Oral Cancer Screening

During a screening exam, a dentist or hygienist will examine your mouth and throat. They may also take a small sample of cells with a brush-like tool and send them to the lab to see if they are cancerous or precancerous.

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Research on commercially available adjunctive techniques that can enhance the accuracy of VOE is ongoing. These include oral rinses and light-based technologies.

Symptoms

Oral cancer can be detected in its early stages with a simple exam. Your dentist looks over your mouth for red or white patches, and sores in the throat or mouth. They may also feel your neck and jaw for lumps. They will look for signs of cancer such as a thin, red or white patch that doesn’t heal, a swelling or lump that doesn’t go away, or a spot in the mouth that appears and feels different than other spots in the mouth.

Your dentist will also check the floor of your mouth for spots that don’t appear in the mirror, such as on the back of your tongue, under your gums or in your throat. They will ask you to open wide, relax and say “ah.” This allows them to see the back of your tongue, where many early cancers are found.

Your risk of oral pre-cancer and cancer increases if you use tobacco products, smokeless tobacco or heavy alcohol consumption, have human papilloma virus (HPV), or have a family history of head and neck cancer. You can lower your risk by eating a healthy diet, avoiding excessive sun exposure and drinking only moderately. Many people with oral cancer never experience any symptoms or die from the disease, but early diagnosis can make treatment more successful.

Diagnosis

The doctor may take a small sample of the tissue to check for cancer cells. This is called a biopsy. The dentist usually sprays the area with numbing medicine before taking the sample, so it does not hurt.

The samples are tested in a lab. If the results show that a lesion is cancerous, the doctor will remove it from the mouth. A doctor can also test a sample of lymph nodes in the neck to find out if the cancer has spread.

Symptoms of oral cancer include pain, numbness or swelling of a soft tissue in the mouth or throat. A patient with these symptoms should visit a doctor or dentist right away.

In addition to a visual examination of the face, throat and jaws, the doctor may recommend other tests. These might include a CT scan of the head and neck or an MRI (magnetic resonance imaging). These tests provide detailed images of the tissues and can help identify tumors, enlarged lymph nodes and other abnormalities.

These PDQ cancer information summaries are developed by the National Cancer Institute (NCI). They are reviewed and updated regularly to reflect new evidence, changes in practice and recommendations of NCI’s cancer centers. This material is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider.

Treatment

According to the American Cancer Society (ACS), some doctors and dentists recommend that people check their mouth, lips, tongue, gums and throat in a mirror at least once a month for any unusual areas. If they find a sore or lump in the mouth that doesn’t heal after 2 weeks, or a white patch on the lips, mouth, throat or jawbone, they should see a doctor right away.

When the healthcare professional finds an abnormal area, they will usually use a tool to brush or scrape the tissue off for testing. They may also shine a safe blue light in your mouth, which helps them to identify any precancerous or cancerous spots. This device is called a VELscope. A 2021 study found that it’s a simple, inexpensive and effective way to test for oral cancer.

The healthcare provider might take a small sample of the area and send it to the lab for further tests. This will help them find out whether the cells are normal or not, and if they’re cancerous, how bad the cancer is.

Depending on the results of these tests, the healthcare provider might suggest surgery or radiation therapy to treat the oral cancer. The type of treatment they choose will depend on the size and location of the tumor, how far it has spread, your overall health and other factors.

Prevention

The use of tobacco in any form and excessive alcohol consumption, in addition to a poor diet, are the main risk factors for oral pre-cancers and cancers. Prevention strategies should be focused on those factors.

Early detection strongly affects the outcome of oral cancer, so screening is important. It is recommended that all adults, especially those with risk factors, receive an oral cancer screening at least every six months and an annual screening for those with risk factors.

During an oral cancer screening, your healthcare provider will look at the tissue inside your mouth and throat for any unusual growths or patches. They may rinse your mouth with a special solution that makes healthy tissues appear dark and abnormal areas look white. They will also feel (palpate) your neck and jaw for any hard, swollen or tender spots. They might shine a special light in your mouth to help identify any areas that are harder to see. They may also ask you to rinse with a special dye, called toluidine blue, which helps them spot any lesions that might be cancerous.

Screening can find some cancers that would never cause symptoms or become life-threatening. This is called overdiagnosis. In addition, treatment of some cancers can have serious side effects. Screening should be done only with the help of a doctor who is familiar with the benefits and risks of screening for these cancers.