Association of Oral and Maxillofacial Surgeons of India

Surgical Pathology

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.

Jaw Cyst & Tumor Pathology

Etiology & Risk Analysis

Oral Cancer & Major Risk Factors

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.

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.

Clinical Oral Cancer Presentation

Key Risk Factors for Oral Cancer:

Tobacco Use (Primary Cause)

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. Heavy smokers who use tobacco for a long time are most at risk, with the hazard rising exponentially when combined with heavy alcohol consumption.

Alcohol Consumption

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 consumed, escalating even more drastically if the person both drinks alcohol and uses tobacco products.

Alcohol Risk Factor

Sun Exposure & Head/Neck History

Sun Exposure: Cancer of the lip can be caused by exposure to the sun. Using a lotion or lip balm with sunscreen can reduce the risk, and wearing a wide-brimmed hat blocks harmful ultraviolet rays.

Personal History: People who previously had head and neck cancer are at an increased risk of developing another primary oral cancer.

Betel Nut & Pan Masala

Pan Masala is a slow poison that causes painful disease in continuous users. Chewing betel quid with or without tobacco or areca nut with or without tobacco are predominant causes of oral cancer and Oral Submucous Fibrosis (OSMF). This precancerous lesion has a high rate of malignant transformation, is debilitating, and has no known cure. Early symptoms present as a white painful formation inside the mouth.

Pan Masala & Betel Quid Hazards

Clinical Screening

Symptoms of Oral Cancer & Early Detection

The Importance of Early Detection

Your regular checkup is an opportune time for your doctor to check your entire mouth for signs of cancer. Routine checkups can detect the early stages of oral cancer or precancerous conditions before they progress.

Routine Oral Cancer Screening

Anyone with persistent symptoms should see a specialist promptly. Most often, symptoms do not mean cancer - infections or other benign problems can cause similar signs.

High-Risk Mucosal Patches

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

White Patches

Leukoplakia

Most common lesion; sometimes undergoes malignant transformation.

Mixed Patches

Erythroleukoplakia

Significantly more likely than white patches to become malignant.

Red Patches

Erythroplakia

Bright, smooth areas that very frequently become malignant.

Other Symptoms of Oral Cancer

A sore on your lip or mouth that won't heal

Burning sensation inside the mouth

Intolerance to hot and spicy foods

Unexplained bleeding in your mouth

Loose teeth without periodontal cause

Difficulty or pain when swallowing

Difficulty or pain wearing dentures

A palpable lump or swelling in your neck

Treatment Protocol

Diagnosis, Surgical Management & Reconstructive Care

Diagnosis of Oral Cancer

If symptoms suggest oral cancer, the doctor thoroughly checks your mouth and throat for red or white patches, lumps, swelling, or other irregularities. Examination includes screening the roof of the mouth, back of the throat, floor of the mouth, insides of cheeks and lips, and cervical lymph nodes.

If an abnormal growth is identified, a small tissue sample is removed (a biopsy), performed under local or general anesthesia. A pathologist examines the specimen microscopically to confirm cancer cells. A biopsy is the only definitive method to differentiate malignant from benign growths.

Management of Oral Cancers

Surgical excision (removal) of the tumor is recommended when the lesion is operable and surgery will result in a functionally satisfactory outcome. Radiation therapy, with or without chemotherapy, is used in conjunction with surgery or as definitive treatment for inoperable tumors.

Reconstructive surgery using bone grafts and microvascular free flaps (such as the radial forearm flap) rebuilds structures resected during tumor excision, ensuring acceptable cosmetic and functional rehabilitation.

Surgeries for Oral Cancers Include:

Maxillectomy

Surgical resection of the upper jaw (maxilla)

Mandibulectomy

Removal of the lower jaw or mandibular segment

Glossectomy

Resection of the tongue (partial, hemi, or total)

Radical Neck Dissection

Cervical lymph node basin clearance

Composite Resections

Combined resections (e.g., glossectomy & laryngectomy)

Nutritional Support

Feeding tube placement to sustain hydration & diet

Following definitive treatment, comprehensive rehabilitation is often essential to restore mastication, swallowing, facial movement, and speech, with speech and language pathologists actively involved. Chemotherapy is utilized in combination with radiation therapy to potentiate treatment efficacy or as palliative care.

Survival Outcomes & Multidisciplinary Oncology Care

Survival rates for Stage 1 oral cancers reach 90%, underscoring the critical importance of early detection and routine clinical screening. Overall 5-year survival is approximately 50% across all initial stages. Treatment is coordinated through an integrated multidisciplinary team comprising oral & maxillofacial surgeons, surgical oncologists, radiation oncologists, medical oncologists, prosthodontists, speech therapists, clinical nutritionists, and psychologists.

Oral Pathology & Oncology