Oral Pathology

What is Oral Pathology?

Oral pathology relates to any disease that affects the mouth and associated structures such as the lips, palate, jaws, tongue and gums.

The different tissues and complex anatomy of the head and neck region make accurate diagnosis of pathology a clinical challenge and often patients are referred to a specialist Oral and Maxillofacial Surgeon to examine, investigate, diagnose and coordinate the management of the pathology.

The most serious disease of the mouth is oral cancer, and any lesions that are found to be malignant (cancerous) need to be surgically removed.

Benign (non-cancerous) lesions that are unlikely to disappear with time are also surgically removed. This includes lesions such as cysts, which are fluid filled sacs that can result in swelling, pain and infection. Cysts can also increase in size affect nearby teeth and cause destruction of the jaw bone.

How do you treat diseases of the mouth?

At the initial consultation Dr Chellappah will take a thorough history including risk factors, perform an oral, head and neck cancer screening examination and arrange for appropriate investigations.  

Investigations can include blood tests, biopsy of the lump or lesion under local anaesthetic and imaging such as ultrasound assessment, OPG dental x-rays, CT, MRI or PET scans.

Dr Chellappah will discuss with you the most likely diagnosis and advise the appropriate investigations to confirm the diagnosis and/or exclude cancer.

It is important for all patients to know that oral cancer is rare compared to the many benign (non-cancerous) lesions of the oral cavity. However, prompt referral is necessary because if cancer is not detected early, within weeks, then patient outcomes can be adversely affected.

Where will I have my surgery?

Depending on your condition and your personal circumstances, you may have the option of having a biopsy performed on the day of your initial consultation. This will be performed under local anaesthetic with injections to numb the teeth, gums and nearby structures so you do not feel any discomfort.

A small sample of tissue is taken and sent to the laboratory for review and microscopic analysis by a specialist Pathologist. Dr Chellappah will have the results of the biopsy within one week and will schedule an appointment for you to discuss the results and any further treatment that is required.

Definitive treatment of cancerous lesions and larger benign lesions is performed in hospital under general anaesthetic.

WHat is recovery like after my procedure?

After your procedure, Dr Chellappah will provide you with specific instructions regarding your post-operative care.  Any prescriptions for antibiotics, pain relief or mouthwash will also be given to you.

You will receive a follow-up phone call from Dr Chellappah or his staff the day after your surgery. If you remain in hospital, Dr Chellappah will continue to see you daily until you are discharged. 

Some general considerations for the period immediately after any surgery are:

• Rest at home after your surgery.

• Do not drive, engage in active exercise or operate machinery until advised.

• Take several days off from work, school or other duties as advised.

• Do not drink any alcoholic beverages whilst you are taking pain killers or antibiotics.

• Do not smoke for at least 5 days after your surgery or at all, if possible.

• Pain may be minor in some people and greater in others. Dr Chellappah will prescribe appropriate pain relief for you.

• Swelling almost always occurs after surgery and can vary from very little to severe. Most swelling takes four to five days to go down completely. Ice packs are recommended to reduce swelling and relieve pain and discomfort.

• Gums may ooze blood slightly for a day after surgery. Apply pressure over the area of bleeding by biting gently but firmly on a piece of cotton gauze. The pressure helps stop bleeding and a blood clot will form.

• A soft diet is suggested for one week after surgery. Dr Chellappah will provide you with a list of recommended foods.

A post-operative follow-up appointment is usually scheduled for 2 weeks after your procedure, unless otherwise advised.

Dr Chellappah will also provide you with an emergency contact number if you have any concerns. Do not hesitate to contact him.