BCOH Oral Pathology

Oral cancer screenings are routinely performed by our board-certified Boston dentists during dental exams and cleanings. We check the face, neck, lips, tongue, throat, cheek tissues and gums for any irregularities.

The soft tissue of the mouth is lined with mucosa, a special type of skin that should appear smooth in texture and pink in color. Any alteration of the color or texture of mucosa may signal the beginning of a pathologic process. The most serious of these pathologic changes is oral cancer, but there are also many other common pathologic problems.

What is oral cancer?

Oral cancer is a general term used when referring to any type of cancer affecting the tongue, jaw, and lower cheek area.

What are the common types of oral pathologic problems?

• Geographic tongue: A condition where the tongue is missing papillae (small bumps) in different areas and a map-like appearance can develop. This condition is usually seen as red well-defined areas on or around the sides of the tongue. The red patches may come and go for hours to months at a time and cause increased sensitivity to certain substances.
• Median palatal cyst: This cyst is of developmental origin and is essentially a fluid filled skin sac. It usually appears in the middle of the palate and may cause substantial discomfort.
• Hairy tongue: An overgrowth of bacteria or a yeast infection in the mouth which can cause the tongue to appear hairy and black. This condition is usually a result of poor oral hygiene, chronic or extensive use of antibiotics or radiation treatments to the head or neck. It is often also seen in HIV positive patients and those who are intravenous drug users.

What does an oral cancer screening involve?

During the course of regular check-ups or comprehensive initial exams (for new patients), the dentist or hygienist will thoroughly inspect the soft tissue of the mouth and take note of any changes. Screening is painless and only takes a few minutes. The dentist or hygienist will use a laser light to assess the soft tissue for cell changes that might be indicative of oral cancer. If there are cell changes present, the dentist will take a biopsy of the affected area and send it away to be analyzed by laboratory specialists. When definitive results are obtained, a course of treatment can be planned.

What does the treatment of pathological diseases involve?

In the majority of cases, the pathological changes experienced in the oral
region are uncomfortable and disfiguring, but not life-threatening. However, oral cancer is on the rise (especially among men) and the chances of survival are around 80% if an immediate diagnosis is made.

Since it is impossible for the dentist to decisively diagnose a pathological disease without taking a biopsy of the affected area, seeking immediate treatment when changes are first noticed is critically important. After a biopsy, your dentist will be able to determine an appropriate course of treatment based on your diagnosis. If the biopsy indicates that oral cancer is present, an excision (removal) will generally be performed.

For less serious problems, there are several treatment options available, such as:

• Antibiotics: In the case of a bacterial infection or persistent soreness, the dentist may prescribe a dose of antibiotics to return the mucosa to its natural state. This will alleviate soreness and discomfort.
• Diluted hydrogen peroxide: When poor oral hygiene is causing changes to the soft tissue, the dentist may prescribe a diluted hydrogen peroxide mouthwash. This will kill more bacteria than regular mouthwash and improve bad breath.
• Oral surgery: If the patient has cysts or abnormal non-cancerous growths, the dentist may decide to completely remove them. This can improve a patient’s comfort level, alleviate breathing problems and make speech substantially easier depending on the location of the cyst.

If you are experiencing any pain or symptoms that cause you concern, we encourage you to contact our office immediately to schedule an appointment.