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How to make a biopsy for this ulcer ?

hi i m a future dentist in the third year - faculty of dentistry - egypt . one of my relatives (17 years old) suffering from tongue ulcer on the lateral aspect of the tongue, it was painful so i adviced her to use a mouth wash after brushing her teeth then i prescribed antibiotic ( flucloxacillin 500 mg ) + analgesic ( ibubrufen 400 mg ) a week ago . the ulcer is now enlarged & appears at the other side of the tongue & become painless ( onset : about amonth ago ) i suspect that it may be malignant ulcer & i want to know how to make a biopsy for this ulcer ? i need your help
Asked On : Tue, 15 Feb 2011
Answers:  6 Views:  404
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Dentist, Oral and Maxillofacial Surgery 's  Response
hi.there can be many cause of ulcers.such as sharp tooth edge, vitamin deficiency, stress, medication, due to systemic diseases(such as tuberculous ulcer).as the age of patient is only 17 years so the chances of malignancy is less, but if the lesion persist for a long time then incisional biopsy should be performed under local anaesthesia.go to ur nearby oral surgeon and get proper check up done.take multivitamins, and if any sharp edge is there it should be smoothened.wish u good health
Answered: Fri, 29 Jun 2012
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Dentist Dr. Amit Sharma's  Response
I would suggest you to ask her to go for brush biopsy/exfoliative biopsy..In it a blunt instrument is scrapped along ulcer to collect the exfoliated cells and then these cells are fixed, then stained and is examined under microscope , patholgist examines it is relatively painless and easy procedure and report comes very fast... since one month is passed and ulcer is enlarging.. and if in exfoliative /brush biopsy any dysplasia are found then contact an oncologist soon.. as tongue is highly vascular in nature and the spread of malignancy is very fast.. then after proper clinical evaluation,incisional biopsy and MRI , USG, OPG the treatment plan and surgical procedures will be decided.. continue the use of antiseptic mouth wash along with antifungal gels as these ulcers can get secondarily infected by fungus and take care of her..
Answered: Fri, 29 Jun 2012
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Dentist, Pedodontics Dr. Karthik Venkataragahavan's  Response
going by the history of the condition your relative is suffering from, i would recommend you to consult a dentist ( oral pathologist/ oral medicine) and initiate necessary treatment. yes biopsy is an option but it is better to have the condition examined first by a specialist and then proceed with the investigations.

Answered: Wed, 16 Feb 2011
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Dentist Dr. Navneet Kumar's  Response
Hi your relatve is probably suffering from non healing ulcer due may be to carcinoma may me just to recurrent trauma due to faulty filling denture or just sharp teeth.advice him to visit a dentist.
Answered: Mon, 21 Feb 2011
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Ayurveda Specialist Dr. Rajesh Lakhanpaul's  Response
i would advice some laxative as many a times stomatitis is the result of improper bowel evacuation and the way you are narrating it's extension I would also like to know if he is anaemic many a times vitamins and iron suppliments cure such ulcers.
Answered: Mon, 21 Feb 2011
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ENT Specialist Dr. Naveen Kumar's  Response

Encourage your cousin do drink plenty of water and avoid alcohol/spicy/oily food/carbonated drinks. Also, he/she can apply triamcilone acetate oral gel twice daily after food for a week, mild oral steroids (such as prednisolone 5mg) for a day/two. Fresh fruits and green leafy vegetables have to be consumed in plenty to help in healing the ulcer. If the ulcer persists even after the above management, please take her to a good ENT specialist.

Dr. Naveen Kumar
Answered: Wed, 16 Feb 2011
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