Oral Pathology

At Kansas City Facial & Oral Surgery, Drs. Lohr and Hollabaugh treat a wide range of pathology, which may include lesions inside the mouth, skin lesions, cysts or tumors of the jaw or facial bones, as well as managing osteonecrosis. If you think you have any suspicions lumps, bumps, swellings, or any of the problems described below, please contact us so we can address your problem.


The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer.

The following can be signs at the beginning of a pathological process or cancerous growth:

  • Reddish patches (erythroplakia) or whitish patches (leukoplakia) in the mouth
  • A sore that fails to heal and bleeds easily
  • A lump or thickening on the skin lining the inside of the mouth
  • Chronic sore throat or hoarseness and/or difficulty in chewing or swallowing

These changes can be detected on the lips, cheeks, palate, and gum tissue around the teeth, tongue, face, and/or neck. Pain does not always occur with pathology, and curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer.

We would recommend performing an oral cancer self-examination monthly. Remember that your mouth is one of your body’s most important warning systems. Do not ignore suspicious lumps or sores. Please contact us so we can assist you with any questions or concerns. 


A variety of cysts or tumors may arise in the bones or soft tissues of the head and neck region. As oral & maxillofacial surgeons, Drs. Lohr and Hollabaugh specialize in the diagnosis, removal and reconstruction of cysts or tumors in the head and neck. Cysts are fluid-filled spaces that slowly expand with time as the fluid in these spaces increases. Tumors are solid masses of tissue that are growing abnormally. Both cysts and tumors may cause the following symptoms:

  • Expansion in your jaws
  • Changes in your bite
  • Loosening teeth
  • New facial asymmetry
  • Nodules under the skin
  • An area of tissue with recurrent swelling and drainage

Depending on the type of cyst or tumor, some may grow very rapidly while others grow slowly. Often these lesions are found by your general dentist on routine imaging and can be treated while they are smaller. Early diagnosis is important because most of these lesions will continue to grow in size until they are removed surgically. Please contact us to assist you with any questions or concern.


Osteonecrosis or MRONJ (medication-related osteonecrosis of the jaws) is a well-known side effect of bisphosphonates and other medications that may be used to treat osteoporosis or cancer. These medications may result in exposed, painful bone, usually following a dental procedure such as a tooth extraction. 

Although these medications may be excellent at managing osteoporosis or cancer, one side effect that may occur is osteonecrosis. Osteonecrosis means “dead bone”. Whenever a tooth is extracted, dental surgery is performed, or trauma is sustained when eating or brushing, your body starts a response to heal the bone and soft tissue in your mouth. These medications interrupt that normal healing process, resulting in dead bone. A procedure to remove the dead bone may be required to eliminate the pain and symptoms involved in osteonecrosis.

Patients who are at risk may have taken the following medications:

  • Zometa® (Zolendronate)
  • Fosamax® (Alendronate)
  • Prolia® or Xgeva® (Denosumab)
  • Aredia® (Pamidronate)
  • Boniva® (Ibandronate)
  • Sutent® (Sunitinib)
  • Avastin® (Bevacizumab)
  • and several others

Patients who have had any of these medications in IV form for cancer therapy have approximately a 5% risk of developing osteonecrosis following an incident such as a tooth extraction. Patients who had taken IV forms of these medications for osteoporosis have approximately a 1% change of developing osteonecrosis. Patients who have taken oral forms of these medications for osteoporosis have approximately a 0.1% change of developing osteonecrosis. 

For patients who have taken these medications, have had dental surgery, and now notice exposed bone in your mouth, you may have osteonecrosis. Osteonecrosis may cause the following symptoms: 

  • Exposed bone in the mouth 
  • Jaw pain
  • Swelling or drainage
  • A bad smell
  • Changes in your bite

Depending on the severity of osteonecrosis, a variety of treatment options are available to treat the exposed bone and pain associated with osteonecrosis. If you are experiencing these symptoms, contact our office today for an evaluation with Drs. Lohr or Hollabaugh.