Oral and maxillofacial pathology
Oral and maxillofacial pathology refers to the diseases of the mouth ("oral cavity" or "stoma"), jaws ("maxillae" or "gnath") and related structures such as salivary glands, temporomandibular joints, facial muscles and perioral skin (the skin around the mouth).
The key to any diagnosis is thorough medical, dental, social and psychological history as well as assessing certain lifestyle risk factors that may be involved in disease processes.
[5] It is sometimes the case that a diagnosis and treatment regime are possible to determine from history and examination, however it is good practice to compile a list of differential diagnoses.
[5] There are many types of investigations in diagnosis of oral and maxillofacial diseases, including screening tests, imaging (radiographs, CBCT, CT, MRI, ultrasound) and histopathology (biopsy).
[5] A biopsy is indicated when the patient's clinical presentation, past history or imaging studies do not allow a definitive diagnosis.
A biopsy is a surgical procedure that involves the removal of a piece of tissue sample from the living organism for the purpose of microscopic examination.
This method is preferred if the lesions are approximately 1 cm or less in diameter, clinically and seemingly benign and surgically accessible.
Large lesions which are more diffused and dispersed in nature or those which are seemed to be more clinically malignant are not conducive to total removal.
If the tumour is deeper inside the mouth or throat, the biopsy may need to be performed in an operating room.
[7] Exfoliative cytology: A suspected area is gently scraped to collect a sample of cells for examination.
[10] Macroglossia is a rare condition, categorised by tongue enlargement which will eventually create a crenated border in relation to the embrasures between the teeth.
[14] Consequences may include noisy breaths – airway obstruction in severe cases, drooling, difficulty eating, lisping speech, open bite, and protruding tongue, which may ulcerate and undergo necrosis.
[16] Stafne defect is a depression of the mandible, most commonly located on the lingual surface (the side nearest the tongue).
[citation needed] Torus mandibularis is a bony growth in the mandible along the surface nearest to the tongue.
Individuals with Sjögren syndrome have a slightly increased risk of developing non-Hodgkin lymphoma, a type of cancer.
[35] Many oral and maxillofacial pathologists in the UK are clinical academics, having undertaken a PhD either prior to or during training.
Generally, oral and maxillofacial pathologists in the UK are employed by dental or medical schools and undertake their clinical work at university hospital departments.
