Many people do not think of the jaws and mouth as common areas to develop ulcers, tumors, cysts, and other abnormal growths. As a group, these abnormalities are referred to as pathology, and the mouth is a very common place for pathology to occur. In fact, in some cases, it is the mouth that can show the first signs of more extensive, farther reaching diseases.
The surgical procedure most closely related to pathology is called a biopsy. A biopsy is the removal of all or part of an abnormal appearing tissue. Not all abnormal appearing tissue needs a biopsy, though. Some cases can be treated with medicine(s) and / or careful observation. Frequently these cases revert to a normal state, all on their own, and may never need any surgery.
Frequently, though, areas that appear abnormal on x-ray or to the naked eye need a biopsy. Equal in importance to a good biopsy in these cases, is to have a well trained doctor inspect the tissue, under a microscope, to give the diagnosis of the abnormality. Doctors that specialize in this microscopic inspection are called pathologists. Within that specialty is the sub-specialty called oral pathology. Oral pathologists only deal with abnormal tissue in the mouth, jaw, and facial region and they have highly specialized training.
It just so happens that a wide variety of uncommon, abnormal growths can arise in and around the mouth and jaws. This is because the mouth is a very dynamic region, for a prolonged period of life, with growth, development, and tooth eruption occurring well into the twenties. Additionally, the mouth is the intersection where the respiratory and digestive tracts meet, as well as where many glands are located. Due to this anatomical mix, pathology can arise in and around the mouth from a variety of different tissue types. Because of this, oral pathologists can be extremely valuable in diagnosing some of the more difficult, rare, and complex pathologies that can occur.
During their residencies, oral and maxillofacial surgeons get extensive training on the pathology that can occur in and around the mouth. They are well versed on the diagnosis, non-surgical management, and surgical treatment of the array of pathologies that can occur. In fact, a very large portion of an oral and maxillofacial surgeon’s board certification is based on their abilities to manage oral and maxillofacial pathology. Both Board Certified Surgeons at Bedford Associates in Oral and Maxillofacial Surgery understand the importance of involving oral pathologists in necessary cases, and they routinely call on oral pathologists in the management of pathology. Whether it be a viral infection, a lump in the gums, a bubble in the lip, a cyst in the jawbone, or a growth suspicious for cancer, our surgeons are confident that they can manage the pathology properly, accurately, and with appropriate expedience.
In some cases, a small biopsy, taking only part of the abnormal appearing tissue, is done. This is done to get an accurate diagnosis, prior to properly planning the next, larger surgery. Although this “double surgery” can be frustrating to patients for a variety of reasons, it is occasionally the proper way to address the case. To do otherwise would be improper treatment of the problem. Although we always try to eliminate excess surgical steps, multiple surgeries are sometimes unavoidable.
Cancer arising anew in the jawbones is very uncommon, but there are other destructive growths that occur in the jawbones. Although these other growths are not cancer, they can be very destructive and can even have a tendency to recur. When they recur, they are still not cancer, but they continue their destructive march through the jawbone. Since many of these growths are not preventable, the best case scenario is to diagnose them as early as possible. Aside from attending regular dental visits and having periodic dental x-rays, early diagnosis is troublesome because few of these growths have any symptoms until they are quite large. Unfortunately these types of growths require removal of large sections of the jawbone, frequently including teeth. These sizable resections of the jawbone are in an effort to be certain that all of the abnormal tissue has been removed and the chances of recurrence are minimized.
Patients who need to undergo these destructive jaw resections still want to have their teeth replaced, therefore their jawbone rebuilt. Not only are the surgeons at Associates in Oral and Maxillofacial Surgery well trained in the curative, resection operations, but they can also rebuild the jawbones with bone grafts and replace the missing teeth with implants. There are many procedures and materials that can be used in this rebuilding process, some of which are better suited for certain cases, and some of which that can be used immediately, at the same operation that the resection is performed. Our surgeons are well versed in these different options and are able to counsel their patients accordingly.