The oral brush biopsy technique may also delay diagnosis if the results are negative. If oral brush biopsy results are negative, no diagnosis is rendered, making it difficult to determine appropriate treatment or anticipate whether an additional procedure is necessary (Potter, et al., 2003).
Although the oral brush biopsy technique has been promoted as “painless” (OralScan Laboratories, 2001), there are no studies examining the pain elicited by oral brush biopsy or comparing this pain with that elicited by scalpel biopsy preceded by administration of local anesthetic (Potter, et al., 2002). Given that an adequate oral brush biopsy sample should include all epithelial layers, the contention has been questioned that oral brush biopsy is completely “painless” or that it is substantially less painful than scalpel biopsy with local anesthetic.
The oral brush biopsy technique has also been promoted as easier to perform than scalpel biopsy, such that dentists who are unskilled at performing scalpel biopsy may be able to perform oral brush biopsy (Sciubba, et al., 2003). However, Potter, et al., (2002) stated that “[f]ear of performing a scalpel biopsy, or inadequate training in its performance, should not be construed as an indication to perform other tests that will further delay completion of the definitive diagnostic test.”
