Oral Cancer Screening: Early Symptoms and How To Detect

Oral cancer is a type of head and neck cancer found in the oral cavity and the oropharynx (oropharyngeal cancer). The oral cavity encompasses most of the mouth, including your:

  • Lips
  • Gums
  • Cheeks
  • Most of the tongue (front ⅔)
  • The hard roof of your mouth (hard palate)
  • The floor of the mouth under the tongue

The oropharynx is:

  • The middle part of the throat
  • The base of the tongue
  • The soft part of the roof of your mouth (soft palate)
  • The tonsils

The good news is that oral cancer survival rates have been steadily improving thanks to increased screening and catching cancer in early stages. When oral cancer gets caught early, it’s much more treatable.

Screening is crucial to detect oral cancer early on. It’s just another way that your mouth and dental wellness are linked to overall health.

Risk Factors for Oral Cancer

Some lifestyle choices will increase your chances of developing oral cancer. The most significant risk factors for developing oral cancer are:

  • Heavy alcohol use. This is defined as more than 8 drinks a week for women or more than 15 weekly for men.
  • Infection with certain strains of human papillomavirus (HPV). The variations to watch are HPV 16 and 18.
  • High sun exposure. UV radiation has been associated with lip cancer
  • Age. You’re at higher risk of oral cancer if you’re 55 or older.
  • Being male. Men are 2 times as likely to get oral cancer as women.
  • Previous cases. Being previously diagnosed with oral cancer raises your risk.
  • Tobacco use. This may include smoking cigarettes, cigars, pipes, chewing tobacco, or using snuff.

If you have any of these risk factors, it’s vital to have your health professional perform an oral cancer screening.

Oral Cancer Types

There are 3 primary types of oral cancer:

  • Mouth cancer
  • Pharyngeal cancer
  • Laryngeal cancer

Your dentist may also screen you for cancer in the sinuses and other parts of the head and neck.

Mouth Cancer

Mouth cancer is any cancer in the oral cavity. Mouth cancer usually involves squamous cells. Squamous cells make up the oral mucosa, the lining of your mouth, and your gums (gingiva).

Pharyngeal Cancer

Pharyngeal cancer (cancer of the pharynx) is also called throat cancer. It usually involves the squamous cells that line the throat, similar to mouth cancer. Adenocarcinoma, a cancer of the secretory cells of the throat, is another common type of pharyngeal cancer.

Laryngeal Cancer

Laryngeal cancer is cancer of the voice box. It is almost always found on the vocal cords, or glottis. In a few cases, laryngeal cancer may also be located in the regions above or below the vocal cords.

What is the most common type of oral cancer? The most common type of oral cancer is squamous cell carcinoma in the oral cavity or the oropharynx. Squamous cell carcinoma accounts for about 90% of all oral cancers.

Symptoms of Oral Cancer

What are the symptoms of oral cancer? The symptoms of oral cancer include:

  • Sores or lesions in the mouth that don’t heal
  • A lump inside the mouth or on the tongue
  • White patches (leukoplakia) on the lining of the throat or mouth
  • Red patches (erythroplakia) on the oral mucosa
  • Pain or difficulty swallowing
  • Mouth pain
  • Ear pain
  • Suddenly poor-fitting dentures
  • Hoarseness or a sore throat that doesn’t go away

If you notice any changes in your mouth, gums, or throat, schedule an appointment with your dentist right away.

Can A Dentist Catch Oral Cancer Early?

Early diagnosis of oral cancer is highly beneficial. If cancer is caught in the early stages, treatment is much easier and more likely to be effective.

How is oral cancer detected early? Oral cancer is detected early by regular screening. Your dentist may perform a screening test at your annual checkup. Ask your dentist to be sure you’re screened for oral cancer at your next visit.

What is an oral cancer screening? An oral cancer screening is an exam performed by your dentist to look for any signs or symptoms of oral cancer. Your dentist or dental hygienist will look all over the inside of your mouth, tongue, and throat for any abnormalities.

What To Expect At A Screening

Getting a cancer screening can cause some anxiety, especially if you don’t know what to expect. Oral cancer screening is generally a quick and painless process.

How is oral cancer screening done? Oral cancer screening is done by examining the inside of your mouth for any signs of cancer. Health care providers are looking for any suspicious areas you might not have noticed yourself, especially in places that are hard for you to see, like under your tongue.

How does a dentist look for oral cancer? A dentist looks for oral cancer by searching for any abnormal bumps, ulcers, or discolored patches inside the mouth.

Here’s what you can expect to happen at your screening:

  • Examining inside the mouth. Your dentist will start out by looking at the skin lining of your mouth and gums. They’ll also feel different parts of your mouth with a gloved hand.
  • Observing the jaw and throat. After examining your mouth, the clinician will look and feel for any lumps that could be cancer in the jaw and throat. Oral cancer can spread to the lymph nodes in your neck, so they will usually check your lymph nodes as well.
  • Lights or dyes, in some cases. Your dentist may use a blue dye or a special screening light to look for abnormal tissue. They will have you swish a liquid around in your mouth that contains the dye for several seconds, then spit it out. This gives the dye time to interact with the cells lining your mouth.

