If you have a lesion on your gums that does not go away within a few days, your doctor or dentist may recommend getting a gum biopsy.
The health of your gums is important as gum diseases and oral cancer can affect your dental health.
Not only this, but they can also affect your overall health if you do not treat them.
Gum biopsy is a minimally invasive procedure that helps to treat different periodontal concerns.
Moreover, with this procedure, your doctor or dentist can examine the tissues and determine whether the lesions are cancerous or not.
During this procedure, your doctor or pathologist will remove the sample of tissue from your gums.
They will then send it to the lab for a test. Gingiva is another word for gums, and many doctors refer it to as Gingival Biopsy.
These gingival tissues are the tissues that immediately surround and support your teeth.
Keep on reading.
A gum biopsy is a surgery in which your doctor or dentist will remove a small piece of gingival or gum tissue and examine it.
Moreover, it is a diagnostic tool that allows the pathologist to test the infected tissue and identify what are the causes of this abnormal tissue.
In case the test reveals cancer, this biopsy can help identify the stage and extent of cancer.
Before the procedure, your doctor or dentist will ask you to avoid eating hours before it takes place and rinses your mouth with an antibacterial rinse.
In most cases, they can perform the procedure with local anesthesia.
However, if the lesion is hard to reach, they may suggest general anesthesia to make sure to experience less discomfort and pain.
Types of Gum Biopsy
There are different types of gum biopsies. Let’s discuss them as follows:
An incisional biopsy is one of the most common methods for gum biopsy.
During this procedure, your doctor will remove a portion of the suspicious tissue and examine it under a microscope.
Moreover, with the help of this type, a pathologist can determine if there are cancerous cells in the gum tissue they have removed.
They can also verify the origin of the cells or if they have spread to the gums, from somewhere else in your body.
During this type of gum biopsy, your doctor may remove an entire growth or lesion from your gums.
During this type of biopsy, they will normally take out a small lesion that is easy to reach.
Moreover, your doctor will remove the growth or lesion along with some of the nearby healthy tissue.
Such a type of biopsy is a procedure where a doctor will insert a biopsy needle through the skin. There are two types of this biopsy.
- fine-needle biopsy
- core needle biopsy
A fine needle biopsy works best for lesions that are easy to see and feel.
On the other hand, a core needle biopsy provides more tissue than a fine needle biopsy.
This type can be useful when your doctor needs more tissues to make a diagnosis.
A brush biopsy is a non-invasive procedure and your doctor will gather tissue y forcefully rubbing a brush against the abnormal area of your gum.
In most cases, a brush biopsy is often the first step your doctor will take in case the symptom does not call for an immediate, more invasive biopsy.
Your doctor can use it for an initial evaluation as well.
If the test results show any suspicious or abnormal cells or cancer, your doctor will likely conduct an incisional or percutaneous biopsy to confirm a diagnosis.
Uses of Gum Biopsy
With a gum biopsy test, your doctor can test for abnormal or suspicious gum tissues.
Your doctor may recommend this o help diagnose:
- a sore or lesion on your gums that tend to last longer than two weeks
- a white or red patch in your gums
- ulcers on your gums
- swelling in your gums that does not go away
- changes in your mouth that can cause loose teeth or dentures
Moreover, your doctor may also use a gum biopsy along with imaging tests to reveal the stage of existing gum cancer.
Imaging tests can include X-rays, CT scans, and MRI scans.
The information they obtain from the gum biopsy, along with the findings of the imaging test can help your doctor to diagnose gum cancer as soon as possible.
An earlier diagnosis means less scarring from the removal of tumors and a higher rate of survival.
Preparing for the Procedure
In most cases, you do not have to do much to prepare for a gum biopsy.
Make sure to tell your doctor if you are taking any prescription medications, over-the-counter drugs, or herbal supplements.
Moreover, also discuss how these should be used before and after the test takes place.
It is important to note that some medications may affect the result of a gum biopsy.
These include medications that affect blood clotting, like blood thinners and nonsteroidal anti-inflammatory drugs, NSAIDs, like aspirin or iburophen.
Your doctor may also provide special instructions if you are taking any of the above medications.
Furthermore, you may also have to stop eating for a few hours before the gum biopsy.
What to Expect during Gum Biopsy?
It is important to note that a gum biopsy often occurs as an outpatient procedure at a hospital or in the office of your doctor.
Moreover, a physician, dentist, periodontist, or oral surgeon will perform this biopsy.
