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Wondering what to expect from your oral biopsy, and why you might need one? Here's an explanation of the procedure from our dentist, who will also answer some common questions about this surgery.
What is an oral biopsy?
During this surgical procedure, tissue is taken from the patient's oral cavity to be examined, usually so a diagnosis can be made.
Why would an oral biopsy be recommended?
If a lesion is interfering with your oral health or functioning, a biopsy may be recommended so the cause can be determined and the proper treatment prescribed. Inflammatory changes sometimes impact bone lesions or the oral cavity and your dentist may be unable to identify them with clinical examination or X-rays.
A biopsy may also be performed if your dentist suspects you have oral cancer (which is found in the mouth, neck and head). If cancer has already been diagnosed, a biopsy can help to determine the extent and stage of the cancer, in addition to its source.
You may be referred to an oral and maxillofacial surgeon, who can diagnose and treat a range of illnesses and injuries affecting jaw, neck, mouth and face. They will perform a thorough exam of your neck and head during the exam and perform an oral biopsy. You might also be referred to an 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 Edmonton dentists can address any inquiries or concerns.