Oral CDX Brush Biopsy

A relatively new screening tool for oral cancer has become available called Oral CDX Brush Biopsy. It consists of a stiff brush which is used to collect a few cells from a lesion (an area of unusual tissue). The cells are sent to a lab and analyzed by a computer and a pathologist.

The test is done without any incisions or needles. Brush Biopsy can tell if the cells are cancerous or if they are unusual enough to need further investigation or if they are normal.

Brush Biopsy is used on lesions that show up as white or rough patches. On the other hand red lesions, lumps, bumps or deep lesions should be scalpel biopsied. (See Oral Patholgy: Scalpel Biopsy)

What Is Oral CDx’s Oral Brush Biopsy?

Oral CDx’s oral brush biopsy allows dentists, for the first time, to easily and painlessly test common, harmless-looking, unexplained white spots in the mouth that may in fact be pre-cancer or cancer. Oral CDx is a system that combines a painless oral brush biopsy with advanced computer analysis.

The Oral CDx oral brush biopsy test was developed to evaluate benign-appearing oral spots, not highly suspicious lesions. Until the advent of the Oral CDx oral brush biopsy, routine, painless testing of common oral spots was simply not available. It now is, and this is why Oral CDx has changed the routine practice of oral cancer evaluation. The technique has been used to diagnose thousands of pre-cancers and cancers among spots that typically would not have been biopsied at time of discovery. Hundreds of lives have already been saved and thousands of disfiguring surgeries have invariably been avoided. By ruling out the chance that a harmless looking spot could be something more, the Oral CDx oral brush biopsy provides assurance that a proper evaluation has been performed.

The Oral CDx oral brush biopsy has been evaluated in a multi-center clinical trial that involved 35 U.S. academic dental sites. The findings were published in the Journal of the American Dental Association (JADA) in October 1999. The test has also been reviewed by the Council on Scientific Affairs of the American Dental Association and has received the organization’s prestigious Seal of Acceptance.

The Oral CDx oral brush biopsy test has resulted in the early detection of thousands of otherwise unsuspected oral precancers and cancers, and the saving of hundreds of lives.

How Oral CDx Works

Using a special, hand-held brush, Dr Reynolds takes a small sample of tissue from the suspicious lesion. The sample is put on a slide and sent to the CDx Laboratories. At the lab, computers use advanced robotics, scanning and imaging techniques to accurately examine the thousands of cells on the sample. The computer is able to look at every cell, compare them to libraries of normal and abnormal cells and determine which cells are potentially problematic. A summary report is returned to our doctors for further discussion with the patient. 

If the Oral CDx test is positive or atypical, Dr Reynolds will then confirm it with a standard scalpel biopsy.

If the Oral CDx test turns out to be negative, but the lesion persists, it should receive a follow-up evaluation and re-brush biopsy yearly.

If Dr. Reynolds notices something that looks very suspicious and dangerous, a scalpel biopsy will be recommended. This requires at least local anesthesia.

What if my dentist did a brush biopsy and it was positive or atypical?

If you are being sent to Dr. Reynolds or Dr. Auble because a brush biopsy done by your dentist was positive for malignancy or “atypia”, then we will perform a scalpel biopsy. A scalpel biopsy is the only way to fully evaluate the lesion. (See: Scalpel Biopsy)

The most important modality in surviving oral cancer is early detection. Oral CDx brush biopsy is one way to improve our methods of detecting oral cancer.

Remember that it is important to have regular check-ups by your dentist. It’s also important to continue to follow previously negative or normal findings on biopsied lesions. Yearly brush biopsy of persistent white lesions is advisable to ensure there is no malignant transformation (change into cancer).