As is generally known, a normal healthy mouth has a lining of specialized skin (mucosa) that is smooth and coral pink in color. Any deviation from this appearance could be a sign of pathology. The most serious of these is oral cancer. The cause of concern is more for those who use tobacco products and/or consume alcohol on a regular basis. The dental specialties like Oral & Maxillofacial Surgery and Oral & Maxillofacial Patholology recommend following the guidelines on oral cancer screenings. A self-examination oral cancer screening should be performed by you on regular basis, which includes looking for:

• Reddish patches (erythroplasia)
• Whitish patches (leukoplakia)
• Reddish-whitish patches (erythroleukoplakia)
• A lump or thickening of the mucosa
• Chronic sore throat or hoarseness
• Difficulty in chewing or swallowing
• Sudden onset of numbness or tingling sensation to lip, chin, tongue or teeth
• Ulcers that don't disappear

In your self examination, if you find or suspect presence of any of these signs, you would do well to schedule an early appointment with the listed specialist dentist with the India Dental Clinics for an evaluation. The dental specialist will perform a thorough evaluation and, if necessary, he will recommend an oral (mouth) biopsy of the suspicious lesion. The tissue or sample will be sent to the lab for analysis to obtain an accurate diagnosis. The results can be used to determine the proper management of the lesion in question. Do not ignore any of the warning signs. Early detection and treatment is our best defense against oral cancer.

What is Oral Biopsy?
The biopsy procedure involves removing a small piece of tissue from an area so that it can be looked at closely under a microscope. This is done in the form of excision or incision. When the biopsy procedure is aimed to remove an area completely, it is called an excisional biopsy. The excision is usually appropriate when only small lumps or swellings are involved. Occasionally on other times, an incisional biopsy is done in which only a small piece of an abnormal area is removed to confirm a diagnosis. Biopsies are considered important diagnostic tool for the diagnosis of lesions ranging from simple periapical lesions to malignancies. Planning prior to performing a biopsy is essential. It will be beneficial to the receiving pathologist in reaching a helpful and meaningful diagnosis, and therefore ultimately and more importantly, to the patient. There is no need to biopsy inflammatory or infectious lesions that respond to specific local treatments, as pericoronitis, gingivitis or periodontal abscesses.

Why is Biopsy done?
It has never been a point of argument that a biopsy is often the only way to diagnose oral lesions and diseases. As is often done with most procedures, there is more than one method of undertaking the surgery successfully. This includes, among others, biopsy of minor salivary glands for diagnosis of Sjögren’s syndrome; excisional biopsy of a nodular lesion of the palate, etc.Whatever the method used, however, the aim is to provide a suitably representative sample for the pathologist to interpret, while minimizing perioperative discomfort for the patient. An unsuitable, unrepresentative sample is of no use to the oral pathologist, clinician or most importantly the patient who would be ill served if the procedure is sought to be repeated.

Where do I get the Biopsy done?
Until recently most biopsies were generally performed in hospital settings. The new developments in this area have enhanced the capabilities of specialist dental practitioners to perform biopsies in office. The new system is not designed to provide the kind of information, specifically cellular architecture, which would be obtained through a punch or incisional biopsy. But it will provide an answer to the question of whether malignancy exists or not, through a quick, minimally invasive, and inexpensive procedure.

How is Oral Biopsy done?
The biopsy of the affected oral region is mostly carried out under local anesthesia using an injection into the area to numb it, which means that the biopsy procedure is painless. It takes only a couple of minutes for the injection to work. The biopsy usually leaves a small hole, and this often requires stitching. In the majority of cases the stitches used are dissolvable and can take around one month to disappear. Leaving aside the preparations, the whole process (local anaesthetic injection, biopsy and stitching) usually takes around 15 minutes from start to finish.

Will there be much bleeding?
A little bleeding at the time of mouth biopsy can always be expected, which normally stops almost within no time. The oral biopsy site wound is stitched and bleeding stops. Should the biopsy site bleed again when you get home, this can usually be stopped by applying pressure over the area for at least 10 minutes with a rolled-up handkerchief or swab. If the bleeding does not stop, please contact the Oral Surgery department.

Will there be much soreness or swelling afterwards?
It takes few hours for the local anaesthetic to wear off. You may start feeling relatively a little pain or/and swelling. Each patient has different level of response to pain. Occasionally, it is necessary to take simple painkillers (e.g., Paracetamol, Ibuprofen). Usually, any discomfort lasts only a few days.

What oral care to take after biopsy?
You are supposed to be consciously aware not to bite the numb areas of your mouth. A vigorous rinsing of your mouth should be avoided at all costs on the day of surgery; as such an act may cause bleeding. You should clean your teeth normally, including those teeth next to the site of the biopsy. If you find that food catches around the stitches, then the area can be gently rinsed with a mouthwash or warm salt water, commencing on the day after surgery. Maintain regular oral hygiene.

There is no need to biopsy inflammatory or infectious lesions that respond to specific local treatments, as pericoronitis, gingivitis or periodontal abscesses.