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Watching for and Preventing Oral Cancer

Medically Reviewed by Poonam Sachdev on October 18, 2021

Regular checkups with your dentist help more than just your smile. They’re an important chance for them to check for signs of 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. Oral cancer, which includes cancers of the lips, tongue, cheeks, floor of the mouth, and hard palate, can be life-threatening if not diagnosed and treated early. This cancer accounts for less than 5% of all cancers in the United States.

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, neck, or ear
  • 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 (especially slurred speech)
  • A change in the way your teeth or dentures fit together
  • Dramatic weight loss
  • A lump in the neck

If you notice any of these changes, contact a health care professional immediately for an exam.

Who Gets Oral Cancer?

Men account for 70% of oral cancers. Men over age 50 have the greatest risk. Oral cancer is the sixth most common cancer among men.

Risk factors for oral cancer include:

  • Smoking. Cigarette, cigar, or pipe smokers are six times more likely than nonsmokers to develop oral cancers.
  • Smokeless tobacco users. Users of snuff or chewing tobacco increase their risk of cancer to the oral cavity.
  • Excessive drinking of alcohol. Oral cancers are about six times more common in drinkers than in nondrinkers. Although alcohol is less potent than tobacco in causing oral cancers, the combination of alcohol with tobacco results in a much higher risk of developing oral cancers, compared to either one alone.
  • Family history of cancer.
  • Excessive sun exposure for lip cancer.
  • Poor dietary habits.
  • Smoking marijuana.

It is important to note that over 25% of all oral cancers occur in people who do not smoke and who only drink alcohol occasionally. In these people, viral infections may be the cause. The human papilloma virus (HPV) has been detected in up to 36% of patients with oral cancers. This is the same virus responsible for the majority of cases of cervical cancer. The presence of an oral infection with this virus greatly increases the risk of developing an oral cancer.

The presence, though, of the HPV virus in oral cancers indicates a better prognosis. This includes a lower risk of developing a second cancer and a lower risk of dying from other tobacco-related illnesses, such as heart disease or lung disease.

What Is the Outlook for People With Oral Cancer?

For oral cancer, the survival rates, by stage are as follows:

  • Stage I: 80%-85%
  • Stage II: 60%-75%
  • Stage III 35%-66%
  • Stage IV: 15%-30%.

The 5- and 10-year survival rates for all stages are 56% and 41%, respectively.

How Is Oral Cancer Diagnosed?

As part of your routine dental exam, your dentist should conduct an oral cancer screening. More specifically, your dentist will feel for any lumps or irregular tissue changes in your neck, head, face, and oral cavity. When examining your mouth, your dentist should look for any sores or discolored tissue, as well as check for any signs and symptoms mentioned above.

That means a thorough look at all the parts of your mouth, including:

  • Your lips, both outside and inside
  • Your gums
  • Your tongue, from all sides and underneath
  • The insides of your cheeks
  • The roof of your mouth
  • The back of your throat

If you wear dentures, you’ll have to take them out so they can check the tissue underneath them.

They might put one finger in your mouth under your tongue and a couple of fingers on the skin under your chin and move them around to feel the tissue between them. Your dentist might also feel underneath your jaw.

The exam should take less than 5 minutes.

Your dentist may go a little more in-depth for your oral cancer screening test and have you rinse your mouth with a blue dye before the exam. Any unusual cells in your mouth absorb the dye so it’s easier to see them.

If your dentist sees tissue that looks suspicious, they may recommend a scalpel biopsy. This procedure usually requires local anesthesia and may be performed by your dentist or a specialist. They take a small piece of tissue from an area that looks troublesome and send it to a lab to test it for cancer cells. These tests are necessary to detect oral cancer early, before it has had a chance to progress and spread.

How Is Oral Cancer Treated?

Oral cancer is usually treated with surgery alone or radiation alone in the early stages. In more advanced cases, a combination of surgery and radiation is the most common treatment. In the late stages of oral cancer, a combination of radiation with chemotherapy, with or without surgery, is usually used.

What Can I Do to Prevent Oral Cancer?

To prevent oral cancer:

  • Don't smoke or use any tobacco products.
  • Drink alcohol in moderation. (Don’t binge drink.)
  • Eat a well-balanced diet, especially with vegetables containing vitamin A.
  • Limit your exposure to the sun. Repeated exposure increases the risk of cancer on the lip, especially the lower lip. When in the sun, use UV-A/B-blocking sun protective lotions on your skin as well as your lips.
  • Because there is a link with the HPV virus, young people engaging in oral sex have a higher risk of developing oral cancer.
  • Avoid using marijuana.

You can take an active role in detecting oral cancer early by doing the following:

  • Conduct a self-exam at least once a month. Using a bright light and a mirror, look and feel your lips and the front of your gums. Tilt your head back and look at and feel the roof of your mouth. Pull your cheeks out to view the inside of your mouth, the lining of your cheeks, and the back gums. Pull out your tongue and look at all surfaces; examine the floor of your mouth. Look at the back of your throat. Feel for lumps or enlarged lymph nodes in both sides of your neck and under your lower jaw. Call your dentist's office immediately if you notice any changes in the appearance of your mouth or any of the signs and symptoms of oral cancer mentioned above.
  • See your dentist on a regular schedule. Even though you may be conducting frequent self-exams, sometimes dangerous spots or sores in the mouth can be very tiny and difficult to see on your own. The American Cancer Society recommends oral cancer screening exams every three years for persons over age 20 and annually for those over age 40. During your next dental appointment, ask your dentist to perform an oral exam. Early detection of oral cancer can improve the chance of successful treatment.

Not all spots or lumps your dentist finds turn out to be cancer. But if they are, catching the condition early means you may have more treatment options.

WebMD Medical Reference

Sources

SOURCES:

American Cancer Society: "Detailed Guide: Oral Cavity and Oropharyngeal Cancer."

The American Dental Association, mouthhealthy.org: “Your Top 9 Questions About Going to the Dentist -- Answered!” “HPV: Head, Neck, and Oral Cancers.”

The American Dental Association: “Oral and Oropharyngeal Cancer.”

Mayo Clinic: "Mouth cancer," “Oral Cancer Screening.”

CDC: “HPV and Oropharyngeal Cancer.”

Journal of the American Dental Association: “What You Should Know About Oral Cancer.”

National Institute of Dental and Craniofacial Research: “Detecting Oral Cancer: A Guide for Health Professionals.”

Oral Cancer Foundation: "Oral Cancer Facts," “Cancer Screening Protocols.”

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