Dental exams are important to maintain oral health. A thorough dental exam includes checking the teeth and gingiva (gums), but it also includes a thorough examination of the soft tissues of the mouth and oro-pharynx (tonsils and upper throat). Specific areas your dentist should look include the roof of your mouth, floor of the mouth, the sides of and underneath your tongue, your cheeks, lips, and even around the outside of your mouth. There are several conditions that can be noticed first in the oral region, but one of the most important is oral cancer. It is estimated that over 49,600 people in the United States will be diagnosed with oral cancer in 2017.
What is Oral Cancer?
Oral cancer is any growth of mutated cells in the oral cavity (mouth) or the upper part of the throat. Not all cancer is malignant, but many oral cancers could be. Oral cancer can appear as a sore, irritation, lump or thick patch in the mouth, lip, or throat, or a white or red patch in the mouth. More advanced stages could include a feeling that something is caught in the throat, difficulty chewing or swallowing, difficulty moving the jaw or tongue, numbness in the tongue or other areas of the mouth, or swelling of the jaw that causes dentures to fit poorly or become uncomfortable.
What Causes Oral Cancer?
Tobacco and alcohol use. Most cases of oral cancer are linked to cigarette smoking, heavy alcohol use, or the use of both tobacco and alcohol together. Using tobacco plus alcohol poses a much greater risk than using either substance alone.
HPV. Infection with the sexually transmitted human papillomavirus (specifically the HPV 16 type) has been linked to a subset of oral cancers.
Age. Risk increases with age. Oral cancer most often occurs in people over the age of 40.
Sun exposure. Cancer of the lip can be caused by sun exposure.
What Type of Cancer is Found in the Mouth?
The most common type of oral cancer is called squamous cell carcinoma (SCC). SCC usually occurs on the surface of the affected tissues, and can appear as a color change (usually red or white), and ulceration, or an asymmetrical mass. Other types of cancers that occur are salivary gland tumors, bone tumors, and lymphomas. It is important to note that not all oral cancers are malignant, but they should all be addressed as early
How is Oral Cancer Diagnosed?
Your dentist will do a thorough examination of all the hard and soft tissues in and around your mouth. This should include visual inspection of your teeth, gums, and lips, feeling your cheeks for lumps, and moving your tongue up and to each side to see the floor of your mouth as well as the sides of your tongue. They may ask you to say “Ahh” in order to see your soft palate, uvula, and tonsils. Your dentist is looking for anything that doesn’t look like normal oral tissues. However, they cannot know for sure whether something is or is not cancer by the way it looks. The only way to know for sure is by putting a piece of the questionable tissue under a microscope. Of course, that means that some (or all) of the lesion must be surgically removed from the mouth. This is called a biopsy. After the biopsy is completed, the surgeon (or your dentist) will discuss the results with you, and go over your options.
What can be Done?
Early stage cancers are much easier to treat than later stage cancers that have progressed. Treatment modalities can range from simple excision (cutting the cancer out) to more advanced treatments to include chemotherapy and/or radiation. If your general dentist finds a suspicious lesion, they will likely refer you to a specialist for further evaluation and treatment.
All cancer is scary, and oral cancer is no exception. Catching suspicious lesions early is the most important step in a successful outcome. We encourage you to see your dentist regularly, and ask for an oral cancer screening with every exam.
Author Dr. Charles Sabadell, DDS is located in Colorado Springs with Dr. Monica Dobbin, DDS and Dr. Richard Dobbin, DDS.
For more information or to schedule an appointment, please call (719) 473-5122
730 Cheyenne Boulevard Colorado Springs, CO 80905
Oral Cancer: Causes and Symptoms & The Oral Cancer Exam. (2015, September). https://www.nidcr.nih.gov/OralHealth/Topics/OralCancer/AfricanAmericanMen/CausesSymptoms.htm
NIH Publication No: 15-6424
Cancer Stat Facts: Oral Cavity and Pharynx Cancer. https://seer.cancer.gov/statfacts/html/oralcav.html