Biopsy from the oral cavity: Why, when, how and especially what not

Caries and periodontal disease are the most common pathologies encountered by general dental practitioners on a daily basis. Although less frequently, the oral cavity is also affected by a plethora of pathologic lesions that may represent either a local process or may be a manifestation of systemic conditions. The etiology of these lesions is diverse and ranges from congenital/ developmental, reactive, to neoplastic (benign and malignant), metabolic and hereditary. These lesions are expected to be recognized by the dental clinicians whose main concern would be to achieve a prompt and accurate microscopic diagnosis. The way to a microscopic diagnosis goes through a biopsy procedure. The principles that should guide the dental practitioner for producing a high quality, artefact-free tissue sample from the oral cavity are reviewed in the article together with notes on errors that should be avoided. The patient's life can sometimes depend on a tissue sample as small as 0.5 cm, hence the utmost importance of the strategic and technique-related considerations to be taken by the general dental practitioner prior to performing a biopsy from the oral cavity. In certain cases, the dental practitioner should use the services of specialists in oral medicine or oral and maxillofacial surgery in order to proceed with the biopsy procedure and get a prompt and accurate diagnosis.