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 cancer has already been diagnosed, a biopsy can help determine the stage and extent of 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).
A small sample of the suspicious tissue will be taken from your mouth or oropharynx during an oral biopsy and sent to a pathologist to be examined for disease. The information in the pathologist's report will then be used to create a unique treatment strategy.
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.
You will typically be asked to rinse with an antibacterial mouthwash when you arrive. You'll likely be awake during the procedure and local anesthesia is typically used. However, if the lesion is in a difficult-to-reach area of the mouth, general anesthesia might be given to you.
Is an oral biopsy painful?
You shouldn’t feel pain during the procedure – perhaps just a sharp pin prick or pinch as a 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.
Depending on where the biopsy was done, the site may be sore for a few days after the anesthesia wears off. You might want to consume only soft foods and use over-the-counter pain relievers (avoid taking NSAIDS, which can increase the risk of 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 Kamloops dentists can address any inquiries or concerns.