Overview

An oral biopsy is simple test that helps diagnose problems with your mouth. It is done if you have a lesion (abnormal area inside your mouth).

A small sample of tissue will be taken from inside your mouth. For example, from your tongue, lip, gum or inside of your cheek.

The sample is sent to a laboratory to be examined under a microscope. This helps us to find what is causing your problem.

Risks of an oral biopsy

The risks are very small, but having a biopsy might cause you some pain, bleeding, discomfort and swelling.

There is small risk that tiny nerves might be damaged in the area where the biopsy is taken. Any risks will be explained to you before you have a biopsy.

Other treatment options

There are no alternatives that can be used to diagnose and confirm the cause of a lesion.

Preparing for an oral biopsy

No special precautions have to be taken before your appointment.

• Eat and drink as normal before your appointment, and do not miss meals.
• Take all your medicines as normal. Before the biopsy, make sure the doctor treating you knows about any medicines you're taking, especially any blood-thinning medicine.
• Make sure you arrive on time for your appointment.

Anticoagulant medicines (blood thinners)

Pleases take these medicines as you normally would:

• aspirin
• clopidogrel
• apixaban
• rivaroxaban
• dabigatran

Warfarin

Do not stop taking warfarin, but please have a blood test to check your INR (international normalised ratio) at your usual clinic, 24 to 48 hours before your biopsy. Bring this result with you to your appointment.

You might be asked to come early for your biopsy and have a blood test at the hospital on the same day.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have the procedure or treatment, we will ask you to sign a consent form. This says that you understand what is involved and agree to have the treatment.

Read more about our consent process.

During an oral biopsy

An oral biopsy usually takes about 30 minutes.

It will be done under a local anaesthetic, which means you will be awake during the procedure, but the area will be numb so you will not feel anything. You will be given an injection to numb the area where the biopsy will be taken.

You might feel a little discomfort when the local anaesthetic is being given to numb the area. The doctor will check that the area is numb before doing the biopsy.

A small piece of tissue will be removed from your mouth. The exact procedure you have will depend on what type of biopsy you are having.

A biopsy of the tongue, lip, inside the cheek or floor of the mouth usually needs 1 to 3 dissolvable stitches to help with healing. The amount of stitches you need depends on the size of the lesion.

If the biopsy is on the roof of your mouth, or your gum, it's not usually possible to stitch the area. A chemical (silver nitrate) might be used to help stop any bleeding. This can leave a grey stain and bitter taste for several days.

After an oral biopsy

Before leaving the hospital, your doctor will check that any bleeding has stopped, and will tell you how to keep your mouth comfortable over the next few days.

The area might be sore. You can take regular painkillers, such as paracetamol or ibuprofen, which you can buy from a pharmacy or shop. Always follow the instructions on the packet.

You can read our information about going home after dental surgery.

When you leave hospital

You will need to be careful what you eat, and we recommend a soft diet.

For the first 24 hours after your biopsy, you should follow these instructions.

• Avoid very hot food or drinks as the area will be numb, and you need to protect it.
• There might be an unpleasant taste in your mouth, but this can be resolved with small sips of water.
• Do not plan anything physically tiring for the rest of the day.
• Do not rinse your mouth and spit out, as this can dislodge blood clots and cause bleeding.
• Keep speaking to a minimum, so that you do not dislodge stitches in your tongue or lip.

Rinsing your mouth

24 hours after your biopsy, you should rinse your mouth with a warm, salt-water mouthwash. This can lower the risk of an infection.

To make the mouthwash:

• mix 1 level teaspoon of salt in a glass of hot water
• let it to cool down until warm

Remember to spit the mouthwash out. Use the mouthwash 3 times a day, after meals. Do this for 5 to 7 days after treatment.

Stitches

Stitches usually partially dissolve and then fall out, and do not need to be removed. They normally take 10 to 15 days to dissolve. Stitches in your tongue or lip are easily dislodged, so avoid crunchy food, and keep speaking to a minimum for 24 hours after your biopsy.

Follow-up appointment

You will be asked to make a follow-up appointment at the hospital to get the results of your biopsy. If you need more treatment, this will also be explained at your follow-up appointment.

Sometimes, when a simple lump is removed and no more treatment is needed, we can give you the results over the phone.