Oral Pathology

Resolving Complex Issues for Healthy Smiles and Lives

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Blending Clinical Excellence with Compassionate Care

As a board-certified oral surgeon, Dr. R. Jonas Collins is an expert in the diagnosis and surgical treatment of oral and maxillofacial pathology in Waynesboro and Charlottesville VA, in addition to having a wealth of expertise in the science and art of dental implants. After receiving his Doctorate of Dental Medicine in 1993, Dr. Collins completed a four-year residency program in oral and maxillofacial surgery at St. John’s Mercy Medical Center in St. Louis, MO. He attained board certification from the American Board of Oral and Maxillofacial Surgery in 1999. Dr. Collins treat patients for oral pathology in Waynesboro, VA and at his newer state-of-the-art practice in Charlottesville, VA.

According to the Centers for Disease Control and Prevention, 47.2% of adults aged 30 years and older have some form of periodontal disease, although this increases to 70.1% in adults older than 65. Healthy gum tissue supports your teeth and jawbone while creating a barrier against bacteria. Gingivitis is the earliest stage of the disease in which plaque, a naturally-occurring film containing bacteria builds up on teeth at the gumline. This can cause swollen, red, and bleeding gums. When plaque accumulates on teeth, it hardens into tartar and releases bacterial toxins that irritate gum tissue, causing periodontal pockets to form. If left untreated, periodontal disease can cause jawbone loss, tooth mobility, and ultimately loss of teeth. Research has also shown that untreated gum disease lowers your immunity, thereby negatively impacting your overall health. Advanced periodontitis is associated with worsening symptoms in people with diabetes, respiratory disease, and heart disease and research suggests it significantly raises the risk of kidney, pancreatic, and blood cancers in men. Seeking prompt treatment from Dr. Collins can prevent more serious repercussions associated with periodontal disease. If you have gum disease, this needs to be resolved before you can get dental implants.
Oral cancer is a malignant neoplasia that can affect the tongue, lips, gums, mouth floor, hard palate, tonsils, oropharynx, and minor salivary glands. The American Cancer Society estimates 54,010 new cases of oral cavity or oropharyngeal cancer will be diagnosed in the U.S. in 2021 and about 10,850 people will die from these cancers. An estimated 90% of oral cancers are classified as squamous cell carcinoma and the prevalence is two to three times higher in men than women. The primary risk factors are tobacco and alcohol use. Secondary risk factors include poor oral hygiene, wood dust exposure, dietary deficiencies, and red and salted meat consumption. Regular oral cancer examinations performed by your oral health professional are the best method for detecting oral cancer in early stages.
Cleft lip and cleft palate are common birth defects occurring in the first few months of fetal development, affecting one in 1,600 babies in the U.S. Cleft lip occurs when the lip doesn’t fuse together, which often causes separation of the upper gum line. Cleft palate is a separation in the roof of the mouth caused by the sides of the palate not completely fusing with one another. Corrective surgery for cleft lip is typically performed by the time an infant is 12 months old, while cleft palate repair is done by 18 months old. Subsequent surgeries are typically needed during childhood to create a functional lip and palate, aid in proper speech development, reduce middle ear problems, help alleviate social problems, and ensure proper development of the child’s teeth and facial bones. Multidisciplinary teams, including an oral surgeon plays a role in delivering this surgical care.
Oral surgeons can correct a wide range of minor and major skeletal and dental irregularities with orthognathic (jaw) surgery, including the misalignment of jaws and teeth. Malocclusion is the medical term for jaws that don’t fit together correctly. This problem can be caused by a congenital defects, injuries, or the jaw not developing at the correct rate. Although most people don’t have perfectly aligned jaws, misalignment severe enough to warrant surgery isn’t common. Sometimes, braces alone can correct these problems. If not, Dr. Collins will work in close collaboration with your orthodontist to determine the most optimal procedure(s) to correct your issues. Corrective jaw surgery resolves functional problem such as chronic pain or discomfort, uneven and excessive wear on the teeth, and the inability to bite, chew, and even breathe normally. It also resolves aesthetic problems such as a lower protruding jaw (classic bulldog look) or a weak chin, dramatically improving a patient’s appearance and self-esteem.
Normal tongues vary and differ in size with increasing age. The greatest growth occurs in the first eight years after birth, with full growth ending by age 18. Macroglossia generally refers to long-term painless enlargement of the tongue and is defined by a resting tongue protruding beyond the alveolar ridge or teeth. Macroglossia is a rare anatomical abnormality and usually a sign of an underlying acquired condition, such as chronic infectious or inflammatory diseases, malignancies, and endocrine and metabolic disorders. Congenital cases are associated with Down syndrome and far rarer syndromes, idiopathic muscular hypertrophy, adenoid hyperplasia, hemangioma, and lymphangioma, among others. Macroglossia is treated with medications, surgery, radiation, and orthodontic treatment. If complications such as airway obstruction occur despite completion of nonsurgical treatment, surgery may be required. Reduction glossectomy is indicated when a patient is suffering from functional impairments including speech and swallowing difficulties, facial skeleton abnormalities, and psychological consequences. Reduction glossectomy is typically required in about 10% of cases of macroglossia. We look forward to helping you and your family achieve optimal oral health and a better quality of life with our specialized treatments.

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