If you have an unexplained lesion on your lips, gums, tongue, cheeks, face, or neck, you should schedule a consultation for oral pathology. It is unlikely that the lesion is cancerous, but you should make sure that you aren’t at risk, both for the sake of your health and to ease your mind.

Dr. Israel Puterman offers patients oral pathology evaluations to determine whether a lesion poses a potential danger. As part of treatment, he will examine the lesion and, if necessary, remove a portion of it (conduct a “biopsy”) to send to an expert pathologist. The pathologist will analyze the tissue under a microscope, and Dr. Puterman will use this analysis either to recommend further treatment or refer the patient to a different specialist.

Dr. Puterman is an accomplished surgeon and periodontist who has spent years performing procedures related to oral pathology. As part of the care he provides, he focuses on patient comfort and safety, promotes an aesthetically appealing outcome should biopsy be required, and takes the time to help patients understand their options after receiving the pathology report.

The Purpose of Oral Pathology

Oral pathology is the medical field of identifying and managing diseases that affect the mouth, neck, and face.  Patients should consider an oral pathology evaluation if they notice:

  • Patches of red or white skin inside the mouth that do not improve over time.
  • A lesion, sore, or raised portion of tissue that does not go away within a couple of weeks.
  • Other unexplained changes to the skin and tissue of the mouth, neck, or face.

These same symptoms often represent completely benign and common skin issues, but further investigation will help patients know with greater certainty about the nature of a lesion. Many of the patients that Dr. Puterman sees for oral pathology visits simply want to be examined for greater peace of mind. In the few cases in which a lesion is malignant, diagnosing the cancer early can give patients more options for successful treatment.                                                                            

How Oral Pathology Works

Patients begin with a consultation at Dr. Puterman’s practice. During this appointment, Dr. Puterman will talk with you about your concerns, examine the site of the lesion, and ask you questions related to your health that may help in diagnosing the lesion. If your oral pathology care requires a biopsy, Dr. Puterman will talk with you about what you can expect during the process and give you answers to any questions you may have.

Each patient’s biopsy procedure will differ depending on the site, size, and potential risk of the lesion. These factors, along with your personal preferences, may determine whether you have the procedure with local anesthesia alone or with sedation. Either option will ensure you feel no pain during the biopsy, but you may prefer to sleep through the experience for your comfort. As a periodontal specialist, Dr. Puterman is certified to conduct both oral and IV sedation techniques.

During the procedure, Dr. Puterman will remove a portion of the lesion to send to the pathologist for analysis. Typically, the pathologist will provide a report of their findings within a few days. Dr. Puterman will call you to discuss these results and the next steps that he recommends. You will receive a digital and hard copy of the analysis so that you can have it for your records or to assist in your further treatment.

“Dr. Puterman is a wonderfully skilled dentist, but more than that, he has an excellent bedside manner. He cared about my comfort level, managed my anxiety, and did a marvelous job with my surgical procedure. I ... ”

- A.L.

“Dr. Puterman and his staff are all so wonderful! I never felt anything but relaxed at every visit. I had two different gum graft surgeries and am incredibly happy with the results. Would highly recommend this ... ”

- Allie S.

“I give Dr. Puterman and his staff 5-star rating for the following reasons: clean, relaxing environment and extremely welcoming staff; no waiting period once I stepped into the office; appointment was scheduled ... ”

- Anne H.

“Dr. Puterman performed a bone graft surgery on my daughter last year. This was a very scary surgery for a 13 year old girl. The staff made her feel comfortable and less scared. They were very patient with her ... ”

- Beatriz G. K.

Before & After Gallery

What Patients Can Expect with Oral Pathology

A biopsy is an important step in determining the risk that a lesion may pose. However, removing a sample should not be the only goal of the surgery. Lesions are often benign, so the procedure should also focus on the patient’s long-term needs, such as the aesthetics and function of the mouth.

The biopsy should leave the site as natural-looking and cosmetically appealing as possible. Dr. Puterman spends extensive time planning and sculpting this type of outcome for his oral pathology patients. He follows a very conservative approach so that biopsy procedures retain as much tissue as possible. His surgical experience and eye for aesthetic detail help him create natural-looking features at the site and its surrounding areas.

If you have an unexplained lesion on your mouth, neck, or face, please contact Dr. Puterman for an examination. Patients can schedule an appointment online or by phone at (301) 652-0939.

Case 1

A small growth is conservatively removed, allowing the gums to grow back with no evidence that anything was done.

Case 2

In a very challenging area, a large gum growth was removed and a gum graft was done at the same time in order to leave this young lady with a very natural appearance.


Case 3

In this case, a large cyst was removed by another surgeon, leaving a large defect. Dr. Puterman drastically improved the appearance and health by performing both bone and gum grafting.