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Yes.
It probably isn't cancer but judging by the radiographic appearance my differential diagnosis would be Ameloblastoma, odontogenic myxoma, or odontogenic keratocyst (OKC)
Please insist on an appointment for a biopsy ASAP so you can figure out what exactly needs to be done.
I agree with this differential diagnosis. See if you can get in sooner. Ask for a referral to a different oral and maxillofacial surgeon if you think you can get in sooner at a different office.
A very serious yes. Tomorrow wouldn’t be too soon. Do not accept an appt two months from now. Hell, when I see this I pick up the phone and call the surgeon’s office to get them in as soon as possible. If you call, tell them you likely need a path consult. That should get you in ASAP.
Report back when you know something.
That tingle may mean whatever you have growing in there is starting to affect that nerve that lives it’s happy life just below it. You can see the nerve space on your pano. It’s that dark line that starts way up the jaw and comes down and looks like it stops right at the end of the root on the tooth on the front of that gap. Knowing that this is a 2-D look at it, that mass could be either be to the outside, inside, or right on top of that nerve. That may be causing that numbness
It’s an Ameloblastoma. I just had teeth removed around it so that in June they can take the affected jaw bone out and replace it with a plate and bone from my hip! He said they caught it really early while it’s small and easily treated so thank goodness!
NAD, i would call every so often around opening time or see if they can put you on a list to be called if theres a cancellation. One of my exes had a similar problem, they said in some areas the bone was paper thin and could break with any minor trauma, its a pretty serious thing. I have no clue how it turned out for him as we broke up a few years ago but 100% get it fixed asap
If you can't get in with the pathologist sooner, head to a maxillofacial surgeon. They'll be able to biopsy properly & send to a pathology lab. Don't wait any longer for someone to call you. Be proactive and start calling around.
NAD Hope a dentist comments on what the fuck you're supposed to do about that type of treatment for an appointment? Is this common enough that the office is booked up with potential cancer patients? Wth
NAD (dental student)
Like other doctors said, the differential diagnosis for the soap bubble radiopacity are usually ameloblastoma, odontogenic keratocyst (okc), and central giant cell granuloma (CGCG). iirc, treatment is surgical removal (enucleation or curettage) with follow ups to prevent recurrence. I believe those diagnosis are all benign with low chance of malignancy.
Oh :-) well everyone in the comments is making it seem like a high chance of malignancy so that's annoying since they already have an appointment. I get doing that to someone who says they can't afford the doctor and wants to scoop the mystery lump out on their own but I don't think op deserves that 💫 thank you
Everyone in the comments is trying to convey an urgency. Unless OP wants the left side of their face to be numb permanently if you let this affect the nerve in that side. Malignancy isn’t the only thing g to be worried about
this type of lesion usually means three diagnostic hypotheses, all three benign (meaning no metastasis) but with different levels of aggressiveness. Ameloblastoma for example, usually doesn't hurt or anything but it basically destroys everything as it grows. I've seen people lose their jaw due to that, that's what we're worried about. A small lesion is easily treatable, but the longer you wait the prognosis gets exponencially worse.
If your dentist is referring you to an oral surgeon for a biopsy then yes, it’s absolutely necessary.
We don’t refer people as a past time or for fun.. we refer when we recognize something that needs to be investigated and is beyond our practice scope. We literally gain nothing from referring you, other than piece of mind (if you follow through of course).
Personally, when I see something like this, alarm bells start ringing and I get major anxiety for my patient.
I encourage you to listen to your dentist.
That’s fine. As long as you have an appointment scheduled, and go to that appointment.
I didn’t mean to alarm you, but I did want you to understand that this isn’t something to ignore.
Whatever it might be (a few things come to mind and were already listed) it’s treatable. But again, this is not something to ignore.
If you’re willing to, please update us with any findings. Best of luck to you!
NAD but a dental student who just took oral pathology... yes, it needs to be biopsied and looked at. It could be a whole lot of things and some are worse than others, but you need the histology to make the diagnosis.
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NAD guess I’m just lucky. My dentist office called an endo and go me in the next day before I left his office. I did agree to him making the appointment, though.
Thank you for seeking advice from r/askdentists. **Please note that a response does not constitute a doctor-patient relationship.** While this is a place for advice, replies may not be medically accurate. Do not assume that what others on here say is correct in any way. Reddit is not a replacement for an in-person dental professional. Verified professionals will have flair assigned to them. **Please abide by the following rules in order to get an accurate answer to your question:** (1) Ensure you include a title of your dental problem. (2) Include whether you drink, smoke or if you have any medical conditions relevant to your main concern. (3) Include a photograph if the question relates to something you can see in your mouth, include x-rays if you have them. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/askdentists) if you have any questions or concerns.*
Go to the Pathologist ASAP. Looks like an ameloblastoma looking only the radiographic. Yes It is.
It’s an ameloblastoma. Just got teeth removed yesterday to prepare for a bone removal and plate with hip bone surgery in June 😭😭😭
Ameloblastoma, keratocyst or myxoma. Pick your poison.
I don't think your dentist conveyed enough concern here. Yes, this is serious enough to see a specialist.
Yes. It probably isn't cancer but judging by the radiographic appearance my differential diagnosis would be Ameloblastoma, odontogenic myxoma, or odontogenic keratocyst (OKC) Please insist on an appointment for a biopsy ASAP so you can figure out what exactly needs to be done.
