Dr looking at images of oral pathology

Building Confidence in Oral Pathology: Knowing When to Refer

Sarah Thiel

Every dental professional has patients they never forget.

About 15 years ago, I was treating a patient who suffered from Pemphigus, a painful autoimmune condition that caused significant oral discomfort. Because it was difficult for her to brush her teeth, I saw her frequently, often once a month to help keep her comfortable and maintain her oral health.

Over time, I noticed a lesion that seemed a little unusual.

At first, it was easy to assume it was related to her Pemphigus. But with each appointment, it seemed to get a little larger. Each time I brought it to the dentist's attention, the response was the same:

"It's probably associated with the Pemphigus."

Still, something didn't feel right.

After several appointments, I finally recommended that she see an oral surgeon. I wasn't certain anything serious was happening, but I knew enough to be concerned.

Then she disappeared from our practice.

About six months later, I saw her unexpectedly at Taco Bell. At first, I barely recognized her.

When I realized who she was, I walked over and asked what had happened.

She told me she had been diagnosed with Stage 4 Squamous Cell Carcinoma.

Half of her jaw had been removed.

I was heartbroken.

The following week, I spoke with the dentist. He admitted he had known about the diagnosis but hadn't shared it because he felt terrible about the outcome.

When I asked why she hadn't been referred sooner, he explained something I have never forgotten.

He had been told by specialists that if he wasn't reasonably sure something was wrong, not to send the patient. Too many referrals that turned out to be nothing meant time spent evaluating patients without reimbursement.

Whether that advice was right or wrong, it created hesitation.

And hesitation can be dangerous.

Would referring her three months earlier have changed the outcome?

I honestly don't know.

But I do know that earlier intervention generally provides more treatment options, better outcomes, and more hope.

That experience fundamentally changed how I think about oral pathology.

It also influenced why I am so excited about our upcoming Oral Pathology Series featuring Dr. Brent Martin and Dr. Brent Accurso.

These aren't speakers who simply teach oral pathology.

They are oral pathologists.

Every day, they evaluate suspicious lesions, review biopsies, diagnose disease, and help dental professionals determine what requires immediate attention and what can be safely monitored.

The goal of this series isn't to turn hygienists and dentists into oral pathologists.

The goal is confidence.

Confidence to recognize when something deserves a second look.

Confidence to document findings appropriately.

Confidence to monitor lesions effectively.

And perhaps most importantly, confidence to refer when your instincts tell you something isn't right.

One of the things attendees consistently tell us after these courses is how practical and applicable the information is.

As one attendee shared:

"I've been a hygienist for 44 years and this course had the most impact on me and my decision making than any course I have ever taken!"

Another attendee wrote:

"I previously worked in an Oral Surgery office and this course would be helpful for all staff. It shows the importance of good diagnostic quality, comparing current and prior films to note changes, and providing information such as pulp testing and tooth vitality testing on referrals."

And my personal favorite:

"Great presentation! I'm caring for a parent with advanced dementia 24/7 at this time. I doubted my sanity in signing up. But considering that she talked all the way through and I still enjoyed the presentation and had additional understanding to take away from it, that's saying something."

Those comments perfectly capture why we continue bringing Dr. Martin and Dr. Accurso back to CE Zoom.

They make complex pathology understandable, practical, and immediately useful in clinical practice.

If you've ever looked at a lesion and wondered:

"Should I be worried about this?"

"Should I monitor it?"

"Should I refer it?"

This series is for you.

Because sometimes the most important thing we can do for our patients isn't having all the answers.

It's knowing when to ask for help.

Join us for our upcoming Oral Pathology Series: $55 for both courses. They are only offered LIVE. The presenters do not allow us to record them due to the sensitivity of the cases they are presenting. 

📅 June 18, 2026 | 7:00 PM – 9:00 PM CST
📅 July 9, 2026 | 7:00 PM – 9:00 PM CST

Your patients trust you to notice what others might miss.

Let's make sure you feel confident doing exactly that.

REGISTER HERE