Exodontia.Info
Oral Biopsies - Operative Warnings
Pain.  As it is a surgical procedure, there will be soreness
after the biopsy.  This can last for several days.

Painkillers such as
ibuprofen, paracetamol, Solpadeine or
or Nurofen Plus are very effective.  Obviously, the
analgesic you use is dependent on your medical history &
the pain you are experiencing.

Swelling.  There will be swelling afterwards.  This can last
several days.

Use of an ice-pack or a bag of frozen peas pressed
against the cheek adjacent to the biopsy site, will help to
decrease the swelling.

Avoidance in the first few hours post-op, of alcohol,
exercise or hot foods / drinks will decrease the degree of
swelling that will develop.

Occasionally, there is bleeding into the cheek or the floor
of the mouth (dependent on where the biopsy took place)
- there may well be limitations to mouth opening or tongue
use respectively.  This also improves with time.

Stitches.  The biopsy will often be closed with stitches.  
These are dissolvable and ‘fall out’ within 10 – 14 days.

Limited Mouth Opening (Trismus).  Often the chewing
muscles and the jaw joints are sore after the procedure
so that mouth opening can be limited for the next few
days.

Scarring / Lumpiness at the Biopsy Site.  Any cut to soft
tissues produces a scar.  Initially, after a biopsy, a scar
will be produced.  This softens and disappears (i.e.
improves) with time.

Regardless, it can feel quite obvious and lumpy
(especially if the biopsy has been in the lips or cheeks.

The scarring can also dependent on the size and size of
the biopsy and the individuals’ tendency to scarring.

Initial Tautness / Tenderness at the Biopsy Site.  The
biopsy margins are brought together with stitches hence
there is some tension at the operation site.  This tails off
as the swelling goes down.

Localised Area of Numbness at the Biopsy Site.  This
especially effects the lips and tongue (tip).  Biopsies can
damage the local nerves resulting in areas of numbness.  
These can take a number of months before normal feeling
returns.

Recurrence.  Dependent on what is biopsied, there is a
chance that the lesion can recur.  They recur either due to
the nature of the lump / patch or due to the recurrence of
conditions that caused the lump / patch to develop.

For instance, during pregnancy many odd lumps and
bumps develop on the gums.  If they are removed /
biopsied, they recur.  They are often left until after the end
of pregnancy as most of the lesions disappear or
dramatically regress.

Polyps on the cheeks or lips can recur as the patient may
bite on these areas again producing the polyps anew.

Inconclusive Results & the Need for Re-Biopsy.  The
biopsy results can come back as inconclusive.

If this is the case, then it is possible that the lesion may  
need to be biopsied again.

If all the lump / bump has been removed, it is very unlikely
that these come back as inconclusive (and also there is no
possibility of re-biopsying the site).

Further Treatment Dependent on Results.  Depending on
what the biopsy results are, will determine whether further
treatment is required.

If the lump turns out to be just a
polyp or granuloma, then
nothing further needs to be done.

If the patch turns out to be symptomatic
lichen planus
then steroids can be prescribed and the patch can be
reviewed in initially by the hospital and then by the GDP /
GMP.  If the lump turns out to be more serious, then
further investigations and treatments may be necessitated.


Anatomical-Specific Warnings:

Tongue – limitation mobility / function of tongue (due to
swelling, tenderness etc); marked swelling.

Gums – gum recession, hot-cold sensitivity due to
exposed dentine as the gum recedes; need for use of
Coe-Pak (surgical dressing / cement) dressing.

Cheeks – numbness / tingling at the biopsy site
(especially if biopsy of lip); problems with salivary gland
ducts (adjacent to the upper 1st molars) being
traumatised, tied off (by stitches) or cut through.

Floor of Mouth - altered sensation; problems with salivary
gland ducts being traumatised, tied off (by stitches) or cut
through.

Roof of Mouth – bleeding from biopsy site due to difficulty
in apposing the wound sides; roof of mouth-floor of nose
communications (especially if the soft palate is being
operated on); need for use of
Coe-Pak.
Last Updated 11th August 2010