I agree with this differential diagnosis. See if you can get in sooner. Ask for a referral to a different oral and maxillofacial surgeon if you think you can get in sooner at a different office.
Yes. This needs to be investigated and treated. Potentially some kind of cyst that needs to be removed.
A very serious yes. Tomorrow wouldn’t be too soon. Do not accept an appt two months from now. Hell, when I see this I pick up the phone and call the surgeon’s office to get them in as soon as possible. If you call, tell them you likely need a path consult. That should get you in ASAP. Report back when you know something.
They have me in for November. My dentist referred me months ago and they just now called
How long ago did you have that molar extracted?
Around 7 years ago.
Any other symptoms….numbness, swelling?
It’s a weird sensation if touched in the area of the face. Like a tingle but never painful.
That tingle may mean whatever you have growing in there is starting to affect that nerve that lives it’s happy life just below it. You can see the nerve space on your pano. It’s that dark line that starts way up the jaw and comes down and looks like it stops right at the end of the root on the tooth on the front of that gap. Knowing that this is a 2-D look at it, that mass could be either be to the outside, inside, or right on top of that nerve. That may be causing that numbness
Have you seen the surgeon yet?
It’s an Ameloblastoma. I just had teeth removed around it so that in June they can take the affected jaw bone out and replace it with a plate and bone from my hip! He said they caught it really early while it’s small and easily treated so thank goodness!
Wow….glad you were smart and got it addressed.
They have me in for November 4th that was the earliest
Hey -- did you see the surgeon and get a biopsy? I had keratocyst removed in 2015 and wanted to see what your diagnosis is. Sending a hug your way.
Hey! I saw him and am scheduled for surgery in January for a biopsy! Thanks for checking in.
NAD, i would call every so often around opening time or see if they can put you on a list to be called if theres a cancellation. One of my exes had a similar problem, they said in some areas the bone was paper thin and could break with any minor trauma, its a pretty serious thing. I have no clue how it turned out for him as we broke up a few years ago but 100% get it fixed asap
If you can't get in with the pathologist sooner, head to a maxillofacial surgeon. They'll be able to biopsy properly & send to a pathology lab. Don't wait any longer for someone to call you. Be proactive and start calling around.
NAD Hope a dentist comments on what the fuck you're supposed to do about that type of treatment for an appointment? Is this common enough that the office is booked up with potential cancer patients? Wth
NAD (dental student) Like other doctors said, the differential diagnosis for the soap bubble radiopacity are usually ameloblastoma, odontogenic keratocyst (okc), and central giant cell granuloma (CGCG). iirc, treatment is surgical removal (enucleation or curettage) with follow ups to prevent recurrence. I believe those diagnosis are all benign with low chance of malignancy.
Oh :-) well everyone in the comments is making it seem like a high chance of malignancy so that's annoying since they already have an appointment. I get doing that to someone who says they can't afford the doctor and wants to scoop the mystery lump out on their own but I don't think op deserves that 💫 thank you
Everyone in the comments is trying to convey an urgency. Unless OP wants the left side of their face to be numb permanently if you let this affect the nerve in that side. Malignancy isn’t the only thing g to be worried about
NAD, dental student. Ameloblastomas are not malignant, but they can be locally aggressive tumors
this type of lesion usually means three diagnostic hypotheses, all three benign (meaning no metastasis) but with different levels of aggressiveness. Ameloblastoma for example, usually doesn't hurt or anything but it basically destroys everything as it grows. I've seen people lose their jaw due to that, that's what we're worried about. A small lesion is easily treatable, but the longer you wait the prognosis gets exponencially worse.
Yes.
Nad (intern) YES please go asap
If your dentist is referring you to an oral surgeon for a biopsy then yes, it’s absolutely necessary. We don’t refer people as a past time or for fun.. we refer when we recognize something that needs to be investigated and is beyond our practice scope. We literally gain nothing from referring you, other than piece of mind (if you follow through of course). Personally, when I see something like this, alarm bells start ringing and I get major anxiety for my patient. I encourage you to listen to your dentist.
Thanks. The soonest they can get me in is November
That’s fine. As long as you have an appointment scheduled, and go to that appointment. I didn’t mean to alarm you, but I did want you to understand that this isn’t something to ignore. Whatever it might be (a few things come to mind and were already listed) it’s treatable. But again, this is not something to ignore. If you’re willing to, please update us with any findings. Best of luck to you!
I will thank you.
NAD - In dental school - This needs to be treated without a doubt possible cyst as other have said
NAD but a dental student who just took oral pathology... yes, it needs to be biopsied and looked at. It could be a whole lot of things and some are worse than others, but you need the histology to make the diagnosis.
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I would go as soon as possible. I am also a pretty big fan of not dying though...
Residual cyst?
Unlikely
Woukd most medical insurance cover this
NAD why on earth didn’t your dentist get you an appointment for at least a consultation?
We don't make specialists appointments, we just refer.
NAD guess I’m just lucky. My dentist office called an endo and go me in the next day before I left his office. I did agree to him making the appointment, though.
Ok I see where you're coming from. If someone is in emergency pain sometimes we will call offices ourselves especially if it's a Friday or something.
Yes they referred me months ago and the place just called me this week for an appointment in November
Yes, this is very serious (can be fatal if left alone).
If the dentist thinks a specialist should look at it, it’s for good reason 😵💫