Oral Pathology

What Is Oral Pathology?

Oral and maxillofacial pathology is a specialty of dentistry and pathology that focuses on diseases of the mouth, jaw, and lower face, including the:

  • Bones (the maxilla and mandible)
  • Joints (temporomandibular joint)
  • Lymph nodes
  • Muscles
  • Nerves
  • Salivary glands
  • Teeth
  • Tongue

Oral pathologists are experts in researching and diagnosing diseases of the oral and maxillofacial areas. They may use microscopes, imaging like MRI and CT, and other specialized tools to examine tissue samples. They have extensive schooling and training to identify cancers, degenerative diseases, infectious diseases, immune system disorders, tumors, and more.

What Do Oral Pathologists Study?

Oral pathology is a study of diseases in, or on, the tissues of the mouth and nearby structures, including the following:

  • Cheeks
  • Face
  • Gums
  • Jawbones
  • Lips
  • Lymph tissue
  • Muscles
  • Neck
  • Palate
  • Salivary glands
  • Teeth
  • Tongue

An oral pathologist is an expert in diagnosing conditions like:

  • Benign migratory glossitis (geographic tongue)
  • Buccal mucosal fibromas
  • Candidiasis (oral thrush)
  • Canker sores (aphthous stomatitis)
  • Fungal infections
  • Herpes labialis (cold sores)
  • Oral cancers
  • Oral epithelial dysplasia
  • Oral lichen planus

What’s the Difference Between an Oral Pathologist and a Dentist?

A dentist is a doctor you’ll see for preventive dental education and care, as well as problems of the gums, teeth, and mouth. They’re specially trained to examine, diagnose, and treat many conditions. Dentists use X-ray machines, lasers, drills, and other tools for dental procedures.

If your dentist finds something abnormal, they may refer you to an oral pathologist for an examination and biopsy. An oral pathologist can study a tissue sample under a microscope when a cause can’t be identified with a visual exam or when more information is needed.

You might see an oral pathologist for issues like:

  • Chronic sore throat or hoarseness
  • Erythroplakia (reddish patches in the mouth)
  • Halitosis (bad breath)
  • Leukoplakia (white patches in the mouth)
  • Lumps of the skin or lining of the mouth
  • Mouth sores that bleed
  • Mouth sores that won’t heal
  • Problems chewing or swallowing
  • Salivary problems
  • Thickening skin in the mouth

Techniques to Identify Oral and Maxillofacial Conditions

Oral and maxillofacial pathologists use specialized techniques, tools, and processes to investigate abnormal cells. Some methods and tools they use include:

  • Stains. Chemicals or stains can be applied to tissue samples to highlight signs of disease or cell abnormalities.
  • Direct immunofluorescence. A special type of staining that helps identify autoimmune diseases.
  • Frozen section. A sample can be frozen and examined immediately if a diagnosis is needed quickly, like during surgery.
  • Immunohistochemistry. This technique uses the body’s own antibodies to help identify the interaction between the antibodies and antigens triggering the immune system.
  • Electron microscopy. A special type of microscope that uses a beam of electrons instead of light, which allows pathologists to examine cell structures not otherwise visible.
  • Flow cytometry. A technique of analyzing the identity and quantity of a type of cell or particle. Samples are suspended in fluid and passed through different light sources, lenses, and filters to generate wavelength data. Flow cytometry can measure characteristics like cell size, total DNA, and more.
  • Toluidine blue (T-Blue). A special dye that can help identify oral cancers.
  • ViziLite® Plus. A cancer-detecting exam using a special rinse and light to highlight possible problem areas.

What Do Results Look Like?

The results of a pathological examination are documented in a biopsy or pathology report, which includes information like:

  • A diagnosis
  • A description of the tissue sample
  • A microscopic description of the disease process discovered
  • Clinical information that helped support the diagnosis
  • Additional information to help determine treatment
  • If cancer is found, it may also contain information like how deep the cancer has penetrated the skin
  • Comments from the pathologist

The report is sent to the treating doctor, who will discuss the results with the patient.

Oral Pathologists

All Pathology Reference Lab pathologists perform oral pathology.