I just had a biospy of my inner cheek to check for buccal mucosa cancer. It was the most painful experience of my life. I am wondering if the correct anesthetic was used.

My dentist had done a screening with the Vizilite and I had scarring on my cheeks that responded. She referred me to an oral surgeon. He couldn't tell for sure so he did a biopsy.

Only a topical anesthetic was used. It was done with a scapel. I almost passed out twice.

Has anyone else experienced a biopsy for buccal muscosa with only a topical anesthetic and not a local anesthetic (shot)?

I'm very wary of going back to the same oral surgeon to get the stitches out and hear the results. I don't want any more pain.

Thank you for any advice.

What he did is not the normal methodology for doing a biopsy. Local infusion of anesthetic by injection is used as a matter of routine even for superficial surface removals. I just had a skin cancer taken off that required a deep almost 2 inch long incision. All done with a local anesthetic. But even when the first superficial shallow slice was taken off the surface for biopsy, I got a couple small jabs with some lidocaine to numb the area. More than just the discomfort to the patient, the doctor must consider what might happen should the patient suddenly jump or jerk around from the pain when they have a sharp object in your mouth....

At least getting the stitches out should be painless and require no anesthetic.

If I were you I don't think I would use this doc again and I might even be tempted to inquire with his licensing Board to see if what he did bordered on unacceptable. Even if the Board takes no action he will have to respond to them and at the very least it will make him think twice about doing something like this again.

Belle,

There is no excuse for an oral surgeon doing a biopsy with only a topical anesthetic. As a dentist, I am shocked to hear this. No anesthetic should be needed to remove the sutures and you should at least go back for the biopsy results.

I wouldn't hesitate to let him know how you feel about not having sufficient anesthesia for the biopsy and I would put him on the spot and ask him if he would have a biopsy done in his mouth with only a topical. The answer could be interesting.

Jerry

Belle,
My first ENT took out part of my gum with only a topical.
He just jerked and I screamed and jumped out of the chair and just cried and cried. Oh my God!! Fortunately, days later, when he told me the bad news, he told me I must go to someone else because his hip would not let him stand up to do surgery.
My new ENT was so mad! He has since done 2 needle biopsys in my
mouth and I did not feel a thing with him. What a relief and also, they were negative, yeah!!
Switch to someone else, that it a bad omen. I am so sorry
for you. Like Jerry said, ask him if you can do that to him!!
Good luck to you,
Debbie
c

Belle,
That sounds like a terrible experience.
I was glad you posted it though, I hadn't even considered that they might do it with just a topical.
I had my biopsies today.
The doctor used a local anesthetic, I felt no pain with the biopsy from the inner right cheek, but the left side wasn't as numb when the biopsy was taken. No stitches.
Can anyone tell me if it is the same for a tongue biopsy?
They did not do that one today.

It's the same procedure for both areas. Unless the doctor is taking something rather large, they many times do not stitch up the area. A punch biopsy is about 5mm in diameter. It takes a nice little core out and does not require closure for the most part, this is sometimes a function of where the punch is taken from and the vascularization of that area. Obviously anything that has the potential to bleed a bit will get a single stitch in it to help it heal. When they just leave it afterwards, this is called healing by secondary intent. The new tissue granulates in from the deepest areas and sides of the wound and it just closes up on its own over a while.

Belle:

Ive had 2 biopsies of my cheek done. The first one I was completely knocked out by a shot in my arm. The second one was done with a local anestethic. Both were done by my oral surgeon.

Dell,

I had a biopsy on my tongue and one on my inner cheek (many years ago and it was benign). Both times sutures were used. I have seen many biopsies done by my surgeon and he always will use sutures as the tongue, being a strong muscle, wouldn't heal very well by secondary intention. As Brian said, if a punch biopsy is done, sutures are not usually needed.

Jerry

Brian, David, Jerry, Debbie, Dell, Christine,

Thank you all so much for your feedback. AFter today's events, I called my dentist and asked for a new referral. When I told her assistant what happend, she was stunned and out of words.

I called the oral surgeon's office last week and asked why I wasn't given anesthetic. I could hear in the nurse's voice that she was suprised (she was not the one that assisted on me). She said there was no way I could have had the biopsy done without a local anesthetic. "You would have been screaming your head off." As you know, it's hard to scream with a scapel in your mouth. She spoke with the doctor, but he didn't talk to me or call me back.

I made an appointment today for next to go over the results and maybe get the stitches out. I was thinking of having my regular dentist take them out.

Then the mail comes. The doctor is a complete bonehead, in my opinion. They mailed a copy of the pathology report to my house! No warning, no please call us to discuss, etc. etc. Based on me and the internet, it sounds like it's maybe pre cancerous, but mostly just chronically irritated tissue and fungual infection.

It says the buccal mucosa is hyperparakeratosis, microvesicular mucositis and cadidal colonization.

So once I get the new referral, I'm having all the tests transferred and go from there.

Thank you again for sharing your knowledge with me.