Oral cancer screening

Overview

Oral cancer screening is an exam of the mouth to look for signs of oral cancer. Oral cancer also is called mouth cancer. This type of cancer can start anywhere inside the mouth, including on the lips. The goal of oral cancer screening is to find areas that could be cancer as early as possible.

Many dentists do an oral cancer screening exam during a regular dental visit. Some dentists may use other tests to help show if sores or red or white patches in the mouth, also called lesions, could have cancer cells.

If you're concerned about your risk of mouth cancer, talk about it with your dentist. Together you can decide whether a screening exam or other test is right for you based on your risk factors.

Why it's done

The goal of oral cancer screening is to find mouth cancer or lesions that could turn into cancer. Healthcare professionals diagnose most mouth cancers after the cancer has spread and may be harder to treat. Finding these cancers early before they spread to other areas of the body may require less-invasive treatment and make a cure more likely.

People with a high risk of oral cancer may be more likely to benefit from screening. Factors that can raise the risk of oral cancer include:

• Tobacco use of any kind, including cigarettes, cigars, pipes, chewing tobacco and snuff.
• Heavy alcohol use.
• History of infection with human papillomavirus (HPV).
• History of significant sun exposure, which increases the risk of lip cancer.

If you're concerned about your cancer risk, talk to a dentist or other healthcare professional. Ask about ways you can lower your risk and which screening tests you might need.

Risks

Oral cancer screening exams have some limitations, such as:

• Oral cancer screening could lead to more tests. Many people have sores in their mouths. Most are not cancer. An oral exam can't tell which sores have cancer cells and which do not.

If your dentist finds a lesion or sore, you may go through more testing to find its cause. The only way to know if you have oral cancer is to remove some of the concerning cells and test them for cancer. This is called a biopsy.

• Oral cancer screening can't detect all mouth cancers. Parts of the mouth might be hard to see. It's possible for a small area of concern to be missed on an exam.

How you prepare

Oral cancer screening doesn't require any special preparation. Dentists typically perform an oral cancer screening exam during a routine dental appointment.

What you can expect

During an oral cancer screening exam, your dentist looks over the inside of your mouth to check for mouth sores or red or white patches, also called lesions. Your dentist may use gloved hands to feel the tissues in your mouth to check for lumps or other areas that don't feel typical. The dentist also may examine your throat and neck for lumps.

Additional tests

Some dentists use other tests in addition to the oral exam to screen for oral cancer. It's not clear if these tests offer any added benefit. Other tests may involve:

• Oral cancer screening dye. You may be asked to rinse your mouth with a special blue dye before an exam. Cells that are not typical may take up the dye and appear blue.
• Oral cancer screening light. The dentist may shine a light in your mouth during an exam. The light makes healthy tissue look dark and makes areas of concern look white.

Results

If your dentist discovers any signs of mouth cancer or lesions that could become cancer, the dentist may recommend:

• A follow-up visit in a few weeks to see if the concerning area is still there and note if it has grown or changed over time.
• A biopsy procedure to remove a sample of cells for testing to see if cancer cells are present. Your dentist may perform the biopsy or may suggest that you see a healthcare professional who specializes in oral cancer diagnosis and treatment.

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