Why is a dye used? The blue dye (methylene or toluidine blue) makes it easier for clinicians to spot abnormal cells. Precancerous and cancer cells pick up the blue dye and look like blue patches inside your mouth. The dye makes it very easy for your dentist to spot abnormal cells.

What do lights achieve in oral cancer screenings? Oral cancer screening lights like VELscope oral cancer screening also work by changing how the mouth tissue looks. Normal tissue appears one color under the light, and abnormal tissue appears a different color.

Some oral cancer screening lights are used in conjunction with a special dye. For this type of screening, you’ll swish a liquid around in your mouth, just like you would the blue dye. When the dye interacts with the light, it glows. Normal tissue will look different from abnormal tissue.

Cost Of An Oral Cancer Screening

How much does oral cancer screening cost? Oral cancer screening costs can vary, but out-of-pocket costs usually run between $20-$65. Some dentists include basic screening in their exams for no extra charge.

Oral cancer screening is often covered by insurance, so you may be screened at no additional cost. Check with your insurance to see what your policy does and doesn’t cover.

After Your Oral Cancer Screening

After your screening, your dental professional will let you know what they’ve found. You’ll learn if they need to run any additional tests on tissues or cells that look suspicious.

What if my dentist doesn’t find anything at my oral cancer screening? If your dentist doesn’t find any cancer at your oral cancer screening, that’s great news! Most screenings don’t turn up anything.

A clean bill of oral health doesn’t mean you can totally forget about screening for the rest of your life. Younger patients should be screened every few years. Older adults should be screened every year since they’re at a higher risk of getting oral cancer.

What happens if my dentist finds something? Occasionally dentists find something during an oral cancer screening that they want to look into further. Your clinician may simply want to keep an eye on the abnormal tissue, or they may ask for further tests.

In these cases, you would simply make an appointment to come back in a few weeks for a follow-up exam. If this happens to you, don’t panic. Additional tests on abnormalities often don’t turn up anything. You may simply have an injury inside your mouth that needs time to heal.

Your dentist may want to run a follow-up test after your initial screening. The most common follow-up tests after an oral cancer screening are:

  • Biopsy: A doctor (either your dentist or a specialist) will take a small tissue sample and send it off to be analyzed. Sometimes biopsies are performed by simply scraping off surface cells and collecting them for analysis.
  • Imaging Tests: Your doctor may order a CT scan, MRI, or PET scan to get a better look at any suspected tumors.
  • Endoscopy: Depending on the location of any suspicious tissue, your doctor may want to use an endoscope with a camera to look inside your nose or throat.

If you are eventually diagnosed with oral cancer, there are effective treatments to help remove the cancerous cells from your mouth and body. There are also many options for a full mouth reconstruction if needed.

Oral Cancer Statistics

According to American Cancer Society estimates, over 54,000 new cases of oral cancer will be diagnosed in 2021. Oral cancer will account for 2.8% of all cancers diagnosed this year.

The 5-year survival rate for oral cancer is 66.9%. This means that 66.9% of oral cancer patients will still be alive 5 years after receiving their diagnosis.

Almost 11,000 people die from oral cancer each year. The survival rate for oral cancer is relatively low compared to other cancers. That’s because most oral cancer is discovered at a later stage, making it much more challenging to treat.

Oral cancer screening is incredibly important in catching oral cancer in its earlier, more treatable stages.

Practical Steps to Prevent Oral Cancer

Prevention is vital, particularly for oral cancer. Here are some simple steps you can take to reduce your risk and prevent oral cancer:

  • Stop using any tobacco products
  • Reduce the amount of alcohol you drink
  • Use a lip balm with SPF or sunscreen on your lips
  • Get the HPV vaccine (the types of HPV targeted by the vaccine can cause oral cancer)
  • Have any toxic dental materials removed from your mouth if your dentist deems it safe
  • Eat a healthy diet full of antioxidants
  • Take care of your overall wellness to improve your oral health
  • Get regular oral cancer screenings to catch abnormalities before they develop into cancer

If you’re at all concerned about your oral cancer risk, schedule a screening. It’s the best way to make sure you are doing everything you can to prevent oral cancer.

Book A Screening Today

The best oral cancer screening comes from trained dental professionals who take the time to look closely for any signs of cancer. At Rejuv Dentistry, our doctors and staff are dedicated to giving our patients thorough screenings to catch oral cancer as early as possible.

Want to schedule your oral cancer screening with a team that holds decades of experience? Click here to book a consultation with us in East Hampton or Manhattan.

Dr. Gerry Curatola is a renowned biologic restorative dentist with more than 40 years of clinical practice experience.

He studied neuroscience at Colgate University and attended dental school at the New York University (NYU) College of Dentistry where he now serves as Adjunct Clinical Associate Professor in the Department of Cariology and Comprehensive Care.