Cincinnati’s Top Practice for Surgical Services for Oral Pathology

Dentists do a lot more than just inspect your teeth and gums; there’s more to examining the overall health of your mouth. Dentists who perform routine cosmetic dentistry and tooth replacement procedures can deal with most common issues with oral health. But sometimes, your dentist will notice an abnormality that calls for the examination of a specialist. That’s where we come in.

As a licensed oral and maxillofacial surgeon, Dr. Puckett is well-versed in oral pathology — the diagnosis and study of the causes and effects of diseases of the mouth. He has over 20 years of experience evaluating and treating pathologies of the face, mouth and jaws.

Oral pathology may manifest itself as a lesion, ulcer or bump in the oral cavity. If your dentist notices anything of concern, a more detailed examination by a skilled oral surgeon is a must. To help determine the cause of the irregularity, maxillofacial surgeons perform biopsies to test a piece of the affected tissue before planning or performing any oral surgical procedure.

Assessment of the Pathology by an Oral Surgery Specialist

This is serious stuff — that’s why a detailed examination is necessary. Naturally, the word “biopsy” can be scary, and waiting for the results is often unnerving. That’s why we make every effort to schedule our pathology/biopsy patients quickly, so you don’t have to wait. You want answers, and we’re here to provide them.

Dr. Puckett will first review your full history of the lesion, your medical history, medications and supplements, your social history, and allergies. He will also do a complete head and neck examination.

Don’t worry. Many oral lesions are benign, and some don’t need to have a biopsy at all. If the area of concern is in your jaw, we will obtain a 3D CT scan to assist with the diagnosis and help to plan the surgery on your mouth and/or jaw.

If a biopsy is performed, we send the tissue sample to an oral pathologist who evaluates the sample and sends an official report back to our office. Oral pathology is the specialty of dentistry that deals with the nature, identification, and management of diseases affecting the mouth and jaw.

Types of Oral Pathologies and their Treatments

Oral pathologies can be congenital (present at birth), or acquired (a result of illness/injury). Whether the oral disease was brought on by genetics, illness or facial trauma, Dr. Puckett is experienced at treating oral pathologies in the pediatric, adult and geriatric populations.

Common Congenital Oral Pathologies in Pediatrics

Because you’re born with a congenital oral malady, the range of conditions and surgical interventions is wide. Congenital pathologies can occur anywhere in the mouth, whether it’s the jaw, muscles, gums, teeth, palate, lips, vascular system, etc. Some common congenital oral conditions we often treat include:

  • Orofacial clefts: This is where the palate doesn’t form correctly and/or fully, leaving a cleft in the lip and along the roof of the mouth. This is treated via maxillofacial surgerywithin days of birth. Cleft lip/palate surgeries in infants require extreme skill and precision by a maxillofacial specialist who understands the sensitive nature of performing oral surgeries on a child.
  • Malocclusion: This is a misalignment between the teeth of the two dental arches when the jaws are closed. This is by far the most common congenital oral pathology. In fact, you’d be surprised to know that virtually everyone’s jaw is somewhat “deformed”! This is often treated with orthodontia, tooth extraction and/or clear aligners, and treatment is begun as early in life as possible in order to correct the growth trajectory of the jaw and face.
  • Ankyloglossia: This condition is also known as being tongue-tied; it’s caused by an unusually short, thick lingual frenulum, which is the skin connecting the underside of the tongue to the floor of the mouth. This issue is easily remedied in infancy by a very simple mouth surgery conducted in our office under local anesthesia.


Common Acquired Oral Pathologies

Acquired oral pathologies usually result from untreated or poorly-treated past facial trauma or, more often, diseases. Some common acquired pathologies our oral surgeon commonly treats include:

  • Plaque-induced gingivitis: Gum disease is an infection caused by bacteria buildup at the gum line. The gums become red, swollen and may bleed. Plaque not removed by brushing and flossing hardens to form tartar that brushing doesn’t remove. If the disease is not too severe, we treat it with chlorhexidine rinses and fluoride toothpaste. Once the infection has progressed, antibiotics may be needed to kill the bacteria.
  • Periodontitis: This more advanced gum disease can develop when gingivitis is not treated. The gums pull away from the teeth and form pockets that harbor bacteria. The bone and connective tissues break down, and the teeth may eventually become loose and have to be pulled. Advanced periodontitis wreaks havoc on your teeth, gums and jaw, but can also increase your risks for respiratory and cardiovascular pathologies to develop. This condition often requires extensive tooth extraction and replacement, even to the point of a full mouth reconstruction.
  • Herpes simplex viruses: These can cause mouth and lip blisters and sores that tend to recur. But unless the person has a compromised immune system, recurrent infections are mild, and brought on by mental or physical stress, sun, menstrual periods, or trauma. The sores generally last 3 – 10 days; they’re very infectious, but go away without treatment.
  • Oral candidiasis (candida): This oral pathology is a fungal infection of the mouth. People who have had an organ transplant, HIV, cancer, or use corticosteroids are more prone to this problem. Other risk factors include dentures and tongue piercings. You may have candida if you have a white, cheese-like patch in your mouth that burns, is sore or irritated. We treat candida with anti-fungal drugs.


With any ulcers, lesions, tumors or cysts, cancer is always a possibility, even if it’s small. Oral cancer is a much more serious diagnosis than these other pathologies, but it can be managed with a variety of surgical and non-surgical modalities. The earlier we catch it, the better the prognosis. That’s why we recommend a full examination for any lesion that is found, including a tissue biopsy to understand what’s going on with your oral health at a cellular level. Early diagnosis and intervention is key to optimizing treatment and long-term wellness.

Prevention, Mitigation & Restoration: Protect Your Oral Health with Advanced Treatment

Wilmington Oral Surgery is a practice based in patient experience. That means providing the best available techniques in oral and maxillofacial surgery, supporting treatment with the latest technology and holistic advances in oral medicine, and fostering an environment of gentle, calm, friendly care that makes even scary situations as easy as possible on our patients. Your oral health is key to your quality of life – let Wilmington Oral Surgery help you get there.

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