Oral Cancer Exam


 What is Oral Cancer?


Cancer is defined as the uncontrollable growth of cells that invade and cause damage to surrounding tissue. Oral Cancer appears as a growth or sore in the mouth that does not go away and includes cancers of the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx (throat), can be life threatening if not diagnosed and treated early.

However, when oral cancer is diagnosed in its earliest stages, treatment is generally very effective.  A good rule of thumb for you as a patient is that if you notice a sore, a lump, swelling, or anything that just doesn't feel or look normal, to contact our office if it does not go away within 14 days. This is an important rule, because we get many such sores and minor lesions of trauma in the mouth, but they usually go away entirely within that two week period.

What Are the Symptoms of Oral Cancer?

The most common symptoms of oral cancer include:

  • Swellings/thickenings, lumps or bumps, rough spots/crusts/or eroded areas on the lips, gums, or other areas inside the mouth
  • The development of velvety white, red, or speckled (white and red) patches in the mouth
  • Unexplained bleeding in the mouth
  • Unexplained numbness, loss of feeling, or pain/tenderness in any area of the face, mouth, or neck
  • Persistent sores on the face, neck, or mouth that bleed easily and do not heal within 2 weeks
  • A soreness or feeling that something is caught in the back of the throat
  • Difficulty chewing or swallowing, speaking, or moving the jaw or tongue
  • Hoarseness, chronic sore throat, or change in voice
  • Unexplained ear pain
  • A change in the way your teeth or dentures  fit together
  • Dramatic weight loss.

Who Gets Oral Cancer?

According to the American Cancer Society, men face twice the risk of developing oral cancer as women, and men who are over age 50 face the greatest risk. It's estimated that over 35,000 people in the U.S. received a diagnosis of oral cancer in 2008. Of that amount 7,000 cases were fatal. Understanding what the risk factors are and trying to control habits that lead to oral cancer is very important.

  • Smoking: Cigarette, cigar, or pipe smokers are six times more likely than nonsmokers to develop oral cancers
  • Smokeless tobacco users:  Users of dip, snuff, or chewing tobacco products are 50 times more likely to develop cancers of the cheek, gums, and lining of the lips.
  • Excessive consumption of alcohol: Oral cancers are about six times more common in drinkers than in nondrinkers.
  • Family history of cancer.
  • Excessive sun exposure:  especially at a young age can lead to cancer of the lips.

When factors are combined, the risk is even higher. For example the number one cause of oral cancer is actually the combination of smoking and drinking  alcohol in excess. Other than the family history of cancer, each on e of these risk factors are behavioral choices that can be controlled. Our office is dedicated to helping you if you need assistance or more information on quitting smoking.

Despite these risk factors, it is also important to note that over 25% of all oral cancers occur in people who do not smoke and who only drink alcohol occasionally, so these routine examinations are very important to prevent the advance of this very serious form of cancer.


Oral cancer exams, diagnosis and treatment

The oral cancer examination is a completely painless process.  During the visual part of the examination, the dentist will look for abnormality and feel the face, glands and neck for unusual bumps.  If you click on the image above you will go to an excellent website hosted by the National Institute of Dental and Craniofacial Research (NIDCR) where you can learn more about this important examination

During the oral cancer exam the sides of your tongue, underneath the tongue, underneath your lips), areas under the lips and around the teeth. The following signs will be investigated during a routine oral cancer exam:

  • Red patches and sores – Red patches on the floor of the mouth, the front and sides of the tongue, white or pink patches which fail to heal and slow healing sores that bleed easily can be indicative of pathologic (cancerous) changes.

  • Leukoplakia – This very common condition is pictured to the right. Leukoplakia is a hardened white or gray, slightly raised lesion that can appear anywhere inside the mouth. Leukoplakia can be cancerous, or may become cancerous if treatment is not sought.

  • Lumps – Soreness, lumps or the general thickening of tissue anywhere in the throat or mouth can signal pathological problems.

If abnormalities, lesions, leukoplakia or lumps are apparent, we will usually take a small sample of the surface cells in a procedure called a "brush biopsy." If this test comes back positive, then you will be referred to an oral surgeon for further diagnosis. The reason for this referral is that the oral surgeon is generally called upon to perform a more thorough biopsy and even to remove a cancerous or precancerous lesion for our patients.

During bi-annual check-ups, the dentist and hygienist will thoroughly look for changes and lesions in the mouth, but a dedicated comprehensive oral cancer screening should be performed at least once each year.

If you have any questions or concerns about oral cancer, please contact our practice.

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