What to look for: Oral Cancer Signs and Symptoms

Important roles dental professionals play in screening Oral, Head and Neck Cancer.

By Jessy Kozak, Emily Smith, and Heather Verrell, Boulton Dental, Merewether NSW.

Firstly we would like to advise that this article is provided for informational purposes only, and does not intend to substitute professional medical advice, diagnosis, or treatment. The Big Hug Box would like to thank our extremely committed partners Boulton Dental and BioMeDent for their ongoing support in providing oral care support and awareness to our Big Hug Box Community this Head and Neck Cancer Day. Please also be aware that this article contains images of the mouth.

Dental professionals including dentists, oral health therapists and hygienists are one of the only health professionals to routinely examine the mouth. This provides an important opportunity to screen for oral lesions and cancer. 50% of oral cancers develop from small less sinister looking lesions. Therefore, early detection, management and preventative action plays a crucial role in treatment.

Signs and symptoms 

Oral cancer can develop in all areas of the mouth including lips, cheeks, tongue, throat, floor of mouth, tonsils, salivary glands, pharynx, larynx and even your sinuses. It is important to recognize any possible symptoms to ensure a visit to your dentist as soon as possible for a comprehensive screen and examination. Oral cancer symptoms can be similar or disguise themselves as other problems, for example a sore throat or a small bump. Usually, symptoms will persist for longer periods, in which case an assessment should be booked in with your dentist. Signs and symptoms may include:

• Lump in neck or mouth.
• Difficulty swallowing or chewing.
• Changes to voice
• White or red patches in mouth
• Sore that doesn’t heal
• Numbness
• Unexplained weight loss
• Sore throat or persistent feeling of caught in throat.

Common Oral premalignant lesions

Image: Leuoplakia on tongue – white or grey patches that do not go away

Image: Erythrolplakia on cheek -Flat or slightly raised areas that are red and may bleed
Image: Submucous fibrosis on cheek – white, mottled or marbled patches
Image: Lichen planus on cheek – White, lace- like patches

Image: Discoid lupus erythematosus on palate – red patch with spots of white surrounding
Image: Discoid lupus erythematosus on palate – red patch with spots of white surrounding
Image: Squamous cell carcinoma on lip – thick, scab like texture with uneven border
Image: Ulcer on lip – white/red in colour and does not heal
Image: Human Papilloma virus – red or white raised wart presentation  
Risk factors for oral cancer
Smoking and tobacco chewing
Sun exposure to the lips
Human papilloma virus (HPV)or oral warts
Epstein-Barr virus (EBV)
Age, genetics, gender, and poor oral and general health

    When you should get checked 
    Book in with your dentist for a regular checkup and clean. Routinely having examinations and screening is the best way to prevent late diagnosis. If you find a spot that concerns you or start displaying symptoms, consult your general practitioner or dentist.

    How to prevent mouth cancer
    Statistically in Australia 1 in 58 people were diagnosed with mouth cancer in 2022. 59% caused by smoking, 31% alcohol, and UV exposure in Australia were the main causes. Quitting smoking, reducing alcohol intake and wearing sunscreen and protective clothing are important steps towards prevention.
    At Boulton Dental every patient at their checkup has an Oral cancer screening.
    Your dentist or dental hygienist/dental therapist should perform an oral cancer screen at each examination appointment. During this time, they will check all the soft tissues in and around your mouth (lips, gums, tongue, cheeks, floor of the mouth), and feel under your jaw & in some cases your neck, checking for any lumps or bumps. They may also ask you about some of the risk factors
    associated with oral cancers.
    We are looking for any changes in the oral mucosa which can be red or white in colour and a present as a range of different shapes. By checking each patient this will lead to early detection of oral cancer. If an ulcer or sore is noticed in the mouth it should heal within 1-2 weeks. If doesn’t clear it is best to get it reviewed by the dental team.
    Before brushing your teeth, a good habit to develop is to look around your mouth, lifting the lips, sticking out tongue and pulling out the cheeks.
    Oral cancer equates to 3.2% of all new cancer diagnosis each year in Australia in 2022 and is the 6 the most common cancer worldwide.
    Before starting Cancer treatment, a full oral health check is recommended so any treatment can be done prior to the being of radiotherapy.

    What happens if something is found during an oral cancer screen?
    Your dental professional should let you know if a lesion is found in your mouth at the time of screening. In many cases, they will simply make a note of it and perhaps take a photo and review the lesion at follow up appointment. If the lesion has not disappeared, or looks suspicious, they may refer you to a specialist. The specialist will look at the lesion, discuss your individual risk factors with you, and likely take a biopsy of the area of abnormal cells. This will help determine if the lesion is cancerous or not. The specialist will then be able to discuss further with you what the next step will be for you. They will also let your general dental professional who referred you what the diagnosis is
    and whether any further treatment is required.
    If you are unsure of you have ever received an oral cancer screen, or have any questions, please ask your dental professional. At Boulton, oral cancer screenings are a regular part of our service and we are always happy to answer any questions you may have about your oral health. The dental staff
    here at Boulton regularly update their knowledge on oral cancer, so we can provide you with the best possible preventive and early diagnosis care.
    The most common treatment for head and neck is radiation which can affect the teeth and oral cavity.

    During radiation treatment patients may experience
    • Ulcers
    • Dry mouth
    • Loss or change of taste
    When a person has a dry mouth, the risk of tooth decay, tooth wear, gum disease and infection increase.

    To moisten the mouth, we recommend trying OH! Care HA-X Gel – Gum Serum or mouthwash. These products contain hyaluronic acid used to relieve dry mouth symptoms, healing mouth ulcers and sore mouths caused by cancer treatments.

    At Boulton Dental provide comprehensive and thorough Oral, Head, and neck cancer screening at every appointment. Our dentists, Oral health therapists and hygienists are all highly trained to detect signs and symptoms and can ensure quick specialist referral and advise.

    1. Mavedatnia, D. et al. (2023) ‘Oral cancer screening knowledge and practices among dental professionals at the University of Toronto’, BMC Oral Health, 23(1). doi:10.1186/s12903-

    2. Irani, S. (2020) ‘New insights into oral cancer—risk factors and prevention: A review of literature’, International Journal of Preventive Medicine, 11(1), p. 202.

    3. Mouth cancer: Causes, symptoms & treatments (2023) Cancer Council. Available at: https://www.cancer.org.au/cancer-information/types-of-cancer/mouth-cancer (Accessed:14 July 2023).

    4. Warnakulasuriya, S. and Kerr, A.R. (2021) ‘Oral cancer screening: Past, present, and future’, Journal of Dental Research, 100(12), pp. 1313–1320. doi:10.1177/00220345211014795.

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