What must be done before performing an oral biopsy?

Correct answer: D. Obtain informed consent

• A. Antibiotic prophylaxis is not routinely indicated for oral soft tissue biopsy in a healthy patient.
• B. A CBC is ordered only when the history suggests a bleeding disorder, immunosuppression, or a haematological cause for the lesion — not routinely.
• C. Smoking cessation aids healing and is worth advising, but it is not a prerequisite and no biopsy should be delayed for it.
• D. CORRECT. Informed consent is a legal and ethical prerequisite for any invasive procedure. For a biopsy specifically it should cover the nature and purpose of the procedure, the risks including bleeding, infection, scarring and nerve injury, the alternatives including observation, and the fact that the result may necessitate further treatment.

Note: The elements of valid informed consent: the patient has CAPACITY, disclosure is ADEQUATE, the patient demonstrates UNDERSTANDING, and the decision is VOLUNTARY. Document all four. A signed form without a documented conversation is weak evidence of consent.