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Things You Need to Know About Oral Biopsy

Oral biopsy is a medical procedure for taking samples of oral tissue for later examination in the laboratory. An oral biopsy is performed to detect any oral tissue abnormalities, especially if there is cancerous tissue. Oral biopsy is generally recommended by doctors in patients with oral tissue disorders characterized by the appearance of lesions, red or white patches, and swelling and ulcers in the mouth. Biopsy is done if the doctor has not been able to determine the cause of oral disease after the patient underwent a physical examination.

Purpose and indication of oral biopsy

Oral biopsy is performed on sufferers of oral tissue abnormalities, such as oral cancer. Generally, oral tissue abnormalities are characterized by the following symptoms:
  • Rash or lesions in the mouth that do not heal within 2 weeks.
  • White spots (leukoplakia) or red in the mouth.
  • The presence of ulcers (ulcers) in the gums.
  • Swelling of the gums or mouth that does not go away.
  • Changes in gum tissue that are marked by teeth feel loose.
Apart from these symptoms, an oral biopsy can also be performed to examine lesions due to infection, such as syphilis or tuberculosis, which are found in the mouth area. Biopsy of these lesions can be done if the patient has undergone a previous infection examination.

Warnings Before Doing an Oral Biopsy

Oral biopsy is a safe procedure to be undertaken by patients in general. However, there are several conditions that cause a person to need special treatment when undergoing an oral biopsy to minimize side effects. These conditions are:
  • Having blood clotting abnormalities.
  • Suffer from multiple neurofibromas.
  • Suffer from a parotid tumor.
  • Suffering from decaying bone tissue (osteonecrosis) in the jawbone.
  • Are taking blood-thinning medication.
  • Underwent treatment with bisphosphonates.

Preparation Before Oral Biopsy

Before undergoing an oral biopsy, the doctor will ask about medicines that are being consumed by the patient, including herbal medicines or supplements. If the patient is taking drugs that affect blood clotting, such as anticoagulant or antiplatelet drugs, the doctor can ask the patient to stop taking the drug for a while. Patients may also be asked not to eat several hours before undergoing oral biopsy.

Oral Biopsy Procedures and Actions

Oral biopsy can be done at a particular hospital or clinic that has biopsy equipment. Oral biopsy will be performed by a dentist. Before sampling, the doctor will give anesthetic cream followed by a local anesthetic injection to relieve pain during the procedure. After that, the doctor will install a device to keep the mouth open by using a retractor if the tissue sampling location is in the mouth. The biopsy procedure can take about 15 minutes. In general, there are 3 techniques for taking oral tissue samples through biopsy, namely:

Incisional or excisional biopsy

Incision or excisional biopsy is done by making skin incisions before tissue sampling. The length of the slice depends on the needs and availability of biopsy techniques Excision or open incision biopsy is done if the required sample is large. After the biopsy is done, the incision will be closed using stitches.

Needle biopsy

A needle biopsy is performed to remove abnormal tissue using a needle, both fine and large needles. If the patient has a needle biopsy, the doctor does not need to make a skin incision, but will make a hole in the skin with the needle. After the procedure, the skin hole does not need to be closed using stitches. Patients will hear a "click" or or a small explosion and discomfort at the time of sampling.

Brush Biopsy

Brush biopsy is done to remove abnormal tissue in the skin outside or inside the mouth by brushing or dredging using a special tool. Patients who undergo a brush biopsy will not be made slices or skin holes. However, patients can experience slight bleeding or pain due to the brushing process. During the biopsy process, the patient will feel pain in the area underwent biopsy, especially when injecting local anesthesia. After that, the doctor will cover the biopsy wound with a sterile bandage and stitches if needed. Slices of the inner mouth wall can be covered with sewing threads which will later merge with the mouth tissue.

Recovery after oral biopsy

Biopsy samples that have been taken will be taken to the laboratory for analysis using a microscope. Laboratory analysis results will be notified by doctors to patients after a few days. The doctor will explain the results and plan further treatment related to the patient's condition. Patients who have had an oral biopsy can go home the same day. Most patients who undergo oral biopsy can immediately move. However, if the biopsy wound is sutured with ordinary threads, the patient will be scheduled to undergo the removal of the thread by the doctor concerned. If a biopsy is done inside the mouth, the doctor will ask the patient to brush teeth carefully and not to rinse the mouth very often in the biopsy area. The patient will be asked to avoid chewing food in the biopsy section.

Complications and Side Effects of Oral Biopsy

Oral biopsy is a safe procedure for patients to undergo. However, oral biopsy can cause side effects or complications in the form of bleeding and infection. Contact your doctor immediately if any of the following symptoms occur:
  • Fever for several days.
  • Severe bleeding in the area underwent biopsy.
  • Pain that does not go away for several days.
  • Swelling of the biopsy area.

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