Most people think of a dental checkup as a look at their teeth and gums. But a thorough dental exam also includes a check of the soft tissues of your mouth and throat for signs of oral cancer. The ADA notes that dentists are often the first health professionals to notice the signs of oral cancer (MouthHealthy: Oral cancer). This guide explains what oral cancer is, who is at higher risk, what the screening involves, and which symptoms should prompt you to get checked.
What is oral cancer?
The National Institute of Dental and Craniofacial Research (NIDCR) describes oral cancer as cancers of the mouth and the back of the throat. They can develop on the tongue, the tissue lining the mouth and gums, under the tongue, at the base of the tongue, and in the part of the throat at the back of the mouth (NIDCR: Oral cancer).
MouthHealthy divides them into two groups:
- Oral cavity cancers, affecting the lips, gums, the front two-thirds of the tongue, the floor and roof of the mouth and the inside of the cheeks.
- Oropharyngeal cancers, found in the throat, tonsils and base of the tongue.
The National Cancer Institute adds that most lip and oral cavity cancers start in squamous cells, the thin, flat cells lining the inside of the lips and mouth, and that they often develop in areas of leukoplakia, which are white patches that do not rub off (NCI: Lip and oral cavity cancer treatment (PDQ)).
How common is it?
According to NIDCR, oral cancer accounts for roughly three percent of all cancers diagnosed annually in the United States, or about 54,000 new cases in 2022. It most often occurs in people over 40 and affects more than twice as many men as women (NIDCR).
Risk factors
NIDCR and the NCI list these risk factors:
- Tobacco of any kind, including cigarettes, pipes, cigars, electronic cigarettes, chewing tobacco and snuff.
- Heavy alcohol use. Using tobacco and alcohol together raises the risk further.
- HPV infection, specifically HPV type 16, which is linked to cancers at the back of the throat. NIDCR notes that most throat cancers are caused by HPV and that HPV-positive oral cancer has risen in recent years.
- Age, with risk increasing over 40.
- Sun exposure, which can cause lip cancer. The NCI includes artificial sunlight such as tanning beds.
- A diet low in fruits and vegetables.
- Certain inherited gene changes.
If you use tobacco, our article on smoking, vaping and oral health covers the wider effects on your mouth and where to find help quitting.
MouthHealthy notes that the HPV vaccine protects against the HPV types that can cause oral cancers, and it summarizes the CDC’s recommendation that 11- to 12-year-olds get vaccinated, with vaccination recommended for everyone through age 26 who missed it earlier. Older adults can discuss the vaccine with their doctor.
Warning signs
NIDCR advises seeing a dentist or doctor if any of these last more than two weeks:
- A sore, irritation, lump or thick patch in your mouth, lip or throat
- A white or red patch in your mouth
- A persistent sore throat, a feeling that something is caught in your throat, or hoarseness
- A lump in the neck
- Difficulty chewing, swallowing or speaking, or moving your jaw or tongue
- Jaw swelling that makes dentures fit poorly
- Pain, bleeding or numbness in the mouth
MouthHealthy adds a change in the way your teeth fit together and loose teeth to that list. Many of these symptoms have harmless causes, such as a cheek bite or a denture sore, but a sore that does not heal within two weeks needs to be looked at.
What happens during a screening
An oral cancer check is usually part of a routine exam and takes only a few minutes. MouthHealthy describes the dentist asking about changes in your medical history and any new or unusual symptoms, then checking your lips, cheek lining, gums, tongue (front and back), the floor and roof of your mouth, and your throat. They also check your tonsils and the area where your tongue meets the floor of your mouth, and examine your jaw and neck for lumps.
It is painless and needs no preparation. If it has been a while since your last exam, our guide to how often you should see the dentist can help you plan.
If your dentist finds something
MouthHealthy stresses that a suspicious spot does not necessarily mean cancer. You may be asked to come back in a week or two to see whether the area has healed on its own, or you may be referred for further tests. A biopsy, which means removing a small piece of tissue for lab examination, is the way a diagnosis is confirmed. If you are referred to a specialist such as an oral and maxillofacial surgeon, our overview of dental specialists explains who does what.
Treatment, briefly
According to MouthHealthy, oral cancers found early are usually treated with surgery or radiation therapy, while those found later may need a combination such as radiation with chemotherapy. Targeted therapy is another option. The right plan depends on the tumor’s location, size and type, whether it has spread, and your overall health. The NCI notes that some people choose to get a second opinion; see our guide to getting a second opinion for how to approach that in dental care.
Cancer treatment can affect the mouth, including causing dry mouth. Our article on dry mouth and your teeth explains how to protect your teeth.
Lowering your risk
- Avoid all forms of tobacco.
- Limit alcohol.
- Ask your doctor about the HPV vaccine for eligible family members.
- Use lip protection in the sun and avoid tanning beds.
- Eat plenty of fruits and vegetables.
- Keep up regular dental exams and check your own mouth for changes.
Checking your own mouth between visits
You see your mouth every day, so you are well placed to notice changes. In good light, with a mirror, look at your lips, the inside of your cheeks, your gums, the roof and floor of your mouth, and your tongue, including its sides and underside. Gently feel your neck and under your jaw for lumps. You are not trying to diagnose anything, only to notice something new. If a sore, patch or lump has not gone away after two weeks, the timeframe NIDCR uses, make an appointment.
Frequently asked questions
Does my dentist check for oral cancer at every visit?
A soft-tissue check is usually part of a comprehensive or periodic exam. If you are not sure, ask. You can also ask your dentist to show you what they look for.
Does an oral cancer screening hurt?
No. It is a visual and hands-on check of your mouth, jaw and neck.
I have a white patch in my mouth. Should I worry?
Not every white patch is serious, but NIDCR lists white or red patches as a warning sign. Have any patch that lasts more than two weeks examined.
Can young people who don’t smoke get oral cancer?
Yes. HPV-related throat cancers can occur in people who do not use tobacco, which is one reason regular checks matter for everyone.
Who should I see if I notice a symptom?
Either your dentist or your doctor. Both can examine the area and refer you for a biopsy if needed.
Sources
- NIDCR: Oral Cancer
- ADA MouthHealthy: Oral Cancer
- National Cancer Institute: Lip and Oral Cavity Cancer Treatment (PDQ), Patient Version
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
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Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.