Oral Pathology Insights: Dr. Bhuvan Nagpal on Understanding Oral Pathology and Its Role in Dentistry (Part 1)

Dr. Bhuvan Nagpal : I am an oral and maxillofacial pathologist by training, currently serving as the Laboratory Director and Senior Consultant Oral Pathologist at Tohana Manglam Diagnostics in Haryana. My core work centers on the diagnosis of oral and maxillofacial diseases, with a strong focus on early detection and precision diagnostics. This involves both clinical evaluation and histopathological analysis of biopsied tissue to diagnose a wide spectrum of conditions. 

I specialize in identifying oral potentially malignant disorders (OPMDs) and oral cancers including persistent ulcers, white or red mucosal patches, jaw cysts, odontogenic and non-odontogenic tumors, salivary gland lesions, and various head and neck anomalies. These conditions are evaluated both clinically and microscopically to ensure timely and accurate diagnosis.

Beyond diagnostics, I serve as the Founder and President of the Practicing Oral Pathologists and Microbiologists Association (POPMA), which is dedicated to strengthening the role of oral pathologists in India through education, collaboration, and advocacy. I am also the founder of Centre of Oral Pathology & Maxillofacial Diagnostics - COPMD, India’s first dedicated chain of oral pathology diagnostic centres, which aims to make specialized diagnostic services accessible across the country.

In essence, my role bridges the gap between clinical dentistry and diagnostic pathology delivering actionable insights that guide patient management, while promoting the visibility and necessity of oral pathology in India's healthcare system.

Dr. Bhuvan Nagpal : From the very beginning of my dental studies, I was fascinated by the “behind-the-scenes” science of diseases. While most of my peers were inclined to head straight into clinical dental practice, I found myself drawn to oral pathology. The idea of looking through a microscope and uncovering the root cause of a problem deeply intrigued me. I have always had a deep curiosity and thirst for knowledge, which pushed me to take an unconventional route after BDS and pursue an MDS in Oral Pathology. Another motivating factor was seeing the impact that early and accurate diagnosis can have on a patient’s life. I realized that as an oral pathologist, I could play a crucial role in catching oral cancers or other maxillofacial serious conditions at an early stage, essentially becoming a “detective” who helps save lives. The field also allowed me to engage in research, for example, studying patterns of oral cancer in India, which appealed to my scientific nature. 

In summary, it was the blend of intellectual challenge, the potential for significant impact on public health, and my own penchant for diagnostics that inspired me to specialize in oral pathology rather than the traditional clinical path.

Dr. Bhuvan Nagpal : The role of an oral pathologist is absolutely pivotal, yet often under-recognized, in both routine dental care and cancer prevention in India. Given the country's high incidence of oral cancer, especially due to widespread tobacco and betel nut use, early detection is not just beneficial but essential.

India faces a huge burden of oral cancer. It's one of the most common cancers nationally, with a very high mortality rate partly because 60–80% of cases are detected at advanced stages (unlike about 40% in developed countries). An oral pathologist’s expertise is key to reversing that trend. In routine dental practice, many lesions or ulcers might appear “normal” or harmless to the untrained eye or even to a busy clinician. Our job is to work behind the scenes to identify if any of those might be precancerous or malignant. By examining biopsy samples, we provide definitive diagnoses that inform the dentist whether a lesion needs urgent intervention or can be managed conservatively. In this way, we act as a safety net in the dental care system ensuring that potentially deadly diseases are not missed.

It’s also worth noting that oral pathologists in India have started to take on more front-line roles in prevention. We engage in screening programs and awareness camps, and we often guide general dentists on what warning signs to look for. In fact, one reason I founded the Practicing Oral Pathologists and Microbiologists Association was to empower oral pathologists to contribute more directly to patient care. Historically, our specialty was underutilized, for example, oral pathologists with an MDS weren’t even recognized by some authorities to sign pathology reports, which was a kind of policy gap I fought to change. Now, with greater recognition, we are being integrated more into the healthcare system. In routine dental clinics, having access to an oral pathologist (or our reports) means that a small tissue sample from a suspicious white patch or ulcer can be analyzed quickly, and if it shows early signs of cancer, the patient can be alerted and treated timely. So, in summary, we are essential team members: we provide the diagnoses that enable early detection of oral cancer and other diseases, thereby directly contributing to cancer prevention and improved patient care.