A gum biopsy (gingival biopsy) is a minor surgical procedure performed to remove a small piece of tissue from the gum line for laboratory examination. This process, called histopathology, allows specialists to analyze the cells under a microscope to determine the cause of an abnormality. Dentists or oral surgeons recommend this procedure for unexplained masses, persistent lesions, or chronic inflammation that does not resolve. The goal is to establish an accurate diagnosis for conditions such as fungal infections, autoimmune disorders, or potentially cancerous lesions.
Procedure Timeline: Surgical Time Versus Appointment Time
The time spent in the chair for a gum biopsy is divided into active surgical time and overall appointment time. The actual surgical part, where the tissue is removed and the site is closed, is brief, usually taking between 15 and 30 minutes.
The total time you should plan to be at the office is typically 30 minutes to one hour. This duration includes preparation steps like reviewing consent forms, taking images, and administering the local anesthetic. It also accounts for the waiting period for the numbing agent to take effect and post-procedure instructions before discharge.
Detailed Steps of the Biopsy Procedure
Anesthesia
The process begins with administering a local anesthetic to ensure the area is completely numb before tissue removal. A topical gel may first be applied to prepare the gum tissue, followed by an injection similar to that used for a dental filling. This step effectively blocks nerve sensation, ensuring the patient feels pressure but no pain during the surgery.
Tissue Removal and Handling
Once the site is anesthetized, the surgeon performs the tissue removal using one of a few common methods. An incisional biopsy removes a small, representative sample of the lesion. Conversely, an excisional biopsy removes the entire abnormal growth, along with a small margin of healthy tissue. A specialized punch biopsy instrument may also be used to remove a small, circular piece of tissue. Regardless of the technique, the sample is immediately placed into a preservative solution, like formalin, and prepared for transport to a pathology lab.
Site Closure
After the tissue is collected, the surgical site requires attention to achieve hemostasis, meaning stopping the bleeding. For many gum biopsies, the area is closed using a few dissolvable sutures that the body absorbs over days to weeks. If sutures are difficult to place, such as in certain areas of the gum or palate, the surgeon may use a chemical agent, like silver nitrate, to seal the small wound and promote clotting.
Immediate Care and Recovery
Following the procedure, initial bleeding is managed by gently biting down on a gauze pad placed over the site for about one hour. Slight oozing or pink-tinged saliva is common for several hours, but persistent, heavy bleeding requires contacting the surgeon. Mild discomfort is expected once the local anesthetic wears off and can usually be managed with over-the-counter pain relievers. Applying a cold compress to the cheek near the site for the first 24 to 48 hours helps minimize swelling.
During the first day, avoid vigorous rinsing, spitting, or using straws, as suction can dislodge the blood clot or sutures. Maintain oral hygiene by brushing all other areas normally while carefully avoiding the surgical site for the first few days. A soft, cool diet is recommended, and you should avoid hard, crunchy, or spicy foods. While the gum surface often heals completely within two weeks, the final pathology results are typically available two to six weeks after the procedure.