Focus on: Oral Pathology

Source: www.dentistrytoday.com Author: Ashley Clark, DDS Ashley Clark, DDS, discusses the specialized field of oral pathology—from what an oral pathologist does, to how to become one, and when to refer your patients to one. Q: First, what is an oral pathologist? A: An oral pathologist is a job description that is difficult to define, but we all have one thing in common: We are trained in microscopy to diagnose oral, skin, and jaw lesions. That is the most essential part of the profession that binds us all. We are also trained in clinical oral pathology—how to identify and manage oral diseases. Usually, oral pathologists work in academic institutions. This means we must do a combination of teaching, service, and research. After a decade in academia, I have chosen a transition to private practice, which is a bit rare for our profession. I spend my mornings driving around the city picking up biopsy specimens, then sign-in for cases that I receive from across the country. I also serve on a tumor board with my colleagues specializing in otolaryngology, radiology, speech therapy, prosthodontics, etc. Finally, I will provide about 70 continuing education courses/lectures this year (ranging from one to 16 hours long), which is more than normal. However, teaching is my favorite thing to do, so I tend to keep my schedule packed. Q: When should someone refer to an oral pathologist? A: If you are lucky enough to have an oral pathologist (or an oral medicine specialist) in your area, the [...]

Decoding the oral leukoplakia/oral cancer link

Source: www.drbicuspid.com Author: DrBicuspid Staff Is there a direct relationship between oral leukoplakia and tobacco and alcohol consumption? Do all oral leukoplakias lead to oral squamous cell carcinoma (OSCC)? Is it possible to detect premalignant oral leukoplakia? These are some of the questions a recent literature review in Oral Diseases attempted to answer (January 11, 2013). A team of researchers from Italy, Spain, the U.K., and the U.S. did a literary search of Medline/PubMed, Embase, and Best Evidence from January 1966 to June 2012. Search terms included leukoplakia, oral leukoplakia, preneoplastic oral, precancerous oral, oral precancerous, oral dysplasia, oral mucosal lesion, proliferative verrucous leukoplakia, multifocal leukoplakias, tobacco, and alcohol. The searches were designed to help the study authors address four key questions: 1.Do tobacco and alcohol cause oral leukoplakias? 2.What percentage of oral leukoplakias evolve into OSCC? 3.Can practitioners distinguish between premalignant and innocent oral leukoplakias? 4.Is proliferative verrucous leukoplakia (PVL) a specific entity or just a form of multifocal leukoplakia? For the purposes of this study, the term oral leukoplakia was used to recognize "predominantly white plaques of questionable risk, having excluded (other) known diseases or disorders that carry no increased risk of cancer." Tobacco, alcohol, and oral leukoplakia Although oral leukoplakia is generally considered one of the primary clinical precursors of OSCC, "the role of alcohol and smoking in this disorder has never been thoroughly assessed," the researchers wrote. "Existing evidence suggests that tobacco and alcohol could be associated with at least a subset of [oral leukoplakia]." It [...]

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