Reviewed by Dr. Nicole M. Berger, DDS — South Florida Smile Spa, Pompano Beach, FL
Oral pathology in Pompano Beach at South Florida Smile Spa is the part of dentistry that deals with everything in the mouth that is not a tooth: the sores, patches, lumps, cysts and discolorations that appear on the lips, tongue, cheeks, gums, palate and jaws. Most of them are harmless and many go away on their own. A few are precancerous or cancerous, and the only reliable way to tell the difference is to look carefully, wait a defined time, and biopsy anything that does not resolve. This page explains what we examine, how a biopsy is done, what the common findings are, and what happens when the result comes back.
Quick answer
Oral pathology is the diagnosis and management of diseases of the mouth’s soft tissues and jaws: ulcers that will not heal, white or red patches, lumps and swellings, cysts seen on X-ray, and changes in the lining of the mouth. At South Florida Smile Spa in Pompano Beach, Dr. Berger examines and documents every lesion, removes any obvious cause, and rechecks it in two weeks; anything still present is biopsied, a quick procedure under local anesthetic in which a small sample is taken and sent to an oral pathology laboratory, with results in about a week. Cysts and small benign growths are removed in-office by our periodontist; cancers and precancers are referred promptly to a head and neck team, with your dental care continuing here.
What We Look For
Signs that need a pathology exam
Most are found at your routine exam, which includes an oral cancer screening every visit. Between visits, these are the reasons to call rather than wait.
- A sore or ulcer that has not healed in two weeks, especially if it is painless. Ordinary canker sores and bite injuries heal in seven to ten days.
- A white patch that does not wipe off (leukoplakia) or a flat red patch (erythroplakia), on the tongue, floor of the mouth, cheek or gum.
- A lump, bump or thickening in the lip, cheek, tongue, palate, jaw or neck, whether or not it hurts.
- A swelling or dark area on an X-ray around a root or in the jaw, which may be a cyst, a granuloma or, rarely, a tumor.
- Numbness, persistent pain, loose teeth without gum disease, or a denture that suddenly stops fitting.
The American Dental Association’s patient page on oral cancer lists the same warning signs and notes that dentists are usually the first to find them.
Common findings, and what is usually done about them
| Finding | What it usually is | Typical management |
|---|---|---|
| Canker sore (aphthous ulcer) | A painful, round ulcer with a white center and red border; not contagious; often triggered by stress, injury or certain foods | Heals in 7 to 10 days; a numbing or steroid gel for comfort; biopsied only if it lasts beyond two weeks |
| Cold sore | Herpes simplex blisters on the lip border, preceded by tingling | Antiviral cream or tablets started at the tingle stage; no biopsy needed |
| Mucocele | A soft, clear or bluish bump on the inner lip from a blocked saliva gland | Often bursts and recurs; removed in-office if it persists |
| Fibroma | A firm, smooth pink bump on the cheek or lip from chronic biting | Removed in a few minutes under local anesthetic; sent for confirmation |
| Leukoplakia | A white patch that cannot be wiped off; a small percentage are precancerous | Cause removed, rechecked at two weeks, biopsied if it persists; followed closely if dysplasia is found |
| Lichen planus | A lacy white pattern, sometimes with red sore areas, on the cheeks or gums; an immune condition | Biopsy to confirm; steroid gel for symptoms; monitored at each visit |
| Oral thrush | Creamy white patches that wipe off, leaving redness; a yeast overgrowth | Antifungal rinse or tablets; denture disinfection; check for underlying causes |
| Torus or exostosis | A hard, bony bump on the palate or inside the lower jaw, present for years | Harmless; removed only if it interferes with a denture |
| Cyst around a root or an unerupted tooth | A fluid-filled sac seen as a dark circle on X-ray, often painless | Removed by our periodontist, often with the tooth or root canal treatment; sent to the lab |
| Oral cancer or precancer | A non-healing ulcer, red or mixed patch, or firm lump, most often on the tongue or floor of the mouth | Biopsy and prompt referral to a head and neck surgeon or oncology team |
Biopsy
How an oral biopsy is done
- Documentation. The lesion is measured and photographed, any obvious cause such as a sharp tooth edge or a denture flange is removed, and you are seen again in two weeks. A lesion that has healed was an injury.
