BIOPSIES
WHAT IS A BIOPSY?
A biopsy is a procedure in which a small sample of tissue in or around the mouth is taken or removed. This is then sent to a laboratory to be looked at under a microscope.
WHY DO I NEED A BIOPSY?
Your dentist may notice a lump, bump or patch that looks different to the normal appearance of the tissues of the mouth. Many of these lumps, bumps or patches cannot be diagnosed by examination only. Many of these lumps, bumps and patches also look similar. A biopsy allows for a sample to be taken and examined under a microscope. A diagnosis can then be made and the lump, bump or patch treated appropriately. Without a biopsy, it is often not possible to confirm the diagnosis and provide you with the most appropriate treatment.
WHAT IS THE DIFFERENCE BETWEEN AN INCISIONAL BIOPSY AND AN EXCISIONAL BIOPSY?
An incisional biopsy is one in which only part of the affected area is removed. This is to ensure that if further treatment is required, the affected area can be easily identified.
An excision biopsy is one in which the whole of the affected area is removed.
The decision to perform an incisional or excision biopsy depends on the appearance of the affected area.
HOW WILL MY BIOPSY BE PERFORMED?
Before I perform your biopsy, I will apply numbing injections around the affected area. I will then leave this for 5 minutes for the anaesthetic to work.
I will check that the anaesthetic has worked by pressing around the area using a dental probe. At this point, you will feel pressure but you should not feel pain. If you feel pain, I will leave more time for the anaesthetic to work or apply more anaesthetic depending on what you can feel.
Your treatment will only start when you are happy that you are numb.
Your biopsy will then be performed.
Any openings in the area will be closed using dissolvable stitches. These stitches will dissolve in 10 - 14 days after your treatment.
WILL I BE AWAKE DURING MY BIOPSY?
Biopsies are short procedures and are often performed under local anaesthetic only.
Treatment under local anaesthesia numbs the affected area. You will be awake throughout your treatment, but you should not feel any pain or discomfort.
Intravenous conscious sedation is administered through a vein in your arm or hand. However, this is not the same as a general anaesthetic which will put you completely to 'sleep'. Instead, intravenous conscious sedation will reduce your awareness of the procedure. The treating team will still be able to speak with you and identify if you are feeling discomfort.
During your consultation I will discuss the advantages and disadvantages of treatment under both local anaesthetic and intravenous sedation at greater length.
WHAT WILL MY RECOVERY TIME BE AFTER MY BIOPSY?
You may experience pain, swelling and bruising after your biopsy.
Pain usually worsens over the first 3 days after surgery. This may take up to a further 10 days to stop, with daily gradual improvements. Provided that you have no allergies, intolerances or reasons why you cannot take them, the following painkillers are advised:
Paracetamol 1g every 6 hours for 7 days
Ibuprofen 400mg every 8 hours for 7 days
I will confirm with you which are best in your case.
Swelling usually worsens over the first 3 days after swelling. This may take up to a further 10 days to disappear, with daily gradual improvements. You may use an ice-pack applied to the outside of the face for 15 minutes in the morning and in the evening to help to reduce the swelling.
Bruising after a tooth exposure is less common. This will usually resolve with any swelling that you may experience.
WHAT CAN I EAT AFTER MY BIOPSY?
Immediately after your biopsy while you are still numb, avoid hot food and drink to prevent burning yourself without realising.
Once the local anaesthetic has worn off, you will find a soft diet for the first 3 days after surgery more comfortable. If you feel that you can return to a normal diet you may do so.
Avoid small grains and pieces that may get caught in the biopsy site for 5 days after your biopsy.
Avoid alcohol for the first 48 hours after your biopsy.
Avoid smoking for at least 72 hours after your surgery - the longer you are able to stop smoking the lower the chances of infection.
CAN I BRUSH MY TEETH AFTER MY BIOPSY?
You should return to toothbrushing as soon as possible after your tooth exposure. Ideally you should start on the same evening as your tooth exposure.
You should not mouthwash with saltwater or mouth wash for the first 48 hours after your surgery. After this, when using rinsing your mouth, ensure that it is a gentle rinse only for the following 5 days.
DO I NEED A REVIEW AFTER MY BIOPSY?
Once your biopsy has been performed, the sample will be sent to a laboratory for examination under a microscope.
On average, the biopsy results take approximately 4 weeks to return.
Once the biopsy results have been received, a review in practice or a telephone review will be arranged to discuss the findings of the results and arrange further treatment if necessary.