A dentist may detect oral cancer during a routine dental checkup. If they suspect abnormalities in the oral cavity, they may refer the person to a doctor or cancer specialist for more tests.

The oral cavity consists of the tongue, lips, gums, palate, teeth, and inside lining of the cheeks. If a person develops cancer in these areas, it is known as oral cancer.

There is no routine screening process for oral cancer. However, dentists and other healthcare professionals may detect cancer or pre-cancer in the oral cavity during routine examinations.

This article looks at oral cancer screening, early detection, diagnosis, and more.

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Oral cancer, oral cavity cancer, or mouth cancer is cancer that starts in any location within the oral cavity. It is a type of head and neck cancer.

Oral cancers can cause symptoms, including one or more of the following:

However, these symptoms do not always indicate oral cancer and could result from other conditions. A person should consult a doctor or dentist if these symptoms persist for more than 2 weeks.

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Learn more about oral cancer.

Cancer screening is the process of looking for cancer before a person displays any symptoms. It can help detect cancer at an early stage. If a doctor detects cancer early, treatments may be more effective.

The American Cancer Society (ACS) notes that there is no routine screening process for oral cancer. However, if a person goes for regular dental checkups, the dentist or dental hygienist may be able to detect abnormalities and possible pre-cancers at an earlier stage.

A person should regularly visit a dentist, dental hygienist, or doctor for regular checkups. The National Institute of Health (NIH) recommends undergoing a dental exam every 6 months.

However, people with gum disease or other dental problems may need to see a dental professional three or four times a year. People who smoke, used to smoke, or regularly drink alcohol may also require more regular checkups.

During health checkups, a healthcare professional may use various methods to look for any abnormalities in the oral cavity that might indicate cancer.

Screening for oral cancer may involve the following:

  • Medical history: It is important to review a person’s health habits, previous illnesses, and treatments. A person who smokes or drinks alcohol may have an increased risk of developing oral cancer.
  • Physical examinations: Dentists, hygienists, or doctors will examine the mouth and throat. They may look for anything unusual, such as lumps or patches.
  • Laboratory tests: If the healthcare professional spots an abnormality, they may send samples of blood, tissue, or other substances to a laboratory for analysis.
  • Imaging tests: These include procedures that take images of the inside of the body, such as MRI scans, PET scans, CT scans, and dental X-rays.

The specific procedures that a healthcare professional may perform to screen for oral cancer include:

Toluidine blue dye test

A dentist or doctor may perform this test at a regular checkup for those with an increased risk of developing oral cancer, such as people who smoke.

To do this, they use a special type of dye called toluidine blue to coat the inside of the mouth. Any abnormal areas that the dye touches will turn a darker blue.

This allows the healthcare professional to detect any abnormal tissue that is difficult to see with the naked eye.

Fluorescent light test

Another test that a dentist or doctor may perform to detect oral cancer early is a fluorescent light test.

They will shine a special light into the mouth, and if the light hits abnormal tissue, it will reflect differently than normal tissue. This allows the healthcare professional to detect any tissue that could indicate cancer.

A newer device called a VELscope also uses fluorescent light. This device allows healthcare professionals to detect any changes in cellular structure that may indicate cancer.

A 2021 study found that VELscope was a simple, noninvasive, cost effective technique. However, the authors note that this technique is not a substitute for conventional screening. Instead, it can complement this process.

Exfoliative cytology

Exfoliative cytology is the study of cells that a doctor has brushed or “exfoliated” from a person’s body.

If a healthcare professional detects any abnormal areas in the oral cavity, they may wish to take some cells for further examination. They will use a brush-like tool to scrape off some of the cells, which they will send to a laboratory for testing.

Pathologists in the lab can then analyze the sample for any cancerous or precancerous cells.

The test is simple and causes very little pain, so it is a good way to detect oral cancer early. However, this method does not show all cancers, and it may sometimes be difficult to tell whether cells are cancerous. In such cases, a doctor may order a biopsy.

The ACS states that some doctors and dentists advise people to check their oral cavity regularly for abnormalities.

A person should examine their mouth, tongue, gums, teeth, and throat in the mirror at least once a month. This is especially important for people who smoke, used to smoke, or regularly consume alcohol, as these behaviors are among the risk factors for developing oral cancer.

