. There are a number of reasons why your dentist could refer you to our surgeons for an oral biopsy. First, of all, you may have a lesion in your mouth that he or she cannot identify. Or, you may have a lesion that hasn’t healed in over two weeks, or one that has grown larger over time. Biopsies are also done to identify the cause of any thick, white lesions rising above your normal oral tissue, or to investigate any lumps below the skin surface. Furthermore, biopsies are indicated when a person drinks or smokes heavily and also has suspicious areas of varying texture inside their mouth. And finally, some medical conditions can make a person more susceptible to intra-oral lesions, which require investigation.
First of all, your surgeon will use a local anesthetic to numb the area to be sampled. Then, he may perform an excisional biopsy, or an incisional biopsy. Excisional biopsies involve removal of the entire lesion or lump, together with some normal tissue. Incisional biopsies require only taking a bit of the tissue, along with some normal tissue; these are typically the type of biopsy done for larger lesion areas.
Once removed, we submit the tissues to a pathologist for microscopic evaluation. The pathologist will perform certain tests on the tissue to determine what kind of activity is taking place, and then will provide results to our office within a week or less. Most of the time, biopsy results tell us that the tissue is benign, not cancerous. Instead, the lesion may commonly be a salivary growth, harmless cyst, fibroma, neuroma, or papilloma. In such cases, your dentist will advise you as to the best treatment.