You've heard the words "oral biopsy", but what is this common procedure, and why would you need one? Our Thornhill dentists explain this dental surgery and answer common questions we've received from patients.
What is an oral biopsy?
During an oral biopsy, a sample of tissue is taken from the patient's oral cavity for examination, typically so a diagnosis can be provided.
Why would an oral biopsy be recommended?
Some lesions can interfere with your oral function. You may need a biopsy to determine what's causing the lesion so a correct diagnosis can be provided and proper treatment can be administered. Potential inflammatory changes can affect the oral cavity or bone lesions your dentist is unable to identify with x-rays or clinical examination.
If your dentist suspects you have oral cancer (which is found in the head, neck and mouth), a biopsy can be performed to confirm whether this is the case. If you've already been diagnosed with oral cancer, a biopsy can help determine the stage and extent of the cancer, in addition to its source.
Oral surgeons diagnose and treat a range of illnesses and injuries affecting the mouth, face, neck and jaw. During your appointment, a thorough exam of your neck and head will completed an an oral biopsy performed. We may also refer you to a otolaryngoloist (an ear, nose and throat doctor).
During an oral biopsy, a small sample of the suspicious tissue will be removed from your oropharynx or mouth and sent to a pathologist, where it will be checked for disease. A custom treatment plan will then be developed based on information in 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?
You do not need to do much to prepare for a 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 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 pin prick or pinch as local anesthetic is injected, or as the needle is used to take the biopsy. The use of 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 Thornhill dentists can address any inquiries or concerns.
