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The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer.

The following can be signs at the beginning of a pathologic process or cancerous growth:

  • Reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth
  • A sore that fails to heal and bleeds easily
  • A lump or thickening on the skin lining the inside of the mouth
  • A mass or lump in the neck
  • Chronic sore throat or hoarseness
  • Difficulty in chewing or swallowing

These changes can be detected on the lips, cheeks, palate, and gum tissue around the teeth, tongue, face, and/or neck. Pain does not always occur with pathology and, curiously, is not often associated with oral cancer.

However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer.

We would recommend performing an oral cancer self-examination monthly and remember that your mouth is one of your body’s most important warning systems. Do not ignore suspicious lumps or sores. Please contact us so we may help.

Biopsy

When you visit our office for an evaluation, we will be looking at your gums, teeth and all your anatomical structures like the tongue, floor of the mouth, uvula, lips, palate etc. If during the exam we find any abnormalities on them, we will then need to do a biopsy.

A biopsy is a diagnostic procedure by which we remove a sample of tissue (incisional biopsy) or all of the abnormal tissue (excisional biopsy) for examination under the microscope by a pathologist. Early detection and treatment of a malignant lesion provide a better chance for a cure.

Abnormal results could mean:

  • Oral Cancer – The most common causes for oral cancer are tobacco and alcohol. Other causes include poor oral hygiene, irritation caused by ill-fitting dentures and rough surfaces on teeth, poor nutrition, some chronic infections and combinations of these factors.
  • Non-cancerous mouth sores (the specific cause can be determined in many cases).

Procedure

In most cases biopsies are carried out under local anesthesia (an injection into the area to numb it). The injection takes a couple of minutes to work and means that the biopsy will be painless. A small piece of the gum tissue that appears abnormal is removed. The biopsy usually leaves a small hole that often requires stitching. In the majority of cases the stitches used are dissolvable and take around two weeks to disappear.


The whole process (local anesthetic injection, biopsy and stitching) usually takes around 15 minutes from start to finish. The biopsy is then sent to a laboratory where a pathologist evaluates it under the microscope. The biopsy report not only helps establish a diagnosis, but also enables us to develop a specific plan of treatment.

After the numbness wears off, the area may be sore for a few days. Occasionally it is necessary to take simple painkillers (e.g. Ibuprofen or Tylenol). Usually any discomfort only lasts a few days.

Most people are able to return to work later the same day. Since the stitches are dissolvable a review appointment is not always necessary but you will usually be given one so that the results of the biopsy can be discussed with you.

Recommendations: self-examination should be performed monthly.