Oral Pathology at Mount Sinai

The multidisciplinary Oral and Maxillofacial Surgery team at Mount Sinai includes a dedicated oral pathologist, Dr. Naomi Ramer, who specializes in evaluating specimens of the jawbone and oral cavity. She reviews slides of biopsies taken both at Mount Sinai and institutions outside the hospital for patients of all ages. These biopsies may be taken by oral and maxillofacial surgeons to diagnose certain conditions, such as cysts, salivary gland tumors, oral cancer and disorders related to the jawbone, lip and palate. Specimens range from common cysts after root canal or from impacted wisdom teeth to complex tumors on the tongue or in the throat.

About Oral Cysts and Lesions of the Oral Cavity and Jaw

A wide variety of benign and malignant pathologic lesions can occur in the oral cavity and jaw. These lesions can be present on - or within - the intraoral soft and hard tissues. Specifically, they may invade or occur in the following tissue areas:

• Soft tissue
  • Mucosa
  • Salivary glands
  • Muscle
  • Nerves
  • Lymph tissue
• Hard tissue
  • Bone (maxilla and mandible)
  • Teeth

The source of pathologic lesions is often unknown; however some can arise from infections, trauma, environmental insults, tobacco, alcohol, genetics, and congenital causes.

How Does an Oral Pathologist Benefit Patients?

Mount Sinai is one of the few hospitals offering the specialized service of oral pathology. Patient benefits of this specialty are threefold:

• Our pathologist possesses more than 20 years of experience focusing solely on the evaluation of oral and jaw conditions to yield the most accurate diagnosis.
• She collaborates closely with our oral and maxillofacial surgeons to help determine the best treatment possible for each patient.
• When appropriate, she interacts directly with the patient, frequently advising them on how to treat oral reactions from prescription drugs (i.e. in the case of an autoimmune disease), how to care for oral cavity blisters affecting the gums, and how to heal a palate burn.

“If a patient has an oral lesion, he or she needs a pathologist with a thorough understanding of the teeth and jawbone to determine whether it is related to the teeth or not,” says Dr. Ramer. “Oral pathology requires extensive training in blisters, a burning mouth, herpes, prescription drug reactions and oral manifestations of systemic diseases, such as Crohn’s disease.” Without this specialized skillset, a misdiagnosis is more likely to occur.

Oral Pathology Diagnosis and Treatment Planning

Once our oral pathologist determines the diagnosis, advanced imaging tests, such as a CT scan or MRI may be necessary. After all the required diagnostic information has been gathered, our oral and maxillofacial surgeons develop the optimal treatment plan for each patient. Our surgeons then relay the recommended treatment plan to the patient and answer any questions at that time and at any point throughout the course of their care.