- Anesthesia. A small amount of local anesthetic numbs the spot completely. Nitrous oxide is available for anxious patients.
- Sampling. For a small lesion the whole thing is removed (an excisional biopsy), which is both diagnosis and treatment. For a larger patch a representative piece a few millimeters across is taken from the most suspicious area (an incisional biopsy). Either takes about ten minutes. A biopsy is performed here, usually by our periodontist at a surgical visit, or by direct referral to an oral surgeon when the location or urgency calls for it.
- Closing. One or two dissolving stitches, or none. Expect mild soreness for two or three days, managed with over-the-counter pain relief and a soft diet.
- The laboratory. The sample goes to an oral and maxillofacial pathology laboratory, where it is examined under the microscope by a pathologist who reads mouth tissue specifically. The written report comes back in about seven to ten days.
- The result. You are called with the result either way, and seen to go over it. Benign findings are noted in your chart and watched. Anything else is acted on that week.
Cysts and growths in the jaw
Not all pathology is on the surface. A dark, round area on an X-ray at the tip of a root is usually a granuloma or cyst caused by a dead nerve, and it resolves with root canal treatment or is removed with the tooth. A cyst around an unerupted wisdom tooth or canine, a dentigerous cyst, grows slowly and silently and can hollow out a surprising amount of bone before it is noticed, which is one reason impacted wisdom teeth are X-rayed periodically even when they do not hurt. Rarer jaw lesions, including keratocysts and benign tumors such as ameloblastoma, look similar on a plain X-ray and are distinguished by a 3D cone-beam scan and biopsy. Our periodontist removes jaw cysts in-office under local anesthetic or sedation, sends the lining to the laboratory, and the bone fills in over the following months; larger or recurrent lesions are referred to an oral and maxillofacial surgeon. Our oral surgery page covers the procedures involved.
If the result is cancer or precancer
A finding of dysplasia, meaning abnormal but not yet cancerous cells, is graded mild, moderate or severe. Mild dysplasia is often managed by removing the cause, stopping tobacco and alcohol, and re-biopsying at intervals; moderate and severe dysplasia are usually removed completely, with a laser or scalpel, and followed closely for years because they can recur. A diagnosis of oral cancer means a prompt referral, usually within days, to a head and neck surgeon and oncology team, and Dr. Berger coordinates that referral and sends your records and images with it. Your dental care does not stop. Teeth are checked and treated before radiation begins, fluoride trays are made to protect them during treatment, and dry mouth, mouth sores and jaw stiffness are managed here throughout, in contact with the medical team. Oral cancer caught at the stage a dentist usually finds it has a five-year survival rate above 80 percent, which is the whole argument for the two-week rule.
Things that look alarming and are not
Patients often arrive worried about findings that are normal variations. Small yellow dots inside the lips and cheeks are Fordyce spots, ordinary oil glands. A white line along the cheek at the level of the teeth is the linea alba, from the cheek resting against them. A map-like pattern of smooth red patches on the tongue that moves around over weeks is geographic tongue, harmless if occasionally sore. Dark patches of pigment in people with darker skin, a purple vein under the tongue, a bony bump on the palate and the ridged edge of a tongue that presses against the teeth are all normal. Dr. Berger will tell you which of these you have, note it in your chart so no one alarms you about it again, and biopsy only what warrants it.
Cost and insurance
The pathology exam is part of your routine visit, so there is no separate charge for looking. A biopsy is billed as a procedure plus the laboratory’s fee, and it is usually covered by dental insurance and often by medical insurance, since the diagnosis of a lesion is a medical service; our team checks both and tells you what to expect before it is done. Removal of a cyst or growth is billed as oral surgery and covered under those benefits. Nothing is scheduled without a written figure.
Care in Pompano Beach
Why patients choose South Florida Smile Spa for oral pathology
- Looked at every visit. The soft tissues of the mouth and the neck are examined systematically at every exam, so most lesions are found before you have noticed them.
