Oral Pathology

oral cancer 3The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process.

The most serious of these is oral cancer.

Dr. Mueller has extensive experience in evaluating and treating abnormalities of the soft and hard tissues (Pathology) of the mouth, facial skeleton and skin of the head and neck. Abnormalities of oral tissues are often noticed by the patient, or discovered upon routine dental examination by your dentist or physician. When these abnormalities appear suspicious for possible pathology, a biopsy (surgical sampling) of the tissue may be indicated.

Biopsies are normally performed comfortably in our surgical center under local anesthesia or IV anesthesia. The biopsy specimen is then sent to a pathologist (a medical or dental specialist) for microscopic examination, and the results are usually available within a week following the procedure. Once the results are received, Dr Mueller will review them with you, and will discuss any further treatment that may be indicated.

Oral Cancer

Oral cancer screenings are very important in detecting lesions that either are, or have the potential to progress into cancerous lesions. Some may also be noticed by the patient but may be ignored, as they are usually painless.

Many doctors say, “let’s watch this for a while and see if it goes away or changes.”  Dr. Mueller is not an advocate of “watching and waiting.”  In general, if the area in question has been present for three weeks or more without resolving, a biopsy is warranted.

Lesions that may be suspicious and should be examined include:

  • Reddish patches (erythroplakia) or whitish patches (leukoplakia) in the mouth
  • A sore that fails to heal and bleeds easily
  • A lump or thickening on the skin lining the inside of the mouth
  • Chronic sore throat or hoarseness
  • Difficulty in chewing or swallowing
  • Any asymmetric colored lesion with rough texture

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Causes, incidence, and risk factors

Oral cancer most commonly involves the lips or the tongue. It may also occur on the:

  • Cheek lining
  • Floor of the mouth
  • Gums (gingiva)
  • Roof of the mouth (palate)

Most oral cancers are a type called squamous cell carcinomas. These tend to spread quickly.

Smoking and other tobacco use are linked to most cases of oral cancer. Heavy alcohol use also increases your risk for oral cancer.

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Other factors that may increase the risk for oral cancer include:

  • Chronic irritation (such as from rough teeth, dentures, or fillings)
  • Human papilloma virus (HPV) infection
  • Taking medications that weaken the immune system (immunosuppressants)
  • Poor dental and oral hygiene

Some oral cancers begin as a white plaque (leukoplakia) or as a mouth ulcer.

Men get oral cancer twice as often as women do, particularly men older than 40.

Sun exposure may cause whitish/yellow/red blotching of the lips. This may be a sign of pre-cancer. Dr. Mueller discovers many of these pre-cancers on routine head and neck exams. If left alone, they may develop into a squamous cell carcinoma. If a pre-cancer is discovered, it can be treated easily in our outpatient center. Early detection is paramount!

The Procedure

The procedure can be performed with either local anesthesia or IV anesthesia.  Dr. Mueller will either remove part of the lesion in question or recommend removing the entire lesion.  This is based on the clinical findings.  Dr. Mueller will explain his concerns and recommendations with you during your consultation.  You may have a few stitches afterwards.  The specimen is sent to the pathologist.  Dr. Mueller will see you the following week and will review your results at that time.  Based on the results, Dr. Mueller will discuss any additional treatments should they be necessary.  Recovery will take 3 – 7 days, depending on the procedure, but most people return to work within a day or two.