OralCDx brush tip

Biopsies: A Slice of Life?

You bet! Whenever we see a suspicious lesion in the mouth, a biopsy helps determine if the cells are a cancer or are pre-cancerous. This is important because cancers of the mouth and throat constitute 3% of all cancer diagnosed annually. Here's an alarming fact that should cause every individual who has a suspicious lesion to seek treatment: survival rates have not changed significantly from this disease despite four decades of advances made in surgery, radiation, and chemotherapy. Half of all people who have oral cancer will die from it.

A study published (March 2002, David Christian) shows that 9.7% of dentists and hygienists attending ADA had unexplained white or red spots needing follow up. If you have 20-40 new or re-call patients a week, that translates to at least 2 brush biopsies a week.

However, early detection of oral cancer can improve cure rates. The trouble is that early malignancies often look the same as benign lesions. By the time pre-cancerous lesions progress to the point where they look "suspicious," valuable time has been lost to treat these lesions. Now a simple, non-invasive test is available that offers a more precise way to study "early" lesions that might be cancerous. It's known as OralCDx.

OralCDx utilizes a sterile brush biopsy technique. Employing it much the same way PAP smears are taken, the oral brush biopsy is rotated five-to-ten times against the surface of the lesion. The material collected on the brush is transferred to a glass slide and flooded with a fixative to avoid air-drying. Once the slide itself is dry, it is sent for a computer analysis that searches for abnormal cells. The computer is able to distinguish between normal and atypical cells, as well as those that are cancerous. A pathologist then reviews the slides to confirm a diagnosis.

In a study published in JADA*, OralCDx was found to be equivalent to scalpel biopsies when it came to detecting pre-cancerous and cancerous lesions. It must be emphasized that the brush biopsy does not replace surgical biopsies; rather it accurately detects which lesions should be biopsied. This multi-center study showed the value of OralCDx as being able to identify benign pre-cancerous and cancerous lesions at early stages when treatments are more effective.

*Sciubba, J.C.: Improving detection of pre-cancerous and cancerous oral lesions. JADA 130: 1445-1457, 1999.

Tip: patients with dentures should still have annual dental checkups to screen for oral cancers and other pathologies.