What is an Oral Biopsy?
An oral biopsy is a procedure that removes a small piece of abnormal tissue from your mouth or oral cavity. This tissue is then sent to a pathologist who will determine what it is, which helps determine treatment. A biopsy is recommended for any lesion in the oral cavity that has been present for a long period of time with no known cause, a lesion that persists despite treatment or the removal of local irritants, or a lesion that interferes with speaking or swallowing.
What to do BEFORE your Procedure
Here are a few things you can do before a biopsy to help things go more smoothly:
- Eliminate ALL medications that thin your blood for two (2) weeks before surgery, unless directed otherwise by your surgeon. Please see this list--Medications to Avoid Prior to Surgery
- Stop smoking at least 2 weeks before your procedure.
What to Expect During the Procedure
Most oral biopsies are done in the office under local anesthesia. However, for larger lesions or those more likely to bleed your doctor may recommend performing this in the operating room under general anesthesia. There are two (2) types of oral biopsies: incisional and excisional. During an incisional biopsy, a small piece of tissue is cut out and sent to a pathologist for further testing. An excisional biopsy involves removing the entire suspicious area as well as a small amount of surrounding healthy tissue. This procedure may require stitches, which usually dissolve on their own within 10 days. The size and location of the lesion are used to determine whether an incisional or excisional biopsy is performed.
What to expect AFTER your Procedure
- Some people may experience pain after the anesthesia wears off, depending on where in the mouth or throat the sample was removed. The biopsy site may be sore for several days, and up to a week. Tylenol is usually sufficient to manage the pain. Avoid taking NSAIDs, such as aspirin, ibuprofen, or Aleve, which can increase the chance of bleeding.
- Bleeding: Some minor bleeding is expected. Your saliva may be blood tinged. If you notice bleeding from the biopsy site, apply pressure with sterile gauze for 15-20 minutes. You may also use a tea-bag.
- Swelling: Soft-tissue swelling may occur and generally peaks after 48 hours. Apply a cold compress over the area if the swelling is bothersome.
- Sutures: if sutures (“stitches”) are present they will dissolve in about 7 days. Do not attempt to remove the sutures by yourself. Occasionally, a suture may pop off earlier than expected. This is usually not a problem, so long as there is no bleeding.
- You should avoid hot, spicy, or acidic foods today for your own comfort.
- Brush your teeth normally but avoid the biopsy site.
- You should not use a mouth rinse other than warm salt water. Don’t rinse on the day of the procedure if possible; otherwise, rinse very gently only to remove food debris.
- You should not smoke for at least 72 hours as this increases your chances of developing a wound infection.
What are the risks of a Biopsy?
As with any procedure, oral biopsies have associated risks. Although the chance of a complication occurring is small, it is important that you understand the potential complications and ask your surgeon about any concerns you may have.
1) BLEEDING: Bleeding is possible with any surgery. Minimal bleeding is expected during and after the procedure.
2) INFECTION: Infection after biopsy is uncommon.
3) NEED FOR FURTHER TREATMENT: Biopsies are performed to determine whether a lesion is concerning or needs further treatment. Based upon the pathology results further treatment may be required.
4). ANESTHESIA COMPLICATION-- There are rare but serious risks of anesthesia. Please feel free to discuss any specifics with your doctor.