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 mouth disease. He has over 20 years of experience evaluating and treating pathologies (diseases) 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. 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 X-ray 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 biopsy 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 (you are born with them), or acquired (they happen later in life).
Common Congenital Pathologies
- Malocclusion: This 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: 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 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: 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, or 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. With oral health, and all health, early diagnosis and intervention is key to optimizing treatment and long-term wellness.