Do you want to know what happens in an oral biopsy and why you would require one? Today our Winnipeg dentists discuss the oral biopsy procedure and answer the most frequently asked questions about this form of surgery.
What is an oral biopsy?
An oral biopsy is a surgical procedure that takes tissues from the patient’s oral cavity in order to examine them, usually to help make a diagnosis.
Why would an oral biopsy be recommended?
If you have a lesion that hinders your oral function, you might require a biopsy to diagnose the cause so a dentist can prescribe the proper treatment. There could also be inflammatory changes impacting the oral cavity or bone lesions your dentist isn't able to identify with clinical examination or X-rays.
A biopsy could also be conducted if your dentist thinks you might have oral cancer (which is discovered in the mouth, neck, and head). If cancer has already been diagnosed, a biopsy could also help determine the stage and extent of the cancer, as well as its source.
Oral and maxillofacial surgeons diagnose and treat a wide variety of illnesses and injuries affecting the face, jaw, neck, and mouth. At your appointment, a thorough examination of your head and neck will be performed and an oral biopsy will be conducted. We might also refer you to an otolaryngoloist (a doctor for the ear, nose, and throat).
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 any diseases. A custom treatment plan will then be developed based on the 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 take a sample of cells or contents from a lesion. If the oral surgeon isn't able to drain fluid or air, it could 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 helps in diagnosing lesions in the oral cavity. These lesions could be caused by infections, herpes, or post-radiation changes.
Though individual cells could be examined, an accurate and definitive diagnosis might 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 might have 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 don't have to do much to get ready 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 don't eat anything for a few hours before the biopsy.
When you arrive, you’ll typically be asked to rinse with antibacterial mouthwash. Local anesthesia is usually used and you will probably be awake for the procedure. However, you might be given 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 – maybe just a sharp pinprick or pinch as a local anesthetic is injected, or as the needle is used to take the biopsy. The use of instruments might also result in some minor pressure as the sample is collected.
After the anesthesia wears off, depending on where the biopsy was performed the site might 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 might be prescribed pain medications.