Dr. Ashley Clark has a stark message for dental professionals: "No one ever died of an incisional biopsy, but I see people every single Wednesday at that tumor board that are going to die because they didn't get one."
Dr. Ashley Clark.
The board-certified oral pathologist and president of Camp Laboratory in Indianapolis shared her concerns during a recent DrBicuspid.com podcast episode.
Clark highlighted a troubling gap in how dentistry approaches biopsies compared to dermatology. While her dermatology partner has five contributors but processes the same number of specimens as Clark's 300 dental contributors, the disparity reveals a fundamental problem.
"I don't want to say we're scared to biopsy," Clark explained. "I think that we like our patients too much and we don't want to scare them. We don't want them to have to pay for this extra procedure. So we're sort of hesitant to biopsy."
Clark emphasized that many oral squamous cell carcinomas begin as sharply demarcated white lesions called leukoplakia. Yet research tracking 5,000 people over eight years found that dentists caught the precancer in fewer than 5% of oral cancer cases.
The pathologist also warned against crowdsourcing diagnoses on social media, noting that people "speak very confidently, and they're just wrong." Her advice is straightforward: "When in doubt, cut it out."
For isolated pigmented lesions, Clark stressed that urgency is even greater. With oral melanoma survival rates at just 10% to 15%, waiting to see if a spot changes can be fatal.
"We cannot afford to guess," she said.
Clark, who also serves on a tumor board and lectures nationwide, encourages dentists who are uncomfortable performing biopsies to refer patients to oral surgeons or periodontists.
Learn more about Clark, and watch our entire podcast interview on the subject below.
