Types of benign jaw cyst or tumors

• • Benign Jaw Cysts—This is a fluid filled sac or pouch. They are labeled odontogenic, if they develop from tooth or dental tissue. Non-odontogenic means they develop from other tissue.
    • Periapical cyst-most common. It forms after a dental injury that resulted in inflammation.
    • Dentigerous cyst—this is the second most common odontogenic cyst. It can form very slowly, usually in the back molars that have not erupted yet. It can also form near the upper teeth.
    • Odontogenic keratocyst—this cyst also can form close to the molars, are slow growing and can be hereditary.

• Benign Jaw Tumors

• • Odontoma—this is the most common odontogenic tumor
    • Compound type-forms in the lower jaw and appear on x-ray as tiny tooth particles that will need to be removed
    • Complex type—usually form in the upper jaw. They have dental make-up, but they appear to be a mass on x-ray. They can keep other teeth from erupting.
  • Centralgiant cell granuloma—this is the most common non-odontogenic benign jaw tumor. It can form in the upper jaw but usually forms in the front lower jaw. It can cause pain and swelling if it grows rapidly. Teeth can be shifted from the pressure of the tumor.
  • Ameloblastoma—This slow growing odontogenic tumor is usually benign but can become malignant eventually. It grows in the back of the lower jaw. There can be dental injury or even structural changes to the jaw if the tumor grows too large.
  • Odontogenic myxoma (myxofibroma)—this slow growing tumor can cause damage to teeth and jaw as it grows

Any growth in your mouth should be evaluated by your doctor. You may discover a cyst or tumor from a routine x-ray during your dental appointment. When these cysts or tumors are small, there may not be any symptoms. But as they grow, you may experience:

• Mouth pain
• Jaw pain
• Swelling
• Lump 
• Loose teeth
• A change in your bite

If you experience any of these symptoms, see your doctor. You will most likely have an exam and testing (x-ray, CT scan, MRI). You will also need a biopsy to determine if the cyst/tumor is benign or malignant. This will help your doctor to plan the best treatment for you.

Management and Treatment of Benign Cysts and Tumors

Surgery—most patients will need surgery to remove cysts and tumors. If the growth is quite large, then the surgery will be more extensive. Affected teeth may have to be removed. Parts of the jaw may also have to be removed. 

• Mandibulectomy-this is the removal of parts of the lower jaw
• Maxillectomy-this is the removal of all or part of the upper jaw.

Oral maxillofacial surgeons are experts in these types of cases. Even though the diagnosis is benign, the surgery can be complex. Additional treatments could include:

• Reconstructive surgery-reconstructing the jaw with bone from the hip or leg may be needed. Our surgeons at OMHNA are experts with these procedures. 
• Dental implants—there are many options for dental implants when teeth need to be removed.
• Nerve repair—may be necessary either during or after surgery.
• Nutrition and Speech therapy-these additional specialties can be very helpful to return the patient to optimum healing.

In general, there are key differences between how benign tumors and malignant tumors react. 

Types of Jaw Cancer

Let’s review the types of jaw cancers. The names of cancer will describe the type of tissue where the cancer cells began. These will include carcinomas (involving epithelial tissue, which covers organs throughout the body), sarcomas (involving connective tissue like bone, fat, muscle, etc) and carcinosarcomas (both epithelial and connective tissue). 

Squamous cells are a type of epithelial cell and when there is an abnormal overgrowth of these cells, it leads to squamous cell carcinoma (SCC). Over 90% of oral cancer is attributed to SCC.

Most common types of jaw cancer.

• • Ameloblastic carcinoma—This tumor can form in the cells that will become your tooth enamel. They can appear in the back of the lower jaw near the molars. This is an aggressive cancer with the potential for metastasis (spreading). It is, however, a rare tumor.

• Odontogenic Carcinomas—These tumors are developed in the tissue that forms the teeth.

• • • Clear cell odontogenic carcinoma—This is another rare and aggressive tumor occurring in the back of the mandible. The cells appear clear under the microscope.
    • Ghost cell odontogenic carcinoma—Also rare and aggressive tumor occurring in the maxilla. Under the microscope, these cells have lost their nuclei.

• Osteosarcoma—This is the most common type of bone cancer usually affecting the longer bones in your arms or legs. Osteosarcoma in the jaw is rare but can occur. The survival rate is better, and it has a lower risk of metastasis.

• Metastatic disease—When a tumor is discovered in the oral cavity or jawbone, there is a possibility that it has spread from another area of the body. Metastatic lesions in the oral cavity are very uncommon. When they do occur, the primary sites are the breast, lung and kidney. The breast is more common to spread metastatic tumors to the jawbone. 

Remember, any symptoms involving your oral cavity or jaw including pain or any lumps should be checked by your doctor. Jaw cancer is rare but we at OMHNA are here for you. Whether you are looking for an initial appointment or a second opinion, Please contact us to make an appointment for a consultation with one of our OMHNA providers.

Common Symptoms of Jaw Cancer

Initially, you may not have any symptoms. As the tumor enlarges, you may see a lump or bump, usually on your lower jaw but it can also be on the upper jaw. The size of the tumor can cause symptoms like:

• Persistent pain in the jaw, face or teeth
• Swelling or noticeable lump in jaw (could be painless)
• Sores in the mouth that don’t heal
• Bleeding in the mouth
• Red or white patches in the mouth
• Difficulty swallowing
• Difficulty opening and closing your mouth
• Loose teeth
• Bite feels different
• Ear pain or pressure
• Fever
• Bad breath

Causes and Risk Factors

When cells grow abnormally and are out of control, it leads to cancer. Doctors continue to research this phenomenon. Sometimes a benign cyst or tumor will turn into cancer. Having a benign cyst or tumor increases the risk of malignancy. Other risk factors are:

• Tobacco use—this is the biggest risk factor. Even second hand smoke is a factor.
• Alcohol use—this is a major risk factor for head and neck cancers. Excessive alcohol and smoking together makes you 30 times more apt to develop oral cancer.
• HPV infection—data shows a huge rise in oral cancers related to HPV infections.
• Family history—similar to other diseases, having a close family relative with oral cancer can increase your cancer risk.
• Age—people over age 55 have an increased risk of jaw cancer
• Sex—males also have an increased risk of jaw cancer.
• Betel nut chewing—these arca palm nuts are found in parts of Asia and are used as a stimulant.

How Jaw Cancer Is Diagnosed

You could be the first to report symptoms to your general dentist. Dentists can also see the first signs of jaw cancer during a routine mouth cancer check.

At this point, seeing an oral maxillofacial surgeon is vital. Our OMHNA surgeons have undergone extensive training in the removal and reconstruction of jaw cancers.  With both medical and dental degrees, our OMHNA head and neck cancer team is well versed in the maxillofacial reconstruction of complex cancer patients.

Patients with malignant conditions will be presented before a multidisciplinary tumor board for discussion and consensus. Depending on the diagnosis, treatment options will be discussed including surgical and non-surgical options.