Oral Cancer Screening: What a Dental Exam Checks For

An oral cancer screening is when a dentist or doctor looks inside your mouth and feels your neck to check for anything unusual. It looks for early signs of cancer in the lips, tongue, cheeks, gums, roof and floor of the mouth, and the back of the throat.

The check is often just part of a routine dental visit.

An oral cancer screening is a simple look and feel, usually built into a regular dental checkup.

During the exam, the provider looks and feels for changes. They usually:

• Look at your lips, gums, tongue, cheeks, and the roof and floor of your mouth
• Ask you to move your tongue so they can see the sides and underneath
• Look at the back of your throat
• Feel the sides of your neck, under your jaw, and around your throat for lumps

They are looking for sores, lumps, thick spots, or red or white patches, and for anything that seems different from healthy tissue.

The exam covers the whole mouth and throat, plus the neck and jaw.

Some people have a greater chance of developing mouth or throat cancer. The main risk factors are:

• Tobacco. Smoking or chewing tobacco in any form raises risk.
• Alcohol. Heavy drinking raises risk, and combining alcohol with tobacco raises it much more than either alone.
• HPV. Certain long-lasting infections with human papillomavirus are linked to some throat cancers.
• Sun exposure. MedlinePlus lists frequent sun exposure as a risk, especially for lip cancer.
• Age and sex. MedlinePlus lists being male or over 40.

If one or more of these apply to you, it is worth talking with your dentist or doctor about how closely to watch.

Tobacco, heavy alcohol, and certain HPV infections are the biggest risk factors.

NCI says there is no standard or routine screening test for oral cavity cancer. It also says no studies have shown that screening lowers the risk of dying from it.

Many dentists do look inside the mouth as part of a normal visit. That look is not a formal screening program, and it is not proven screening that you need to seek out. Go to the dentist for the usual reasons. For oral cancer, what matters most is reporting a change that is not getting better, rather than relying on being checked.

Whether or not you are being formally screened, it helps to know the warning signs.

• Call 911 or go to an emergency department if bleeding in your mouth keeps going despite steady pressure, if you are swallowing blood, or if breathing or swallowing your own saliva has suddenly become hard. Do not drive yourself.

• Call your care team the same day if new trouble swallowing is keeping you from eating or drinking.

• Call your dentist or doctor within a day or two if any of the signs below appear. Two weeks is a rough guide for something mild and unchanging, not a waiting period to serve out: anything that is worsening, bleeding, painful, or spreading should be looked at without waiting.

• A sore or lump in the mouth or throat that does not heal (MedlinePlus: see a provider if signs last more than two weeks)

• A red or white patch that does not go away

• A thick or rough spot

• Trouble chewing, swallowing, or moving the tongue or jaw

• A lasting sore throat or a feeling that something is stuck

• Numbness, pain, or bleeding in the mouth

Most of these turn out not to be cancer. Still, having them checked is the right move.

A sore or patch that is not settling is worth getting checked. Do not wait out two weeks if it is getting worse.

• National Cancer Institute: Oral Cavity and Nasopharyngeal Cancer Screening (PDQ)
• National Cancer Institute: Oral Cavity, Pharyngeal and Laryngeal Cancer Prevention (PDQ)
• National Cancer Institute: Head and Neck Cancers fact sheet
• MedlinePlus: Oral Cancer