A periodontist is a dentist who specializes in diseases that are related to gum and mouth tissue.
Preparing the Area
At first, your doctor will sterilize the gum tissue with something topical. It can be something like a cream.
They will then inject local anesthesia to numb your gum. However, it may sting.
Instead of the injection, your doctor may also choose to spray a painkiller onto your gum tissues.
After this, your doctor may use a cheek retractor to make it easier to access your entire mouth and this tool also helps to improve the lighting inside your mouth.
In case the location of the lesion is hard to reach, you may receive general anesthesia.
This can put you into a deep sleep for the whole procedure. With that, your doctor can move around your mouth and reach difficult areas without causing any pain or discomfort.
Incisional or Excisional Open Biopsy
Whether you are having an incisional or excisional open biopsy, your doctor will make a small incision through your skin.
Moreover, you may also feel some pressure or minor discomfort during the procedure.
However, the topical anesthesia your doctor will administer will help prevent you from feeling any pain and discomfort.
Electrocuterixation may also be necessary in order to stop bleeding and this procedure involves using an electric current or laser to seal blood vessels.
In some cases, they may place stitches that are absorbable. This means that they will dissolve naturally.
If not, you will need to return to your doctor in about a week to have them removed.
Percutaneous Fine Needle Biopsy and Percutaneous Core Needle Biopsy
In case your doctor recommends percutaneous fine needle biopsy, your doctor will insert a needle through the lesion on your gum and extract some cells.
Moreover, they may also repeat the same technique at several different points in the affected area.
On the other hand, in case they choose to perform a percutaneous core needle biopsy, your doctor will press a small circular blade onto the affected area.
The needle they will use cuts out a section of skin with a round border.
Pulling on the center of the area, they will then extract a plug, or core, of cells.
It is important to note that you may hear a loud clicking or popping sound from the spring-loaded needles when your doctor is pulling out the tissue sample.
There is rarely much bleeding from the site during this type of biopsy and the area tends to heal without needing stitches.
During the procedure of brush biopsy, you may not need topical or local anesthesia at the site as it is a minimally invasive procedure.
Your doctor will rub a brush strongly against the abnormal area of your gum.
However, during this, you may experience only minimal bleeding, discomfort, or pain during the procedure.
Since the technique tends to be non=invasive, you will not need stitches afterward.
Recovering after Gum Biopsy
After the procedure of gum biopsy takes place, the numbness in your gums will gradually wear off.
And you can resume your normal activities and diet on the same day as well.
During your recovery, the biopsy site may be sore for a few days and your doctor may ask you to avoid brushing around the site for at least one week.
However, if you receive stitches, you will have to return to your doctor or dentist to have them removed.
Make sure to contact your doctor if you experience any of the following:
- if your gums bleed
- become swollen
- remain sore for a long period of time.
Risk of Gum Biopsy
Prolonged bleeding and infection of the gums are two potentially serious, however, rare risks of getting a gum biopsy.
Make sure to contact your doctor if you experience the following:
- excessive bleeding at the biopsy site
- soreness or pain that tends to last longer than a few days
- fever or chills
- swelling of the gums
Results of a Gum Biopsy
The tissue sample that your doctor or pathologist takes during the gum biopsy procedure will go to the pathology lab.
There, a pathologist, who specializes in tissue diagnosis will examine the biopsy sample under the microscope.
Moreover, they will identify any signs of cancer or other abnormalities and make a report to your doctor or dentist.
In addition to cancer, an abnormal result from a gum biopsy can indicate the following:
Systemic Amyloidosis: In this condition, abnormal proteins, i.e. amyloids, buildup in your organs and spread to other parts of your body, including your gums.
Thrombotic Thrombocytopenic Purpura, TTP: TTP is a rare, potentially fatal blood clotting disorder that can cause bleeding of the gums.
Benign Mouth Lesions or Infections
In case the results of your brush biopsy show precancerous or cancerous cells, you may need an excisional or percutaneous biopsy.
This will help your doctor to confirm the diagnosis before the start the treatment.
However, if your biopsy shows gum cancer, your doctor can choose the treatment plan based on the stage of cancer.
Moreover, early diagnosis can help to make sure that you have the best chance of successful treatment and recovery.
Gum biopsy is a minimally invasive procedure that can help diagnose oral cancer and other periodontal issues.
It is important to note that you should not avoid any lesion on the gums that does not go away in a few days, as it can be life-threatening. Thus, seek medical advice or consult your doctor as soon as you can.