My husband went in for his cleaning in September with his dentist and he checked him with the velescope. I velescope showed a dark area on the left lateral area of his tongue which wasn't not very was not very easily seen under normal light. The dentist had him come back two weeks later to recheck. The area still was dark under fe velescope but was a little smaller and a little lighter. He suggested my husband see an oral surgeon. On Monday which will have been a month and half we went back to the dentist to recheck the area. The dark spot was still there maybe a little smaller. On Tuesday yesterday my husband had a biopsy on the side if his tongue with a oral surgeon who has a horrible bed side manor. I guess the dentist spoke with the surgeon prior to biopsy and he was suppose to share the velescope pics with him since the area was very hard to see in normal light. When the oral  surgeon came in the room I tried to point out the general area the dentist showed me. I couldn't see well and there wasn't a lesion very apparent. He started to want to tHe the biopsy from where my husband but his tongue the day before. He took was few millimeter area our on almost the underside of his tongue. My question is after taking a photo of the biopsy area the spot in which the dentist pointed out to me is still apparent. I called his dentist who said it was in the general area of the dark area in the velescope. He said it may just be a few millimeters off. My main concert is if the is who didn't have the velescope biopsied the wrong spot even just a few millimeters off will it still detect some sign of abnormality if cancer is present even if it's not the exact dark area? I am just besides myself that these doctors are so stubborn and not communicating that well to each other or us. His dentist told me not to worry and just wait on the biopsy results. He will not go back until the 25th for his recheck and biopsy results. He had the frost biopsy on the same side if his tongue but farther up and farther back on 1-2012 by a local ent. I just remember that ent saying that you can biopsy one spot and it not show cancer but still have cancer a millimeter over. So of course my anxiety is kicking in they took the sample from the wrong area of the tongue. He will not go back in for another biopsy bc he is in extreme pain now. I don't know who is right and who is wrong. So my question us will cancer cells show up if the biopsy was taken a few millimeters off from the ark area under the velescope?

Velescope image sept 18, 2013

Velescope image 10-14-2013

Biopsy taken 10-15-2013

The arrow is pointing to the spot I thought the dentist said was where was dark under the velescope which is still there on his tongue. I can't make out the area on the velescope images bc they are so close up.i think the dentist said what was apparent under normal light was a small red area with a white outline. The os also said he removed just a small red area about the size of an eraser without a white outline and it was a littler redder than the normal pink surrounding tissue.

I am so very confused and unable to consult either dentist or surgeon at this time bc there busy. I appreciate your time to look and give me your opinion. Thanks.

ANSWER: Hi Kim and thanks for your follow up in letting me know what happened with your husband, it is much appreciated.

Let me say that you aren't alone with your experience of the oral surgeon.  Surgeons generally have "unlearnt" the basics of patient management, not out of arrogance but more as an indication of their professional and academic priorities - ie they focus their attentions on the problem or pathology, often at the cost of their rather blunt demeanor.  Don't take offense to this, but also please bear in mind how the oral surgeon might have perceived your "input" and suggestion of which area should be biopsied.  These are specialists with extensive training and experience and generally take the lead i.t.o. oral pathology - they certainly would not be used to being told what to do by any lay person, so don't take it too personally.

Let me just put you at rest right now - no oral surgeon would risk their professional reputation and entire career by biopsying the incorrect area, resulting a mis-diagnosis of something as serious as oral cancer.  That thought must ring true to you, irrespective of your emotional feelings about the specialist. But irrespective of this, you still have difficulty believing that what is being done to your husband does not constitute the best care that he can possibly get - and that worries me immensely, because at some point you will have to force yourself to believe that this is in fact the case and your husband is at no greater risk for developing oral cancer than any "average" person walking the streets daily. Your predisposition with oral cancer is serving no benefit at all, other than now depleting your dental aid funds, with the very serious risk of developing a dental fear/phobia in your husband as a result of a series of unnecessary tests - in my opinion.  And all this so that your fear and concerns can be addressed - which they have on countless occasions by numerous clinicians. And even when the area was now biopsied for the second time, you dispute the location of the biopsy and should the results come back negative for oral cancer, you have already convinced yourself that that merely indicates that the wrong area was biopsied and nothing more.  The reality of the results being negative due to the absence of oral cancer and nothing more, hasn't been given the chance to take flight in your mind and set you finally free from this prison that you are building around yourself.  as i said before, you are the only one who can change yourself, but you must want to and be able to identify the triggers that spark off this negative pattern of thinking and behavior and be willing to work at not giving into it - no matter what.  I strongly suggest you approach a psychologist who could guide you through the best way to achieve this, because you will need some support to facilitate this effectively and make the changes substantial and long-lasting.  And please don't take offense to this statement - millions of people worldwide seek out the help of psychologist daily, to give them direction, focus and equip them with the necessary life tools to ensure they live the happiest life possible - and that's all I want for you.

