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Why would my dentist recommend an oral biopsy?

Posted Sep 21st, 2021 in Surgery

The thought of having an oral biopsy can be intimidating. Our Smithers dentists are here to go over the procedure and many of the questions that are commonly asked.

What is an oral biopsy?

An oral biopsy is a surgical procedure to take tissue from the patient’s oral cavity to examine, typically so a diagnosis can be made.

Why would an oral biopsy be recommended?

If you have a lesion that interferes with your oral function, you may need a biopsy to determine the cause so proper treatment can be prescribed. There may also be inflammatory changes affecting the oral cavity or bone lesions your dentist is unable to identify with X-rays or clinical examination.

A biopsy can also be performed if your dentist suspects you have oral cancer (which is found in the mouth, head and neck). If you have already been diagnosed with cancer, a biopsy can help determine the stage and extent of the cancer, as well as its source.

Oral and maxillofacial surgeons diagnose and treat a range of illnesses and injuries affecting the neck, jaw, face and mouth. During your appointment, a thorough exam of your head and neck will be done and an oral biopsy performed. We may also refer you to an otolaryngologist (an ear, nose, and throat doctor).

During your oral biopsy, a tiny piece of the suspicious tissue will be removed from your oropharynx or mouth and sent off to a pathologist who will examine it for diseases. A personalized treatment plan will be constructed from the information given by the pathologist's report. 

Types of Oral Biopsies

The 6 types of oral biopsies include:

Aspiration Biopsy

A needle and syringe are used to remove a sample of cells or contents from a lesion. If the oral surgeon is not able to drain fluid or air, it may mean the lesion is solid.

Brush Biopsy

The surgeon applies firm pressure with a circular brush, rotating it to pick up cellular material that will later be transferred to a glass slide, preserved and dried.

Cytology

This type of oral biopsy aids in the diagnosis of lesions in the oral cavity. These lesions may be caused by infections, herpes or post-radiation changes.

Though individual cells can be examined, an accurate and definitive diagnosis may not be possible without an excisional or incisional biopsy also being performed.

Excisional Biopsy

Performed for small oral lesions (typically measuring less than 1 cm) that appear benign during a clinical exam, an excisional biopsy completely removes the lesion.

Incisional Biopsy

Your surgeon will complete this type of biopsy to obtain a representative sample of the oral lesion. If your oral lesion is large or has differing characteristics, more than one area may need to be sampled.

Punch Biopsy

Best suited for diagnosing oral manifestations of ulcerative and mucocutaneous conditions of the oral cavity (such as lichen planus), a punch biopsy is completed using a punch tool.

How should I prepare for my oral biopsy?

There isn't much you can do to prepare for your biopsy appointment. If the biopsy will be performed on part of a bone, your dentist will recommend X-rays or CT scans first, and ask that you not eat anything for a few hours before the biopsy.

Once you arrive, you’ll typically be asked to rinse with an antibacterial mouthwash. Local anesthesia is usually used and you will likely be awake for the procedure. However, you may be provided general anesthesia if the lesion is in an area of the mouth that’s hard to reach.

Is an oral biopsy painful?

You shouldn’t feel pain during the procedure – perhaps just a sharp pinprick or pinch as local anesthetic is injected, or as the needle is used to take the biopsy. The use of dental instruments may also result in some minor pressure as the sample is collected.

After anesthesia wears off, depending on where the biopsy was performed the site may feel sore for several days. You may want to stick to soft foods and take over-the-counter medication for pain (avoid taking NSAIDS, which can increase the risk for bleeding).

If you experience significant pain from the biopsy, you may be prescribed pain medications.

Do you have questions about your upcoming oral biopsy? Our Smithers dentists can address any inquiries or concerns.

Do you have questions about an upcoming oral biopsy? Our Smithers dentists can answer any questions you might have about the procedure. Contact us today.

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