Mr Christopher Vinall Consultant Oral & Maxillofacial Surgeon Arrange a consultation

Treatments / Oral lesions & biopsy

Oral lesions, ulcers and lumps

Specialist assessment, biopsy and treatment of changes to the lining of the mouth and lips, with prompt appointments when something needs looking at quickly.

Changes in the mouth that deserve a specialist opinion

The lining of the mouth is checked by your dentist at every routine visit, and most of what turns up is harmless: a bitten cheek, a mouth ulcer, a small mucocele on the lip, a fibrous lump where a tooth rubs. But some changes need to be examined by a specialist and, where there is any doubt, sampled. The general rule is that anything in the mouth that hasn't healed within three weeks should be seen.

Chris assesses and treats:

  • Ulcers that persist beyond three weeks, or keep returning
  • White patches (leukoplakia), red patches and lichen planus
  • Lumps and swellings of the cheek, tongue, floor of mouth, gums or palate
  • Lip lesions, including mucoceles and sun‑related changes
  • Salivary gland swellings and blocked salivary ducts
  • Other soft‑tissue lesions found by your dentist or GP

Biopsy

A biopsy is the removal of a small piece of tissue, or the whole lesion if it is small, so that it can be examined under a microscope. It is done under local anaesthetic in the outpatient clinic or as a short day‑case procedure, usually takes ten to twenty minutes and heals within a week or two. The result normally comes back within one to two weeks, and Chris will go through it with you in person or by telephone, whichever you prefer.

For most patients the result is reassuring. Where it isn't, Chris is part of the head and neck service at University Hospitals of Leicester and can make sure you are seen by the right team without delay.

Treatment of benign lesions

Many lesions can be removed completely at the time of biopsy rather than needing a second procedure. Others are monitored, with photographs and regular review, rather than removed. Where a lesion is inflammatory, such as lichen planus, management is usually with topical treatment and follow‑up rather than surgery. Chris will explain which approach he recommends and why.

What happens

  1. Consultation

    A careful examination of the whole mouth, neck and lips, a discussion of your history and habits, and photographs for the record.

  2. Biopsy or removal, if needed

    Arranged as a separate appointment in a treatment clinic or day‑case theatre, usually within a week or two, under local anaesthetic.

  3. Results and plan

    Results explained plainly, with a written summary to you and, with your permission, to your dentist and GP.

Do I definitely need treatment?

Not necessarily. Chris will first establish whether treatment is needed at all and whether there are reasonable alternatives to surgery. He may recommend leaving things alone when:

  • a change is clearly caused by something obvious such as a sharp tooth or a cheek bite, and disappears once the cause is dealt with
  • a harmless condition such as geographic tongue or a small fibrous lump is confirmed and causing no trouble
  • a lesion such as lichen planus is better managed with topical treatment and regular review than with surgery

What does the next week look like?

A typical recovery. Yours will be discussed with you individually before you decide to go ahead.

That evening
Numb for a couple of hours, then mildly sore. Ordinary painkillers are enough. Avoid hot drinks until the numbness has gone.
Day one
A small ulcer at the biopsy site is normal and feels worse than it looks. Salt‑water rinses after meals.
Days 2 to 3
Sore when eating anything spicy, salty or sharp. Otherwise fine.
By one week
Healing well; dissolving stitches are usually gone by 7 to 10 days. Chris will have your result at around this point.
Practicalities
Driving
Same day after local anaesthetic.
Work
Same day or next day.
Eating
Avoid very hot, spicy or crunchy food for 2 to 3 days, otherwise as normal.

Chris's view

"The commonest thing I say in this clinic is 'that's nothing to worry about'. But I say it after looking properly, and if there's any doubt I take a sample, because a three‑week rule exists for a reason."

Mr Christopher Vinall

When should I get advice?

Arrange an assessment for any ulcer that hasn't healed in three weeks, any white or red patch, any lump in the mouth or on the lip that is new, growing or bleeds, or if your dentist has asked for a specialist opinion.

Arrange a consultation