Oral Diagnosis & Biopsies
Complete Exam by Oral Surgeon
When a dentist or oral surgeon examines a patient, they are looking at more than just teeth. They look in and around the oral cavity for anything that appears abnormal, such as color changes, mucosal lesions, or swellings. They also assess facial anatomies such as the lips, tongue, oral mucosa, gingiva, and palatal tissues. In fact, a complete examination and routine screenings may be your first line of defense when it comes to detecting particular oral or systemic ailments.
The dentist will ask you about your oral hygiene habits and any changes you’ve noticed in your mouth recently. They will visually inspect your oral tissues and use tools to examine areas that are difficult to see. They may also palpate (feel) your soft tissues for any lumps or swellings. In some cases, the dentist may order other diagnostic imaging, such as x-rays, to get a better look at the teeth and surrounding structures.
Sometimes an abnormality or suspicious lesion will be found during an oral examination that requires further investigation. In this case, the dentist may perform a biopsy procedure, which is the removal of oral tissue for closer examination in a laboratory setting by a pathologist. After a few days, when the pathology report is complete, you will be called by the dental office to go over the results. A surgical biopsy is essential for a definitive diagnosis.
Oral Diseases to Look For
Some oral diseases, such as gingivitis and periodontitis, are easy to spot during an oral examination. Others, such as oral cancer, may not be obvious without additional tests. The following oral diseases may be detected during an oral examination:
- Leukoplakia: A condition in which white patches of oral mucosa appear that cannot be removed by rinsing. Usually, they are benign, but to get an accurate diagnosis, they are often biopsied.
- Fibroma: A non-cancerous growth of oral tissue that may feel like a bump.
- Pyogenic granuloma: Non-cancerous oral lesions caused by inflammation that bleed easily.
- Oral cancer: A malignancy affecting the oral tissues and pharynx. Early detection is key to treating oral cancer successfully, which is why oral examinations are so important for your overall oral health.
- Oral Lichen Planus: A chronic inflammatory disease that affects the oral mucosa and skin.
- Oral candidiasis: Also known as thrush, oral candidiasis is a fungal infection of the oral mucosa that can occur in anyone but is more common in those with compromised immune systems.
- Mucous Membrane Pemphigoid: MMP is an autoimmune disease that affects the oral mucosa and skin, causing blistering and ulceration.
- “Pregnancy tumors”: Non-cancerous growths that may occur on the gum tissue of pregnant women.
- Some systemic diseases like Crohn’s and diabetes may also first be detected during an oral examination.
Oral cancer is very treatable, especially when it is detected early. That’s why oral examinations are so important. During an oral cancer screening, a dentist or hygienist will look closely at the oral and pharyngeal tissues, looking for any signs of oral cancer or precancerous lesions, such as leukoplakia or oral candidiasis. They will also feel for any lumps or swellings.
Tobacco use is the leading cause of oral cancer. This includes cigarettes, cigars, pipes, and chewing tobacco. If you use tobacco in any form, be sure to get oral cancer screenings more frequently.
Non-smoking young people should be aware of oral cancer as well. HPV, oral herpes, and other oral infections can cause oral cancer. That’s why oral examinations are so important – they are your first line of defense against oral cancer.
Approximately 42 million Americans are infected with HPV, the most prevalent sexually transmitted disease in the United States. It has been reported that at least half of all sexually active people will get it at some point during their life. Most strains lead to different symptoms, like warts that the body can fight. But HPV16 has been linked to cervical cancer and is now known to be responsible for new cases of oral cancer.
Another oral condition that may be detected during an oral examination is geographic tongue. Geographic tongue is a benign oral condition characterized by the appearance of smooth, red patches on the oral mucosa without any signs of oral cancer. These patches and their borders have irregular shapes and tend to change in size and location over time. A dental professional should always be consulted if you notice any changes to your tongues appearance.
The type of biopsy performed will depend on the location and size of the lesion. Some oral biopsies may be a simple in-office procedure, while others will require a trip to an oral surgeon.
The most common types of oral biopsy are:
- Fine Needle Aspiration Biopsy (FNA): In this procedure, a tiny biopsy needle is used to aspirate cells from a growth or lesion. The cells are then examined under a microscope to look for cancer cells.
- Oral Brush Biopsy: A specially designed brush is used to painlessly obtain cells for testing.
- Punch Biopsy: In this procedure, a small circular cutter is used to remove a small piece of tissue from the growth or lesion. The biopsy sample is then examined under a microscope to look for cancer cells.
- Incisional Biopsy: In this procedure, a small incision is made in the oral tissue to remove a part of the growth or lesion. The tissue sample is then examined under a microscope to look for cancer cells.
- Excisional Biopsy: With this scalpel biopsy procedure, the entire growth or lesion is removed. The tissue is then examined under a microscope to look for cancer cells.
After the biopsy, it is important to keep the area clean and free of irritants. You may be given a special oral rinse to use after eating and brushing your teeth. Avoid using tobacco products and alcohol for at least 24 hours after the biopsy. You may also be given a prescription for pain medication to help with any discomfort.
The oral tissue will take some time to heal, so it is important to be gentle with the area. Avoid eating hard or crunchy foods, and avoid touching the area with your tongue.
The AZ Difference
At AZ Dental, we take oral health seriously. Oral examinations are an important part of oral health, and they can help catch oral cancer and other diseases in the early stages. If you have any oral health concerns or questions, we encourage you to visit us at AZ Max today. Our skilled dentists and surgeons will work with you to provide the best oral care possible, helping you achieve and maintain healthy, beautiful teeth and gums. So don’t wait – contact us today to schedule your appointment! Call (480) 830-5866 or complete the online booking form.