My husband’s dentist noticed a small leukoplakia on the underside of his tongue during a routine dental appointment. She sent him to an oral surgeon for a biopsy; the report (by a lab that does only oral pathology) came back as moderate dysplasia but warned of a possible “skip effect,” meaning that there could be bad cells in areas that weren’t sent for study. Because cancer had not been diagnosed, he scheduled an excisional biopsy of the whole thing with a well-regarded ENT, who removed it a month later.

He was one of the unlucky ones whose dysplasia turned to cancer; the excisional biopsy (which got it all) came back as SCC in situ, with a small bit superficially invasive. He immediately switched his care to an oral cancer specialist at Johns Hopkins, who determined that no further treatment was necessary and followed him closely over the next few years. He’s now 12 years out and is regularly examined with a VELscope as part of his dental care; he has been referred to the oral surgeon a couple of times for what turned out to be routine mouth irritation.

I can’t speak to the differences between laser and scalpel removal, as laser was never discussed.