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Jaw Tumors and Cysts

Oral and maxillofacial surgeons diagnose and treat the full spectrum of cysts and tumors in the oral cavity which includes benign as well as malignant tumors.

Because the mouth and jaws are composed of many different types of tissues, such as bone, muscle, glands and mucosa they are more susceptible to developing abnormal growths than other parts of the body.

Although tumors and cysts of the jaw can affect anyone, a number of risk factors have been identified that increase a person's chance of developing them. The main risk factors are tobacco and alcohol use. Others include poor oral hygiene, irritation caused by ill-fitting dentures, rough surfaces on teeth and poor nutrition.

Oral Cancer

Oral cancer can develop in any part of the oral cavity. Most oral cancers begin in the tongue and in the floor of the mouth.

When oral cancer spreads (metastasizes), it usually travels through the lymphatic system. Cancer cells that enter the lymphatic system are carried along by lymph, a clear, watery fluid. The cancer cells often appear first in nearby lymph nodes in the neck.

Who's at risk?

This disease is not contagious. You cannot "catch" oral cancer from another person. Research has shown that people with certain risk factors are more likely than others to develop oral cancer. A risk factor is anything that increases your chance of developing a disease.

The following are risk factors for Oral Cancer:

Tobacco: Tobacco use accounts for most oral cancers. Smoking cigarettes, cigars, or pipes; using chewing tobacco; and dipping snuff are all linked to oral cancer. The use of other tobacco products (such as bidis and kreteks) may also increase the risk of oral cancer. Heavy smokers who use tobacco for a long time are most at risk. The risk is even higher for tobacco users who drink alcohol heavily.

Alcohol: People who drink alcohol are more likely to develop oral cancer than people who don't drink. The risk increases with the amount of alcohol that a person consumes. The risk increases even more if the person both drinks alcohol and uses tobacco.


Sun: Cancer of the lip can be caused by exposure to the sun. Using a lotion or lip balm that has a sunscreen can reduce the risk. Wearing a hat with a brim can also block the sun's harmful

A personal history of Head and Neck Cancer: People who had head and neck cancer are at increased risk of developing another primary oral cancer.

Beetlenut and Pan Masala: Pan Masala is a slow poison that will cause painful death to people who are using it continuously. Chewing of betel quid with or without tobacco or areca nut with or without tobacco are the predominant causes of oral cancer. In most areas, betel quid consists of a mixture of areca nut, In most areas, betel quid consists of a mixture of areca nut, slaked lime and several other ingredients according to taste, wrapped in a betel leaf. These products have been strongly implicated in the recent increase in the incidence of oral sub mucous fibrosis. This precancerous lesion, which has a high rate of malignant transformation, is extremely debilitating and has no known cure. The use of tobacco with lime, betel quid with tobacco, betel quid without tobacco and areca nut have been classified as carcinogenic to humans. The early symptom of oral cancer caused by Pan Masala products is a white painful formation inside the mouth which if not diagnosed or treated in initial stages may develop into cancer.

What are the symptoms of Oral Cancer?

Early Detection

Your regular checkup is a good time for your doctor to check your entire mouth for signs of cancer. Regular checkups can detect the early stages of oral cancer or conditions that may lead to oral cancer.

Symptoms

Common symptoms of oral cancer include:

Patches inside your mouth or on your lips that are white, a mixture of red and white, or red:

  • White patches (leukoplakia) are the most common. White patches sometimes become malignant.
  • Mixed red and white patches (erythroleukoplakia) are more likely than white patches to become malignant.
  • Red patches (erythroplakia) are brightly colored, smooth areas that often become malignant.

Other Symptoms include:

  • A sore on your lip or in your mouth that won't heal
  • Burning sensation in mouth
  • Intolerance to hot and spicy food
  • Bleeding in your mouth
  • Loose teeth
  • Difficulty or pain when swallowing
  • Difficulty wearing dentures
  • A lump in your neck


Anyone with these symptoms should see a doctor so that any problem can be diagnosed and treated as early as possible. Most often, these symptoms do not mean cancer. An infection or another problem can cause the same symptoms.

Diagnosis of Oral Cancer

If you have symptoms that suggest oral cancer, the doctor checks your mouth and throat for red or white patches, lumps, swelling, or other problems. The examination of the patient includes proper screening of the roof of the mouth, back of the throat, and insides of the cheeks and lips. The floor of your mouth and lymph nodes in your neck also are checked.

If an examination shows an abnormal growth, a small sample of tissue may be removed. Removing tissue to look for cancer cells is called a biopsy. Usually, a biopsy is done with local anesthesia. Sometimes, it is done under general anesthesia. A pathologist then looks at the tissue under a microscope to check for cancer cells. A biopsy is t he only sure way to know if the abnormal tissue is a malignant or benign growth.

Management of Oral Cancers

Surgical excision (removal) of the tumor is usually recommended if the tumor is small enough, and if surgery is likely to result in a functionally satisfactory result. Radiation therapy with or without chemotherapy is often used in conjunction with surgery, or as the definitive radical treatment, especially if the tumour is inoperable.

Surgeries for Oral Cancers include

  • Maxillectomy
  • Mandibulectomy (removal of the mandible or lower jaw or part of it)
  • Glossectomy (tongue removal, can be total,hemi or partial)
  • Radical neck dissection
  • Combinational e.g. glossectomy and laryngectomy done together.
  • Feeding tube to sustain nutrition.

Owing to the vital nature of the structures in the head and neck area, surgery for larger cancers is technically demanding. Reconstructive surgery may be required to give an acceptable cosmetic and functional result. Bone grafts and surgical flaps such as the radial forearm flap are used to help rebuild the structures removed during excision of the cancer. An oral prosthesis may also be required. Most oral cancer patients depend on a feeding tube for their hydration and nutrition. Some will also get a port for the chemo to be delivered.

Survival rates for oral cancer depend on the precise site, and the stage of the cancer at diagnosis. Overall, survival is around 50% at five years when all stages of initial diagnosis are considered. Survival rates for stage 1 cancers are 90%, hence the emphasis on early detection to increase survival outcome for patients.

Following treatment, rehabilitation may be necessary to improve movement, chewing, swallowing, and speech. Speech and language pathologists may be involved at this stage.

Chemotherapy is useful in oral cancers when used in combination with other treatment modalities such as radiation therapy. It is not used alone as a monotherapy. When cure is unlikely it can also be used to extend life and can be considered palliative but not curative care.

Treatment of oral cancer will usually be by a multidisciplinary team, with treatment professionals from the realms of radiation, surgery, chemotherapy, nutrition, maxillofacial surgeons, and even psychology all possibly involved with diagnosis, treatment, rehabilitation, and patient care.