Every six months, usually during your dental hygiene appointment, your dentist and hygienist will perform an intraoral examination. They’re not just looking for cavities; they are also looking for any pathology that may have developed in your mouth since your previous visits. They may also be checking to make sure that certain areas that they are monitoring have not gotten larger or have gone away since your last visit. This process is called an Oral Cancer Screening (OCS) and is a vital component in the prevention and early detection of oral cancer. If your dentist sees something unusual, they typically refer you to an oral and maxillofacial surgeon or more rarely an oral pathologist or otolaryngologist.
When you arrive at the oral surgeon’s office, the examination will be repeated. We are looking for anything that your dentist may have missed on their exam and more importantly to identify and diagnose the area of concern. The vast majority of lesions, cysts, tumors and other abnormal findings in the mouth are totally and completely benign (non-cancerous). Most often, however, if we can confirm the presence of something abnormal in the mouth a biopsy is recommended. This does not mean that something bad is going on. It is extremely difficult and sometimes impossible to visually tell the difference between certain variations and similar looking pathologic conditions. The only way to obtain a definitive diagnosis of your problem is to have the tissue examined under a high powered microscope at a pathology lab. Your surgeon is trying to make an accurate diagnosis so that we can accurately treat the condition. Once our suspicions are confirmed or an accurate diagnosis is obtained you will have the diagnosis reviewed at your reevaluation appointment, typically one week later.
As with all the procedures in our office, the biopsy procedure can be performed either with local or general anesthesia. Some larger conditions due to the size or location of the lesion are best removed under sedation or general anesthesia for our patient’s comfort and/or safety. Talk with your surgeon about your treatment options. You may choose to have the area reevaluated and defer the biopsy procedure until a later date. As with everything there are positive and negative aspects of having or not having the biopsy performed. Rarely a biopsy result will be reviewed with some variety of oral cancer. The treatment in these cases all depend on the size of the area, location of the lesion and progression of the disease. By recommending biopsy in most cases we are trying to detect an issue as early as possible to prevent spread or progression of the disease. All of these issues should be discussed with your treating surgeon at the consultation appointment. The goal of the entire team involved in the care of our patients is the detection, prevention and appropriate treatment of all oral pathology.