- The two-week rule, applied. Measured, photographed, rechecked, and biopsied if still there. Nothing suspicious is left to “see how it goes.”
- Biopsy and removal in-office. Our periodontist performs biopsies and removes cysts and benign growths here, with sedation if wanted, and direct referral when a case needs a hospital team.
- A pathologist who reads mouths. Specimens go to an oral and maxillofacial pathology laboratory, and you are called with the result either way.
- Care through treatment. If the diagnosis is serious, your dental care during cancer treatment is managed here in coordination with your medical team.
Patients come to us for oral pathology and biopsies from Pompano Beach, Lighthouse Point, Deerfield Beach, Fort Lauderdale and Coconut Creek. If something in your mouth has been there more than two weeks, it is worth a look this week.
A sore, patch or lump that has not gone away
Call and we will see you this week. Most findings are harmless and you will leave reassured; the few that are not are far easier to treat found now than later.
South Florida Smile Spa · Dr. Nicole M. Berger, DDS · 572 E McNab Rd, Suite 102, Pompano Beach, FL 33060 · (954) 785-1100
Frequently Asked Questions
Does an oral biopsy hurt?
No. The area is numbed with a small amount of local anesthetic, the sample takes a few minutes, and most patients feel pressure at most. Afterward the site is sore for two or three days, like a bitten cheek, and over-the-counter pain relief and soft food are enough. Nitrous oxide is available if you are anxious.
How long do biopsy results take?
About seven to ten days. The sample is processed, stained and examined by an oral pathologist, who sends a written report. We call you with the result either way and arrange a visit to discuss it if anything needs doing. Urgent cases can be expedited.
How do I know if a mouth sore is serious?
By how long it lasts more than by how it looks. Canker sores, bite injuries and burns heal within two weeks. A sore, patch or lump that is still there after two weeks, especially if it is painless, needs to be examined, because early oral cancers are often unimpressive and do not hurt. If in doubt, call; looking takes two minutes.
What is a white patch in my mouth?
If it wipes off, usually thrush, a yeast infection treated with an antifungal. If it does not wipe off and has an obvious cause such as cheek biting, it is a callus. A white patch with no cause that persists is leukoplakia, which is biopsied because a small percentage show precancerous change. A lacy white pattern is usually lichen planus, an immune condition that is confirmed by biopsy and monitored.
Who performs biopsies at South Florida Smile Spa?
Dr. Berger examines, documents and follows every lesion. Biopsies, cyst removals and the removal of benign growths are performed in our office by our periodontist at a surgical visit, with sedation available. When a lesion is in a difficult location or needs to be seen faster than we can schedule, you are referred directly to an oral surgeon.
What is a cyst in the jaw, and does it need surgery?
Usually a fluid-filled sac from a dead tooth nerve or around an unerupted tooth, seen as a dark circle on an X-ray. Small ones at a root tip resolve with root canal treatment. Larger ones, and any around an impacted tooth, are removed and sent to the laboratory, because a few jaw lesions that look like simple cysts are more aggressive and need to be identified.
Can you tell if something is cancer just by looking?
No one can, reliably. Experienced eyes can tell what is almost certainly harmless and what is worrying, but the diagnosis is made under a microscope. That is why anything that does not resolve in two weeks is biopsied rather than guessed at, and why a biopsy result that comes back benign is good news rather than a wasted procedure.
Is a biopsy covered by insurance?
Usually, by dental insurance as an oral surgery procedure and often by medical insurance as a diagnostic service; the laboratory bills its own fee. Our team checks both before the biopsy and tells you what, if anything, you will owe. The examination itself is part of your routine visit at no extra charge.
Do you see patients from outside Pompano Beach?
Yes. Patients come for oral pathology exams and biopsies from Lighthouse Point, Deerfield Beach, Fort Lauderdale, Coconut Creek and across Broward County. The office is at 572 E McNab Rd, Suite 102, Pompano Beach. Call (954) 785-1100 or request an appointment.