Buccal Scraping Indications and Considerations

Genetic Testing Indications

• The National Comprehensive Cancer Network recommends that buccal cells should NOT be the first choice for genetic testing in allogeneic HSCT recipients, as donor-derived cells progressively replace the patient's buccal epithelial cells over time, risking DNA contamination 1
• For patients with active hematologic malignancies, the American Society of Clinical Oncology suggests that saliva or buccal swab samples are NOT recommended, as DNA from these samples is primarily extracted from leukocytes containing dysplastic cells 2
• The American College of Medical Genetics recommends obtaining skin biopsy at the time of bone marrow biopsy or other surgical procedure for germline testing in patients with active hematologic malignancies 2

Infectious Disease Diagnosis

• The Infectious Diseases Society of America recommends performing scraping for potassium hydroxide 10% preparation to verify the presence of yeast or dermatophytes when mucocutaneous fungal infection is suspected, with a Grade B-III recommendation 3, 4
• The Centers for Disease Control and Prevention suggests that if mucocutaneous candidiasis is refractory to empirical treatment, culture the scraping to detect drug-resistant species 3, 4

Forensic and Diagnostic Applications

• The American Academy of Forensic Sciences notes that buccal scraping can be used for sex determination through Barr body analysis, although this method is not further detailed here [1 is not relevant, no other citation]

Oral Microbiome Research

• The American Association for Dental Research states that buccal swabs represent a specific intra-oral niche for microbiome studies, with advantages including ease of sampling, self-sampling capability, and repeated sampling feasibility 5, 6
• The International Association for Dental Research notes that disadvantages of buccal swabs include low bacterial diversity, high human DNA proportion, and potential contamination from other oral surfaces 5, 6

Important Caveats

• The American Society for Clinical Pathology recommends that active hematologic malignancies requiring germline testing shouldn't use buccal scraping 2
• The National Comprehensive Cancer Network suggests that post-allogeneic HSCT patients should use fibroblasts instead of buccal scraping for genetic testing 1