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When Do You Need an Oral Biopsy?
An oral biopsy might be recommended if an abnormality is discovered in your mouth during a dental checkup. It is a surgical procedure that involves removing a small portion of tissues from the anomaly so tests can be performed to determine if it is malignant and its cause. The sample used for an oral biopsy might be taken from a tooth, the jawbone, or from gum tissues.
Reasons a surgeon might recommend an oral biopsy
Some of the reasons why an oral surgeon might suggest a biopsy include:
1. To assess a lesion
Lesions in the mouth can interfere with its function and cause discomfort. A biopsy is often recommended when a lesion is detected to determine its cause so appropriate treatments can be performed and to assess if it is cancerous.
2. To detect oral cancer
A dentist might recommend a biopsy if symptoms are found on a patient’s head, mouth, and neck. The procedure is performed to confirm the dentist’s suspicions, and, if cancer is detected, to asses how far its progress and its source.
Oral cancer can affect the floor of the mouth, roof, inner lining of the cheeks, tongue, gums, and lips. Cancers that occur inside the mouth are sometimes called oral cavity cancers.
Some of the signs and symptoms that indicate a patient might need a biopsy to determine if they have oral cancer include ear pain, mouth pain, difficulty swallowing, loose teeth, reddish or whitish patches in the mouth, and sores on the mouth or lip that do not heal.
Oral biopsies involve a thorough examination of the patient’s head, neck, and mouth before a biopsy is done. During the procedure, a tiny portion of tissue is removed from the patient's mouth and sent to a pathologist who checks it for diseases. A customized treatment plan is then made for the patient based on the pathologist’s findings.
The different types of biopsies performed by oral surgeons include:
- Aspiration: This procedure entails using a syringe and needle to remove a sample of cells from a lesion. However, this approach is only effective when the oral surgeon can drain air or fluid from the lesion. Other options will need to be explored if the lesion is already solid.
- Brush: This technique involves applying firm pressure on the abnormality with a circular brush to pick up cellular material that is transferred to a glass slide, dried, and preserved before being sent to a pathologist for evaluation.
- Cytology: This technique is often used to diagnose lesions in the oral cavity caused by issues like herpes and infections. It is often combined with other types of biopsies to make an accurate diagnosis.
- Excisional: This procedure is typically reserved for small lesions in the mouth that appear benign. It involves cutting away the lesion and sending it for further testing.
- Incisional: This involves cutting into a lesion to collect tissue samples. Samples are usually taken from multiple parts of the lesion.
- Punch: Punch biopsies are used to diagnose mucocutaneous and ulcerative lesions in the mouth, like lichen planus. It involves using a punch tool to collect a tissue sample.
Preparing for an oral biopsy
Patients do not have to do much to prepare for biopsies. CT scans or X-rays are usually performed before collecting tissue samples. Patients are typically advised to avoid eating a few hours before the procedure.
An oral biopsy often starts with the patient rinsing their mouth with an antibacterial mouthwash. Local anesthetics are typically used so patients stay awake for the entirety of the procedure. In rare cases, general anesthesia might be recommended if a patient’s lesions are located in hard-to-reach areas.
The most pain patients typically feel during biopsies is a sharp pinch as the local anesthetic is injected around the lesion. Patients might also feel some pressure as instruments are used to collect tissue samples.
Patients might feel some discomfort after the anesthetic wears off. The area that was worked on might be sore for several days so it is often best to stick to soft foods. Over-the-counter pain medication can be used to manage any discomfort, but patients should avoid NSAIDS since they increase the risk of bleeding.
An oral biopsy helps to detect health issues early
An oral biopsy can help with the early detection of oral cancer, which is responsible for almost 10,000 deaths in the U.S. each year. Give us a call or stop by our Arroyo Grande clinic if you notice any abnormalities or lesions inside your mouth.
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