Diagnosis and management of oral soft-tissue lesions: the use of biopsy, toluidine blue staining, and brush biopsy.

Upon discovery of a lesion after thorough oral soft-tissue examination, the dentist is confronted with the often-troublesome decision of how best to manage the patient. The management protocol must provide for early diagnosis in the case of oral cancer so as to reduce cancer morbidity and mortality. Options for management would include an observation period of some defined time, use of toluidine blue stain or oral brush biopsy to screen the lesion, or immediate biopsy and follow-up. This article reviews the assets and limitations of each and suggests a rational, science-based approach to diagnosis and management.