Oral (mouth) biopsy

This leaflet aims to help you understand any future treatment you may have, and answer many commonly asked questions. If you have any queries after reading this leaflet, please ask a member of staff.

What is a biopsy?

A biopsy is a simple way of helping us to diagnose an abnormal condition. We remove a small piece of tissue from your mouth, so it can be examined under a microscope.

Why do I need this procedure?

We often take a biopsy when we are not certain of the cause of a disease, or we do not know how far it has spread, or exactly what it is like. Sometimes by doing a biopsy we completely remove the diseased area and cure the problem.

What are the benefits of the procedure?

A biopsy can help us to:

• Diagnose many conditions to find out exactly what is wrong with you.

• Confirm a diagnosis that we already suspect.

• Measure how serious your condition is.

Will the biopsy hurt?

In most cases, biopsies are done using local anaesthetic (an injection is given to numb the area). The injection takes a couple of minutes to work and means that the biopsy will be painless.

How long will I be in hospital for?

The whole process (local anaesthetic injection, biopsy, and stitching) usually takes around 15 to 30 minutes from start to finish. You can go home after your procedure.

What happens during my procedure?

How we do your biopsy depends on the type of tissue sample we want and from where we take it.

• Scraping cells

  In some cases, simply taking a scraping of the surface layer of cells on the lining of your mouth gives us a big enough sample to look at. This can be uncomfortable but not painful, so you will not need an anaesthetic.

• Incisional biopsy

  An incisional biopsy is a sample of the surface of the lining of your mouth, which we use to diagnose mouth conditions. Your dental surgeon will use a small, sharp medical knife (scalpel) to remove a small amount of the surface lining of your mouth, and then stitch the wound back together. We will usually give you a local anaesthetic for this biopsy, so the area will be numb.

• Needle biopsy

  A needle biopsy involves taking a sample of tissue from under the surface of your skin. To do this, your dental surgeon uses a special needle. They push it through your skin into the area which they want to look at, and use this needle to suck out some tissue. We will sometimes give you a local anaesthetic for this biopsy, so the area will be numb.

• Excision biopsy

  An excision biopsy involves surgery to remove a larger area of tissue (usually a lump) which needs to be examined. We will give you a local anaesthetic to numb the area. This type of biopsy will usually cure your problem.

• Bone biopsy

  We use a bone biopsy to diagnose abnormal conditions affecting your jaw bone. Your dental surgeon will take a small sample of bone after making a small cut in your gum. They will then stitch the cut together.

Which biopsy we do will be discussed with you before your procedure.

Will there be much soreness or swelling after my biopsy?

After a few hours the local anaesthetic will wear off and you will have a small amount of pain and / or swelling; this usually only lasts a few days. If you need to, take simple painkillers (such as paracetamol or ibuprofen) to help with your pain.

Will I have stitches?

The biopsy usually leaves a small hole that often needs stitching. In most cases the stitches used are dissolvable and take around two weeks to disappear.

Will there be much bleeding after my biopsy?

Although there may be a little bleeding at the time of your biopsy, this usually stops very quickly and is unlikely to be a problem if your wound is stitched.

If your biopsy site bleeds 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 hospital (see contact details at the end of this leaflet).

When can I return to work?

This depends on your job and how you feel after your procedure. Most people are able to return to work later the same day.

Are there any things I should do when I get home?

Yes.

• Be careful not to bite the numb areas of your mouth.

• On the day of your biopsy you should avoid rinsing your mouth out vigorously, as this may cause bleeding.

• The day after your biopsy, the area can be gently rinsed with warm salt water (dissolve a teaspoon of kitchen salt in a cup of warm water). Do this three times a day, after meals, for one week.

• You should clean your teeth normally, including those teeth next to the site of your biopsy (see point above).

• You will be able to eat and drink normally after your biopsy, but please avoid eating or drinking anything hot for the rest of the day and allow all meals and drinks to cool to room temperature.

• Do not do any strenuous exercise for the rest of the day, either at work or during your leisure time.

Will I need a follow-up appointment?

Since your stitches are dissolvable a review appointment is not always needed, but you will usually be given one so that the results of your biopsy can be discussed with you.

What if I have any further questions and / or concerns?

Your dentist will discuss the procedure with you before you have your biopsy, but if you still have questions once you return home, please contact one of the following Maxillofacial Units.

• Kent and Canterbury Hospital, Canterbury
  Telephone: 01227 766877 extension 722-5494

• Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
  Telephone: 01843 225544 extension 725-3157

• William Harvey Hospital, Ashford
  Telephone: 01223 616045