Gerald S. Fine, D.D.S.

   Oral and Maxillofacial Surgery

Brookline Office
Tel: 617-731-6060

Our commitment is to provide you the highest standard of oral and maxillofacial surgery in a professional manner.

Patients With Suspicious Lesions

A few months ago a general dentist called my office to get my advice. The dentist had noticed a lesion, which had persisted for several months. The dentist wanted to know how long should a suspicious lesion be watched before a biopsy was indicated as well as what are the indications for a biopsy.

The answer to the second question, "What are the indications for a biopsy" is as follows:

Any persistent pathologic condition which cannot be diagnosed clinically including:

Any lesion which is felt to have malignant or premalignant characteristics including the following:

Confirmation of clinical diagnosis suspicions.

Any lesion which doesn't respond to routine clinical management, such as antibiotic treatment or endodontic treatment over a reasonable period.

Any lesion, which is a source of extreme concern to the patient (that is cancerphobia). The patient's fear about a persistent lesion may be of greater than the concern about undergoing a minor surgical procedure.

If a lesion has not resolved or changed with in 7-14 days, the dentist must decide whether further observation or biopsy is most appropriate. For lesions with a low index of suspicion, a preliminary diagnosis should be recorded and a photo of the lesion obtained. In general, patients should be re-evaluated at 1, 3, 6, and 12-month intervals. If a biopsy is negative but clinical suspicions remain high, the biopsy report should always be interpreted with the clinical impression in mind and a repeat biopsy may be appropriate. If unsure as to how to proceed, the dentist should obtain a specialist's opinion.

When dealing with suspicious but not frankly malignant or premalignant lesions, close follow-up, detailed documentation, and timely referrals are essential.

‍Gerald S. Fine, D.D.S.
Practice limited to oral & maxillofacial surgery‍