Is a Lip Biopsy Painful?

Lip biopsy helps identify Sjogren syndrome. The test itself does not make the diagnosis of Sjogren syndrome. Lip biopsy is also useful in identifying other conditions, such as:

• To know if you have risk factors for the development of lymphoma
• To understand the degree of destruction of the salivary glands
• If immunotherapy is required for your condition

Approximately 1000 minor salivary glands are lining the inside of your mouth and swallowing passages. The main function of these glands is to produce mucus and saliva to keep the lining of the mouth moist and lubricated. During a lip biopsy, the surgeon removes five to eight minor salivary glands located just under the inside lining of your lower lip. These glands feel like cobblestones when you rub your tongue against them.

Before the procedure

You need to take care of the following instructions:

• Avoid taking any Aspirin or nonsteroidal anti-inflammatory medication at least 2 weeks before the biopsy.
• Discontinue any blood thinners like Coumadin at least 5 days before the biopsy.
• Inform about any allergy to lidocaine, shellfish, or iodine before the procedure.

During the procedure

• The physician holds your lower lip outwards to expose the inside lining.
• Next, the physician injects local anesthesia into the lining to numb the area.
• After numbing the area, the physician makes a small incision of 1.5 cm to locate the minor glands.
• The physician identifies and protects the nerve fibers during the biopsy to avoid injury.
• Finally, the physician closes the site with three to four stitches. The excised tissue is sent to the laboratory and examined under a microscope.

After the procedure

You can expect the following things after the surgery:

• Your lip may feel very large and numb due to the local anesthetic injection for an hour.
• Drink fluids immediately after the biopsy. Avoid drinking hot liquids.
• Eat 2 hours after the biopsy.
• Avoid eating hard, chewy foods for 1 week.
• Gargle with a saltwater after eating. Do this till the stitches are dissolved.
• If you notice any bleeding, apply pressure to the area for 10 to 15 minutes with a gauze.
• Refrain from smoking for at least 72 hours because this increases the chance of wound infection.
• Take the prescribed antibiotics to prevent any wound infection.
• Restart any aspirin or blood thinners 24 hours after the biopsy.
• If the sutures do not dissolve within the week, contact your surgeon for the simple removal of sutures.
• Some of the complications of lip biopsy include:
  • Numbness of the lower lip
  • Pain and swelling of the lip
  • Minor bleeding
  • Infection
  • Tingling
  • Mucocele (obstructed drainage to minor salivary gland in lip)