If a person notices any changes in their oral cavity, such as the development of sores, lumps, or white patches, they should make a note of it. If these symptoms persist for more than 2 weeks, they should contact a doctor or dentist.

If a healthcare professional finds any abnormal areas during the screening process, they may suspect cancer.

However, they will need to conduct more tests to make a diagnosis. These may include:

  • A panendoscopy: This involves using a camera with a thin, flexible handle to examine a person’s mouth and throat. The person will be under general anesthesia while a doctor inserts the device into their throat to look for tumors in their mouth, throat, windpipe, and voice box.
  • A biopsy: This involves taking a small sample of tissue for further examination. The type and location of the biopsy depend on the specific case. When the results come back from the lab, a doctor will know whether cancer is present.
  • Imaging tests: MRI, CT, and PET scans may show a doctor if tumors are present. They may also reveal the location of any tumors and indicate the areas where they may have spread.

After a doctor diagnoses a person with oral cancer, treatment can begin. The ACS notes that a person should stop smoking before receiving any treatment for oral cancer.

The treatment methods for oral cancer include the following:

  • Surgery: This is often the first option for treating oral cancer. A doctor may recommend different types of operations depending on the stage and location of the cancer. A surgeon may remove the tumor and the area around it. If the cancer has progressed further, they may have to remove all or part of certain organs, such as the tongue.
  • Radiation therapy: This technique uses X-rays to destroy cancer cells. A doctor may recommend using it after surgery or alone if a person cannot have surgery. In some cases, a person may receive radiation therapy alongside another treatment, such as chemotherapy.
  • Chemotherapy: This involves using drugs that kill cancer cells. A person can take the drugs by mouth or via an injection into a vein.
  • Targeted therapy: This method uses medications that target certain proteins in cancer cells. These proteins help cancer cells spread and grow, so removing them with targeted drugs may help treat the cancer.
  • Immunotherapy: A doctor may use medications that help enhance a person’s immune response. This may encourage their body to find and destroy cancer cells. It may have less side severe side effects than chemotherapy.

Some people are at a higher risk of developing oral cancers. The risk factors for oral cancer include:

  • using tobacco
  • drinking alcohol
  • having a human papillomavirus (HPV) infection
  • being male
  • being older than 55 years
  • having poor nutrition
  • having certain genetic syndromes, such as Fanconi anemia or dyskeratosis congenita

Oral cancers are twice as common in males than in females. Some people suggest that a person’s overall oral health may affect their risk of developing oral cancer, so it is important to brush the teeth and floss regularly and go for dental checkups.

Quitting smoking will reduce the risk of oral cancer. Tobacco use — through smoking, chewing, or any other method — is one of the most significant risk factors for oral cancer.

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Learn more about quitting smoking.

The outlook for people with oral cancer will depend on several factors, including the location, stage, and type of cancer. A person’s age and overall health will also play a role in their recovery.

The table below shows the relative 5-year survival rate for people with mouth cancer, according to the ACS. These statistics show how likely people with oral cancer are to survive at least 5 years after diagnosis compared with people in the overall population.

The survival rate varies depending on the stage of the cancer. Whereas localized cancer has not spread, or metastasized, beyond its original site, regional cancer has spread to nearby structures or lymph nodes.

Doctors will classify cancer as distant if it has spread to areas of the body further away from the original site.

StageTongueLipFloor of the mouth
All stages combined68%91%52%

It is important to note that these data are based on people who received a diagnosis between 2011 and 2017. Screening and treatment methods are continually improving, so a newly diagnosed person may now have a better outlook than these data suggest.

Healthcare professionals may be able to detect abnormal or precancerous cells during routine dental checkups. Some tests that they may use to screen for oral cancer include a toluidine blue dye test or a fluorescent light test.

A person should visit a dentist once every 6 months. People who smoke or drink alcohol — both of which can increase the risk of developing oral cancer — should go for a dental checkup three or four times a year.

A person can also perform self-screening by regularly examining their mouth, throat, and tongue in the mirror. They should report any persistent abnormalities and symptoms to a doctor or dentist.

The treatment options for oral cancer include surgery, radiotherapy, and chemotherapy.