Oral Biopsy
What are the types of oral biopsies?
What are the potential benefits of an oral biopsy?
What am I likely to experience during the procedure?
What am I likely to experience during the post operative recovery?
What are the potential risks and/or side effects?
Do I need to see a specialist?
Do I need antibiotics for this procedure?
Do I need a follow up appointment after this procedure?
Who will be undertaking the oral biopsy procedure?
How much is the oral biopsy going to cost me?
- An oral biopsy is a procedure where a sample(s) of the tissues in your oral cavity is removed surgically and then transported to a laboratory to have the cells in the tissue reviewed under a microscope.
- An oral pathologist reviews the cells under the microscope and describes their findings (which also usually includes a diagnosis) in a report, which is sent back to the clinician who undertook the oral biopsy procedure.
| Type of biopsy | Excisional | Incisional |
|---|---|---|
| Description | Entire lesion removed | Part of lesion removed |
| Clinical suspicion | Benign | Suspected malignancy or unknown diagnosis |
| Size | Usually, < 1cm | Usually, >1cm |
- Diagnostic – e.g confirm or exclude a diagnosis
- Therapeutic – e.g remove an irritating lesion
- Provide additional reassurance: e.g there are ‘no cancer cells’ in this lesion
The procedure is quick to perform and the combination of happy gas sedation and local anesthesia ensures that you remain relaxed and comfortable throughout.
- Local anaesthetic – an injection to get you numb
- Removal lesion (whole/partial) usually with a scalpel or similar instrument
- Suturing of the soft tissues together to promote healing where applicable
- Placement of gauze over the biopsy site to help control any bleeding
The oral biopsy procedure is usually fairly minor and you are likely to make a full recovery in a couple of days. You would not usually need time off work to recover. You may experience
- Minor soreness
- Minor swelling
- Slow bleeding, which may occur intermittently for the next couple of days but is easily controlled by firmly pressing gauze for 30 minutes.
- A complication from an oral biopsy procedure is a rare occurrence.
- The majority of patients make a full recovery after the biopsy procedure.
- Potential risks of the procedure include the following:
| Category of risk | Discussion points |
|---|---|
| Common | Scar, numbness, bleeding, soreness – often unnoticeable, minor or self-resolving |
| Rare | Lesion recurrence Indeterminate histopathology result Potential need for additional investigation, referral +/- hospital management |
| If patient specific risk factors are present (e.g smoking, immunocompromised) | Infection Non-healing biopsy site |
| Anatomical specific risk factors | Injury to adjacent vital structures such as nerve, artery, duct or sinus (if applicable) |
Lesions in the oral cavity can be very complex and may be due to a medical condition elsewhere in the body.
Dr Daniel will assess you clinically including a history, examination, radiographic examination and histopathological examination, where applicable. Depending on the diagnosis, you may require
- no further management or monitoring
- further management and monitoring
- referral for specialist management which may or may not be required in the hospital setting. Common specialists that manage oral & related conditions include Oral Medicine Specialist, Oral and Maxillofacial Surgeon, Ears, Nose and Throat Surgeon, a Dermatologist or a Rheumatologist.
- Healthy patients undertaking a simple oral biopsy procedure do not require antibiotics.
- Some patients with certain high risk heart conditions require a single dose of an oral antibiotic 1hour before the procedure.
- Some patients who are severely immunocompromised may require a short course of oral antibiotics after the procedure.
| Feature | Do | Don’ts |
|---|---|---|
| Rest |
Return to work same day Usual activities of daily living |
Strenuous activity for 3 days |
| Nutrition |
Aim to drink over 1-1.5L of water / day Regular diet |
Hot and cold foods for 6hours after the procedure Hard or sharp foods such as nuts & chips for the first 2 weeks Alcohol for 2 weeks |
| Oral hygiene |
Brush teeth twice a day Gently rinse 10mLs of Curasept Mouthrinse (antibacterial) in your mouth for 30 seconds then spit out, four times a day, until the bottle is finished. |
Brushing the biopsy site Food remaining stuck at biopsy site (rinse it off) Smoking (1month) |
| Pain |
May be sore for a couple of days Take two 500mg paracetamol tablets four times a day for 2 days then as required Take one 200mg neurofen tablet three times a day as required |
Take neurofen for more than 5 days |
| Swelling | Usually there will be a minimal amount of swelling from the biopsy site which may increase for 2 days before resolving by the end of the week | N/A |
| Bleeding |
The biopsy site might bleed slowly on and off for a couple of days after the procedure Place gauze over the biopsy site and apply firm pressure for 30minutes. If bleeding re-occurs, repeat this step. |
Don’t check the bleeding every 5minutes once you have placed the gauze there (it usually takes 30minutes for the bleeding to settle with firm pressure) |
- An appointment will be scheduled to review you by tele consult approximately 2 weeks after the procedure & to inform you of the histopathology result & additional management or referrals if required.
- Dr Daniel, a currently registered and practicing Dentist with the Australian Health Practitioner Regulation Agency (AHPRA) will be undertaking the oral biopsy procedure.
- He has also completed a medical degree and has worked in the hospital system as a medical practitioner for over half a decade.
- Dr Daniel has undertaken a year of surgical training in the hospital system in the Oral and Maxillofacial Surgery department at a registrar level where he routinely managed oral pathology and performed oral biopsy specimens under the auspices of the Oral and Maxillofacial Surgeons.
- He currently undertakes oral biopsy procedures in private practice regularly with excellent results.
- The prices depends on the type and complexity offered and a formal quote will be provided at the consultation appointment. Consultation appointments are held by teleconsult for 20 min and has a fee of $90.
