Oral Pathology

If abnormal tissue occurs in the mouth, a small piece may require removal by an oral and maxillofacial surgeon and sent for testing. This is known as a biopsy and tissue samples are taken using a variety of cutting instruments. Your surgeon will send the tissue samples to a pathologist, who can determine whether the sample is non-cancerous (benign) or cancerous (malignant). The pathologist will send a report to your surgeon who will discuss the results in detail with you. A second biopsy may sometimes be required if the results of the first biopsy are not definitive.

In order to attain a comfortable fit for dentures, surgery on one or both dentoalveolar ridges may be necessary.

• Correct uneven or malformed alveolar ridges caused by excess gum tissue, fibrous tissue, scar tissue or bony outgrowths.
• Remove cysts, lesions and other tissue abnormalities.
• Remove buried teeth, retained roots and bone fragments.

In some patients, particularly the elderly, the healing capacity following surgery to assist in the fitting process of dentures, can be reduced.

These are fluid-filled sacs that can result in swelling, pain and infection. Some cysts become large and affect nearby healthy teeth. A cyst will not resolve by itself. If it starts to cause problems it is usually best to have the cyst treated before symptoms become worse.

The purpose of the treatment is to remove the cyst so that bone grows into the empty space. The two most common surgical treatments include: 

• Enucleation: This involves the cyst being opened and the lining of the cyst is removed.
• Marsupialisation: The cyst is opened and part of the lining is removed, an incision is then made so that the remainder of the lining is continuous with the tissue inside your mouth.

While your surgeon makes every attempt to save teeth involved with the cyst, one or more teeth may have to be removed depending on the size and location of the cyst.

Once your surgeon is satisfied with your recovery, you will be able to go home. A family member or friend should take you home following the surgery. The following points are important for your recovery:

• Do not drive, engage in active exercise or operate machinery 48 hours following a general anaesthetic.
• Do not brush your teeth near the area of the surgery for at least the first day following the procedure.
• You may require some time off work. You can arrange for an off-work certificate from your surgeon.
• Do not consume alcohol while taking pain relieving medication or antibiotics.
• Avoid hot food and drink. Consume soft foods, such as soups, yoghurt, jelly, or any pureed foods.
• Do not smoke for at least two weeks to facilitate healing.
• Drink plenty of fluids.
• If stitches have been used to close an incision, do not disturb them. Some stitches dissolve after a few days and other stitches may need removal by your surgeon.

Pain may be experienced as minor in some people and greater in others. Your surgeon will prescribe pain relief for you. The pain generally begins to decrease over the second day. However, some people may still require pain relief after one week. If your pain does not improve following this period of time, contact your surgeon.

If bleeding should start, apply pressure over the area by biting gently (but firmly) on a piece of cotton gauze. The bleeding should cease after a few minutes when blood clotting forms. It is important not to disturb or aggravate the area, or bleeding may recommence. The gums may ooze blood slightly for a day following surgery. Any bleeding should cease by the second day. If bleeding does not stop, contact your surgeon.

Swelling is common following surgery and can vary from minor to severe. Most swelling takes 4-5 days to subside. Swelling can be reduced by applying ice packs to the area.

Your surgeon will want to review you to check healing and discuss any results.