I hope this helps and wish you all the best further, take care.

Kind regards

---------- FOLLOW-UP ----------

QUESTION: I did speak with his dentist this morning. He said the area biopsied from what he can tell by looking at the photo I emailed him after the biopsy was in the general location of where the dark area was showing up on the velescope. He did say the dark area had gotten smaller and lighter since he first noticed it but still was very persistent on the biopsy. The oral surgeon said he spoke with the dentists and saw the pics but I don't know bc he almost cut on a different spot where my husband bit his tongue prior to the biopsy. The hard part is there wasn't a very apparent lesion they were just judging by what was seen through the velescope. I prey the results are negative and they were correct in the area biopsied. I know I am not a dentist or surgeon so I am just going to wait and see. My 30th birthday is coming up in a week and half. The best birthday present would be a negative result for anything bad and some peace of mind bc I really don't know how much more if this I can withstand.

Dear Kim

I really sympathize with you and your plight over this issue - it must be grooling. Be assured that I will keep both yourself and your husband in my prayers and I know that your birthday wish will be granted - because you deserve it so much.  Take care.

Kind regards


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Dr Craig W Peck ( B.Med.Sc., B.Ch.D., Clin. Botox, Cosmet. Derm.)


I am a General Dental Practitioner, with special interests in Cosmetic Dentistry & facial aesthetics and Periodontology, placing a strong emphasis on the establishment and maintenance of a healthy periodontium (the support structure of the tooth) before cosmetic options are considered. I uphold all principles of prevention above interventional treatment and try as far as possible, to remain conservative in my approach. I believe in detailed, open and honest patient discussion, establishing what the patients expectations are and what the reality is of achieving this and involving the patient at every level of the treatment. I have strong principles on ethical treatment and appropriate patient management. I have chosen to treat and rehabilitate many nervous and phobic patients, who, for whatever reason, find it impossible to take part in the very important task of even a routine check-up. I will accept questions relating to general and cosmetic dentistry (in conjunction with the use of facial cosmetic procedures) and dental fears/phobias. I will be more than willing to answer any academic questions in dentistry, biology, physiology, psychology and health sciences in general. As most dentists will tell you, there is often not only one way of dealing with a dental issue - so very often, there is no precise right and wrong way of approaching the problem. All clinicians vary when it comes to treatments and what works best in their hands is often the treatment that is advised. Be understanding of this and bear in mind that nothing lasts forever! Patients are happy to accept only a one-years warrantee when buying a new car, but seem to expect that dental work is going to last them their lifetime.


I have worked for many years in the UK and RSA as a general dental practitioner - within the NHS, private practice and the government dental health services. I am certificated for the administration of Botox and Dermal Fillers for facial lines and wrinkles as I have attended further courses in minimally invasive facial cosmetic procedures. I started seeing an increasing number of patients who presented with severe to moderate dental fears, even with full-blown phobias, so I started with the slow and patient task of tackling this problem and have successfully rehabilitated many patients. The key is good, effective, concise and understandable communication, shifting control from the dentist to the patient in order to slowly, but confidently, regain their trust back in dentistry, thereby giving them the feeling of achievement and this self-empowerment which drives them to the next level of treatment.

Academy of General Dentistry. American Dental Education Association. IAPAM (International Association for Physicians in Aesthetic Medicine). Professional Speakers, Writers and Managements Consultants in Dentistry. The British Dental Association. UK Aesthetics Group. ARC - Aesthetic Professionals. Botox. Aesthetics & Beauty. American Association for Dental Research. FDI - World Dental Federation. SOURCE1uk. World Dental Hygiene Forum. ProDentalCPD. Public Health Dentistry. Dentist Network. LinkedIn. Who's Who of South Africa.

B.Med.Sc. Degree (Medical Physiology and Medical Virology; Physiology Cum Laude; Stell 1994). B.Ch.D. Degree (Bachelor of Dental Surgery; Clinical Dentistry Cum Laude; Stell 1997). CPR and CPR-Advanced Courses (2000/2001; UK). Clinical Botox (UK, 2001). Cosmetic Dermatology (Botox and Dermal Fillers; RSA 2011).

Awards and Honors
Placed on the Dean's List at University for academic achievement (1994). Highest achievement in the subject Dental Materials. Medal from 3M and the Radiology Association of South Africa for highest achievement in the subject Dental Radiology and Imaging. Medal from The Periodontal Association of South Africa for highest achievement in the subject Periodontology. Highest achievement for Oral Medicine. Highest achievement in Oral Pathology. Received the DASA (Dental Ass. of South Africa) Gold Medal for highest achieving dental student across the 5 1/2 years of the Degree. Passed the subject, Clinical Dentistry with distinction in final year.

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