When Would You Need an Oral Biopsy?

An oral biopsy is a type of surgery through which the doctor collects a tiny section of soft oral tissue for testing. The goal is to see if the source is benign or malignant. Performing this procedure is necessary to determine the next steps to take. Here are the details on when you would need an oral biopsy.

Lesions and the need for biopsy

There are some oral lesions that cause difficulty in speaking and eating. The dentist may need to perform an oral biopsy to see what is causing them. A clinical exam or digital dental X-rays can help spot any bone lesion or inflammatory changes in the oral cavity. A patient who might have oral cancer can go through an oral biopsy as well. The procedure can help determine the source and the current stage of the cancerous lesion.

The dentist will refer the patient to a surgeon who has more experience and knowledge when it comes to illnesses in the mouth, face, neck, and jaw. A thorough examination will happen before an oral biopsy. Then, the dentist will take a tiny piece of the tissue from the patient’s mouth or oropharynx. Examining the tissue sample will come next. This procedure can help provide the patient with a correct diagnosis and create a custom-fit treatment plan.

The procedure

The surgeon should be aware of the patient’s health status before the oral biopsy. A review of the patient’s medications and allergies is important. The surgeon should also check the patient’s use of alcohol, tobacco, and illicit drugs. Ordering oral scans can give the surgeon a complete picture of the patient’s jawbone, teeth, and gums.

A local anesthetic will numb the area around the lesion. This area can also get a regional nerve block technique. The anesthetic will not go into the lesion. If it does, there could be false diagnosis.

The surgeon will extract the soft tissues around the lesion. The incision should be an elliptical shape. Its margin should be at least 1 millimeter. The surgeon will separate the lesion from the soft tissues and place it into a sterile specimen container. There should be a fixative of 10% buffered formalin. Labeling it with the patient’s birthdate and name, as well as the site and date of biopsy, is important.

There should be firm pressure on the biopsy site. This can help stop any amount of bleeding. The surgeon will close the incision using sutures. Resorbable sutures are ideal because the body absorbs them when they dissolve. A sterile gauze can help the area close and heal. It can also help with clotting and prevent the patient from swallowing blood.

Mild bleeding from the oral biopsy area will persist for about a day. The patient must change the gauze every 20-30 minutes. Do not keep the gauze in the mouth overnight. The surgeon will add more instructions that the patient must follow at home, such as not eating until the anesthetic fades.

The different types of oral biopsies

A local anesthetic will block any pain during an oral biopsy. The patient may feel a sharp pricking sensation during the injection. The same may happen as the surgeon takes the sample tissue. There could be some pressure when the dentist uses dental tools during the sample collection. Here are the different types of oral biopsies that the surgeon may discuss:

• Brush biopsy is when the surgeon applies hard pressure on the site with a circular brush. The surgeon will rotate the brush to pick up sample material. The sample will go straight to a glass slide. It will then be dried and preserved.
• Aspiration biopsy is when the surgeon uses a syringe and a needle to remove the cell samples or fluids from a suspicious lesion. A solid lesion will not yield any air or fluid.
• Cytology biopsy helps in the diagnosis of lesions in the patient’s oral cavity. Radiation or infections may have caused the lesions.
• Excisional oral biopsy is for small lesions less than a centimeter. These lesions may appear benign during a regular exam. This type of biopsy will remove the whole lesion.
• Punch biopsy uses a punch tool to take samples of mucocutaneous and ulcerative conditions. The patient can take pain relievers after the procedure.
• Incisional biopsy takes a piece of the lesion. If there are lesions in at least one area, the surgeon will take a sample from each.

An oral biopsy can help determine if the lesion is benign or malignant

Your dentist may spot a suspicious lesion in your mouth during one of your checkups. This is more than enough reason to recommend an oral biopsy. A surgeon will perform the surgery with a local anesthetic. Working with your surgeon and dentist can create a custom-fit treatment plan for you.

Request an appointment here: https://www.centralcoastoms.com or call Wilson Oral Surgery at (805) 910-1213 for an appointment in our Santa Maria office.

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