Pediatric Oral Pathology: A Retrospective Survey of 4,554 Biopsies

Purpose: The purposes of this study were to: (1) report patient age, gender, and anatomical information on a large number of pediatric oral biopsies in the United States; and (2) highlight differences in recent pediatric oral lesions compared to past pediatric studies and an adult population. Methods: A total of 4,554 pediatric biopsies received over the past 13 years (2001-2015) were surveyed. Patient's age, gender, anatomical site of biopsy, and diagnosis were described under 10 diagnostic categories: (1) malignant neoplasm; (2) benign neoplasm; (3) infectious; (4) reactive; (5) precancerous; (6) developmental; (7) healthy tissue; (8) immune dysfunction; (9) physical trauma; and (10) other. Results: A gradual increase in the number of biopsies with age was noted. The most common diagnosis observed was mucocele, consisting of 28 percent of all biopsies. Biopsies across pathological categories were most commonly obtained from the mandible. Conclusions: Biopsies received from a pediatric population are largely reactive in nature. Compared to an adult population, the pediatric population has a significantly lower rate of malignant and precancerous lesions but a higher rate of developmental diagnosis. A diverse array of pathoses was seen in the gingiva and mandible, whereas palatal mucosa and the floor of the mouth exhibited more variation.