A jaw bone tumor is the tumor or swelling that affects the jaw bones of the oral cavity and could be benign or malignant. A benign form of tumor usually manifests as a slow-growing swelling and is easy to miss in the initial stages. The group of people affected vary from children to adults and from male to female.
Few tumors have a predisposition for the lower jaw and a few are seen commonly in the upper jaw. Tobacco chewers and smokers are at an increased risk of jaw cancer.
In this article, we will talk about how to identify jaw bone tumors; the most common signs and symptoms and a few treatment options. Like all other tumor or cancer, jaw bone cancer also has a chance of successful treatment if it is detected in the early stages.
What is jaw bone tumor?
A tumor is an abnormal growth of new cells which doesn’t stop even after removal of stimuli. Tumors can be benign or malignant. The jaw is composed of the maxilla (the upper portion of the jaw) and mandible (the lower portion of the jaw).
Jawbone cancer is the malignant growth of cells in maxilla or mandible. There are two types of jawbone cancer as primary and secondary jaw bone cancer.
Cancer which starts from within the jawbone cells called the primary jaw bone cancer. But when the cancer cells from somewhere else in the body travel to the jawbone to give rise to a tumor, it is called secondary bone cancer.
Squamous cell carcinoma is the most common example of this form where cancer cells from the oral cavity travel to the jaw bone to form a tumor in the jaws. The primary form is quite rare.
Types of jaw bone tumor
Let’s see some types of jaw bone tumor.
Benign jaw bone tumor
Ameloblastoma – this is a slow-growing form of jaw bone tumor; mostly affects the mandible and the molar region in the mandible. Usually, the age group between 20 years and 40 years is affected. It is a slow-growing and painless tumor.
Odontoma – this is a slow-growing painless, hard mass and affects people between 10 to 20 years. The maxilla is more commonly involved. Odontomas are of two types – compound and complex.
The compound form is more common than the complex form of odontoma. Compound odontoma affects both genders equally. Usually associated with an unerupted canine.
Benign tumors even though slow growing and non-aggressive, do cause a considerable amount of bone loss and teeth loosening in the affected area.
Malignant jaw bone tumor
Primary malignancy is rare in the jaw bone. For example- Osteosarcoma which is a common and aggressive form of cancer in growing bones in other parts of the body is relatively slow growing and much less aggressive as primary jaw bone cancer.
Apart from osteosarcoma, Chondrosarcoma and Ewing’s sarcoma are the two other forms of bone cancer. Usually, jaw bones are affected by a secondary type of cancer. Most commonly squamous cell carcinoma of the floor of the mouth and gingiva invades the mandible to involve it secondarily.
Osteogenic sarcoma is the most common sarcomatous lesion which involves the mandible. Some benign tumors mimic the malignant tumor in radiographic images. In such cases, a biopsy helps with the diagnosis.
Human Papillomavirus (type 16) is a definite cause of jaw cancer. Other common risk factors of jaw cancer are smoking and tobacco use, alcohol consumption, betel nut chewing, constant mucosal irritation caused by a sharp fragment of the broken tooth.
Staging of jaw bone cancer
There are four stages of cancer. This staging is same as the one followed for other forms of cancer. The various stages are –
- In Stage 0, also referred to as carcinoma in situ, the cell growth is within the jaw bone
- In stage 1, the growth of cancerous cells involves tissues in the joint and subcutaneous tissue and muscle may not be involved
- In stage 2, the tumor involves the subcutaneous tissues, muscles, ligaments, and tendon
- In stage 3, the cancer cells spread to regional lymph nodes and affect the lymph nodes of the neck and head region
- In, stage 4 the malignant cells spread to rest of the body parts and patients in this stage usually have a poor prognosis
Identifying features of jaw bone cancer
Every disease has some symptoms which help in early detection and successful treatment of the disease. In case of jaw cancer they are:
This is one early sign of jaw cancer. Mobile teeth in a short period despite teeth looking perfectly okay and devoid of cavities. Loose teeth are caused by absorption of bone around the tooth socket by the tumor.
In such cases, the dentist usually is the first one to diagnose cancer when the patient visits with complain of loose teeth.
The tumor causes swelling as it grows and presses on the jaw, teeth, nerves and blood vessels. The swelling could be on the face or inside the mouth. If the tumor is on the inner surface of the jaw- then swelling will be inside the mouth.
In case the swelling is on the outer surface- then it will cause swelling on the face. As the tumor lump grows in size; it could cause pain.
Jaw pain is absent in the initial stages but as the tumor grows the pain starts getting worse. The patient feels constant, dull aching pain. If the tumor presses against a nerve, then there might be the pain in the head and neck region.
In later stages, as the swelling grows, the pain increases and daily activities like chewing and opening mouth become difficult since tumor disrupts the temporomandibular joint.
The patient will feel paresthesia or numbness in the jaw, and a tingling sensation might be present.
Diagnosis of jaw bone tumor
The dentist will do an oral examination and then take x-rays of the affected area. This will show the extent of spread and the amount of bone loss, but x-ray is just a preliminary test in case of cancer.
Diagnostic tests like CT scan, blood tests, and biopsy will be required to diagnose the type of tumor- whether benign or malignant. After the proper diagnosis; treatment will be chalked out accordingly.
A biopsy is removing a small piece of tissue from the lump including a bit of adjacent natural appearing area. This tissue is studied under a microscope to decide on the staging of the tumor and how far the tumor has metastasized. A biopsy is a definitive test to differentiate between benign and malignant tumor.
Treatment of jaw bone tumor
Treatment of jaw tumor usually is surgery or a combination of surgery and chemotherapy/ radiotherapy. The benign tumor causes resorption of bone and loosening of the tooth, so it is advisable to remove benign tumor via surgery.
Stage 1 and stage 2 cancer usually treated with surgery or radiotherapy. Advanced stage(3 and 4) tumor is treated with surgery and chemotherapy to kill the cells that have metastasized.
Surgery might involve removing a portion of the jaw to eliminate the tumor. In such cases, reconstructive surgery is performed to restore jaw and help restore functions of the jaw.
Some cases of a tumor( recent onset of trismus, the base of skull involved and distant metastasis) are considered inoperable and are treated palliatively (chemotherapy or radiotherapy).
Patients undergoing chemotherapy or radiotherapy become immuno-compromised and so are kept in isolation so that they don’t succumb to some other infection.
A final note on jaw bone tumor
Regular dental check-ups are mandatory to detect any lump or swelling in the early stages. Also if you notice any swelling or loose teeth/tooth, do not delay your dental visit.
Like all other cancers, jaw bone cancers if detected early have a good prognosis. Regular dental check-up or visiting the dentist the moment you notice a lump might be the difference between good prognosis and a bad prognosis.
In case of cancer cells confined within the jaw bone, single modality treatment takes away a lot of mental trauma that a patient has to undergo in the latter stages.