Sometimes, your dentist or physician will notice an abnormality in your oral cavity or jaw during an examination. He or she may recommend further evaluation from a qualified oral surgeon who is specialized in oral pathology.

Oral pathology is the diagnosis and study of the causes and effects of mouth disease. The disease may manifest itself as a lesion, ulcer or bump in the oral cavity. If your dentist notices anything of concern, a more detailed examination is a must.

Dr. Puckett has over twenty years of experience evaluating and treating pathologies (diseases) of the face and jaws. He realizes that hearing the word ‘biopsy’ mentioned instills fear of the worst for many patients. At Wilmington Oral Surgery, we make every effort to schedule pathology / biopsy patients in an expedient fashion, due to the elevated level of concern and worry.

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

Don’t worry. Many oral lesions are benign and may not need to have a biopsy. If the area of concern is in your jaw, we will obtain a 3-D X-ray to assist with the diagnosis and help to plan the surgery.

If a biopsy is performed, we will send the tissue to an Oral Pathologist who will evaluate the biopsy and send 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 (you are born with them), or acquired (they happen later in life).

Common Congenital Pathologies

  • A malocclusion is a misalignment between the teeth of the two dental arches when the jaws are closed. This is often treated with orthodontia, tooth extraction or clear aligners.
  • Ankyloglossia, also known as tongue-tie, is caused by an unusually short, thick lingual frenulum, the skin connecting the underside of the tongue to the floor of the mouth. It is easily remedied by a very simple surgery conducted in our offices under local anesthesia.

Common Acquired Pathologies

  • Plaque-induced gingivitis (gum disease) is an infection caused by bacteria. 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 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 tooth may eventually become loose and have to be pulled.
  • Herpes simplex viruses, which can cause mouth and lip blisters and sores, tend to recur. But unless the person has a compromised immune system, recurrent infections are mild, brought on by mental or physical stress, sun, menstrual periods or trauma. The sores generally last 3 – 10 days, are very infectious, but go away without treatment.
  • Oral candidiasis, or candida, is a fungal infection of the mouth. People who have had a transplant, HIV, cancer or use corticosteroids are more prone to this problem. Other risk factors include dentures and tongue piercing You may have candida if you have a white cheese-like patch in your mouth that burns, or is sore or irritating. We treat candida with anti-fungal drugs.

Oral cancer is a more serious diagnosis, but it can be managed with a variety of surgical and non-surgical modalities. The earlier we catch it, the better the prognosis. That is why we recommend a full examination for any lesion that is found.