Michelle,

My advice would be to contact a good ENT as soon as possible. In my humble opinion, which Brian may well disagree with, when it comes to cancer, dentists, including oral surgeons, are simply not up to the task. The sign of a good dentist is that they actually recognize their limitations and refer you to an MD/DO.

My own dentist referred me to an oral surgeon last October, when a sore under my tongue did not heal. The oral surgeon then did an excisional (not brush) biopsy, which then proved to be positive. He was very prompt in giving me the bad news, and immediately referred me to an ENT. Since this oral surgeon was an experienced maxillofacial surgeon, who performs a wide variety of restorative procedures, I asked him why he was "passing me off" to an ENT. He said once oral cancer has been positively diagnosed, the ENT is the next appropriate stop. He said the work of an oral surgeon is primarily restorative, not curative, and something as serious as cancer is the proper domain of the medical community (MDs and DOs). Now that's a good dentist!

Assuming you want real peace of mind, Michelle, I would find a good ENT as quickly as possible and have him or her do a thorough workup. It may very well end up being a completely benign condition, but, regardless of outcome, you want to make sure you receive the diagnosis from the person most qualified in the area of head and neck cancers. Simply revisiting the oral surgeon while he "tries" different approaches is a waste of precious time.

Remember too, that the ENT is not the be-all and end-all when it comes to oral cancer. As Brian has pointed out many times, oral cancer requires a multidisciplinary approach, tapping into the expertise of dentists, oral surgeons, ENTs, head and neck surgeons (many, but not all ENTs are), medical oncologists, radiation oncologists, and speech therapists. But in terms of initial diagnosis, and possible surgical treatment, the ENT is really the expert in this area.

I would also like to mention that my own ENT echoes the comments of kimt30's ENT (see previous post): a brush biopsy does not provide adequate tissue sampling to render a definitive diagnosis, especially with certain types of oral cancer such as tongue cancer (my type). This is not to say that it's not a valuable screening tool. In other words, if the test is positive, it has obviously proved its worth by providing an early diagnosis and possibly saving one's life. But if it's negative, the result may be inconclusive. Cancer cells may still be present in the deeper tissue layers, that the brush will never reach. Here again, this is a judgement call for a qualified ENT, who will assess the location of the lesion, your overall health history, etc., so don't kick yourself for not demanding one at the oral surgeon's office. (Frankly, I think the brush biopsy is designed primarily for dentists, whom we don't want wielding scalpels too close to vital structures such as one's tongue! My own dentist would probably agree.)

Best of luck to you, Michelle, and please remain optimistic. Remember, as of this moment, you have absolutely no reason to be otherwise.

Mark