Early detection is crucial for improving oral cancer outcomes. While traditional methods like visual exams and scalpel biopsies are effective, they are invasive and involve significant tissue removal. A newer, noninvasive tool, the brush biopsy, is gaining attention for its ability to provide high diagnostic accuracy without the discomfort and tissue removal associated with traditional methods.
A brush biopsy is a noninvasive procedure that uses a small, soft-bristle brush to collect cells from suspicious oral lesions, often without anesthesia. This technique is less invasive than a scalpel biopsy but provides high diagnostic accuracy.
“The brush biopsy is not only quick and painless, but also well-tolerated by patients,” reassures Dr. Perrone. “It's a comfortable procedure that helps us catch cellular changes early without causing unnecessary discomfort.”
In a typical brush biopsy, the brush is gently rotated over the lesion to collect epithelial cells. These cells are then analyzed for atypical or cancerous changes. If abnormalities are found, a follow-up scalpel biopsy may be recommended. This process not only provides a less invasive alternative to traditional biopsies but also allows for early detection of cellular changes.
Brush Biopsy: A Breakthrough in Oral Cancer Detection
The brush biopsy technique continues to evolve as a pivotal innovation in oral cancer screening. Notably, researchers Guy Adami and Dr. Joel Schwartz from the UIC College of Dentistry developed a next-generation brush biopsy test specifically designed to detect oral squamous cell carcinoma (OSCC) in its earliest stages.
Unlike traditional surgical biopsies, which can be invasive and may deter timely patient care, this newer brush biopsy method simplifies the process. Using a small, soft brush, clinicians gently collect cells from suspicious lesions in the mouth without anesthesia or incisions.
“Patients are far more receptive to a non-invasive screening tool,” explains Dr. Marielaina Perrone, DDS. “It increases compliance and helps us intervene before disease progresses.”
How It Works and Why It Matters
The diagnostic system collects surface-level cells, which are then analyzed for genetic markers of OSCC. This newer generation of brush biopsy tests has demonstrated over 90% accuracy, making it a highly reliable screening tool.
Crucially, the test is designed to identify early-stage cancers, when treatment is more effective and outcomes more favorable. It also offers greater access for high-risk populations, such as Black men, who face higher oral cancer mortality rates due to disparities in access and diagnosis.
Benefits Over Traditional Biopsy Techniques
In addition to its non-invasive nature, the updated brush biopsy approach:
- Reduces the potential for unnecessary tissue damage
- Avoids the risk of spreading cancerous cells through surgical manipulation
- Provides precise, targeted sampling for accurate diagnosis and follow-up
- Encourages broader participation in oral cancer screenings, particularly in communities where patients may be reluctant to undergo surgical biopsies
“It’s not just a comfort issue,” Dr. Perrone notes. “It’s a public health opportunity—especially when combined with tools like the VELscope, which helps us identify abnormal tissue before it becomes clinically obvious.”
Looking Ahead: Broader Applications in Dentistry
To accelerate the availability of this technology in clinical practice, Adami and Schwartz co-founded Arphion Diagnostics, a company focused on commercializing the brush biopsy system. Their long-term vision includes expanding the diagnostic utility of this platform beyond oral cancer—potentially using microRNA signatures to detect a variety of oral diseases.
“It’s an exciting time in oral diagnostics,” says Dr. Perrone. “We’re entering an era where non-invasive screening could transform how we detect and manage oral conditions.”
Diagnostic Accuracy & Clinical Use
Clinical studies indicate that brush biopsies have high sensitivity and specificity, making them effective screening tools. Although they don’t replace scalpel biopsies entirely, they serve as a useful triage method—identifying lesions that warrant further investigation.
Dr. Perrone emphasizes:
“Brush biopsies allow dentists to monitor lesions over time and intervene early, which is essential for patient care.”
Incorporating Brush Biopsy in Dental Practice
To implement brush biopsy in your dental practice:
- Identify unusual lesions—persistent red or white patches, ulcers, or unexplained lumps.
- Perform the brush biopsy in-office—it's fast, easy, and doesn’t require anesthesia.
- Send collected cells for cytological analysis.
- Follow up based on results—negative findings need monitoring; positive results require scalpel biopsy and referral.
“It’s about adding precision to oral exams,” says Dr. Perrone. “Brush biopsy bridges the gap between visual inspection and surgical biopsy.”
Patient Impact and Public Health Benefits
Brush biopsy can significantly reduce patient anxiety and the need for invasive procedures, improving compliance with oral cancer screening. This is particularly important for patients with barriers to care or low tolerance for surgical procedures.
“By offering this non-invasive option, dentists can expand screening efforts and potentially save lives through earlier detection,” Dr. Perrone remarks. The potential of brush biopsies to save lives underscores the importance of early detection and the crucial role of dental professionals in oral cancer screening, making you feel the significance of your work.
Final Takeaway
The brush biopsy represents a significant advancement in oral cancer screening. While it does not replace traditional biopsies, it offers a comfortable, effective, and time-efficient method for early detection—especially when integrated thoughtfully into dental care. By incorporating brush biopsies into your practice, you can provide your patients with a reliable and comfortable screening method, enhancing their confidence in your care.
“Early detection saves lives,” Dr. Perrone asserts. “Brush biopsy is one more way dentists can proactively protect their patients.”
About Dr. Marielaina Perrone, DDS
Dr. Perrone is a cosmetic and implant dentist in Henderson, NV, with over twenty years of experience. She integrates preventive and diagnostic tools—like brush biopsy—into her practice to advance patient care and oral health outcomes.