I have a non-healing ulceration on my toungue and white coloration on the entire right underside.I am going to see a couple of DMDs about a biopsy. What should I look for/ask about to make sure I choose the practice that will not miss a malignancy if its there. Is toluidine blue a legitimate stain for tongue tissue?

Thanks!

Hello

First thing to figure out is how long has your sore been there. Try to remember when you first saw it and if it now looks any different. One indicator that it is something potentially serious is if you have a nonhealing sore in your mouth for over 2 weeks. Then its time to get it checked out. Ususally an oral surgeon or an ENT would do a biopsy and it will take about a week for the results to come back. Its not cancer til it says so in a biopsy report.

Sorry but I have no info at all about a blue stain.


Best of luck.

To elaborate a little on what Christine has told you, the only way to be sure whether the areas are cancer or not is by having a biopsy done. The blue stain is not a conclusive way to find out. It is often used in conjunction with with an adjunctive oral cancer screening system called ViziLite.

Many general dentists will do a biopsy and many will refer you to an oral surgeon or an ENT.

I would check with the office(s) where you have an appointment and if they don't do biopsies, you should call an oral surgeon or an ENT and not waste time going to an office that will end up referring you.

Good luck.

Jerry

The "two week" concept has somehow been mixed up. What we typically say around here is if you are given a prescription for antibiotics and the region of interest (ROI) hasn't responded in 2 weeks then it's time to see the ENT. If it is an infection it may not resolve by itself without antibiotics.

Any non healing lesion that has persisted with or without treatment for 14 days needs to be biopsied. That period of time can be determined by the patient coming in and saying "it's been there for a couple of weeks" or the dental team noticing it and starting to count it from that point. Many times the patient is unaware of it because the sore/lesion can be painless. So the 14 day period is when most things resolve on their own. Cold sores, apthous ulcers, cheek bites, pizza burns on your tongue, etc. all heal by themselves in 14 days or less. So anything persisting after that length of time deserves further exploration, and a biopsy is a black and white answer to what it is. Antibiotics for these things usually are not productive because so many of them are viral in origin, and of course antibiotics have no impact on viral etiology lesions.

A biopsy is a simple inexpensive, little physical pain, procedure that leave you with an finite answer. The earlier a finite answer, the earlier you can deal with something dangerous, or the earlier you can quit worrying about something benign.

Since you are seeing a dentist, I would add that I am not a big proponent of brush biopsy procedures which some dentists do. They give you back an ambiguous answer, and in your case where you say you have a visible lesion, not just a white spot, they are contraindicated for what is essentially a class two lesion. If it is to be biopsy, see that they refer you to an oral surgeon to get a small piece of it taken and read by a certified oral pathologist.... don't mess round wasting time with a brush biopsy.