Oral cancer screening

Overview

Oral cancer screening is an examination performed by a dentist or doctor to look for signs of cancer or precancerous conditions in your mouth.

The goal of oral cancer screening is to identify mouth cancer early, when there is a greater chance for a cure.

Most dentists perform an examination of your mouth during a routine dental visit to screen for oral cancer. Some dentists may use additional tests to aid in identifying areas of abnormal cells in your mouth.

Medical organizations disagree on whether healthy people without risk factors for mouth cancer need oral cancer screening. No single oral exam or oral cancer screening test is proved to reduce the risk of dying of oral cancer. Still, you and your dentist may decide that an oral exam or a special test is right for you based on your risk factors.

Why it's done

The goal of oral cancer screening is to detect mouth cancer or precancerous lesions that may lead to mouth cancer at an early stage — when cancer or lesions are easiest to remove and most likely to be cured.

But no studies have proved that oral cancer screening saves lives, so not all organizations agree about the benefits of an oral exam for oral cancer screening. Some groups recommend screening, while others say there isn't enough evidence to make a recommendation.

People with a high risk of oral cancer may be more likely to benefit from oral cancer screening, though studies haven't clearly proved that. Factors that can increase the risk of oral cancer include:

• Tobacco use of any kind, including cigarettes, cigars, pipes, chewing tobacco and snuff, among others
• Heavy alcohol use
• Previous oral cancer diagnosis
• History of significant sun exposure, which increases the risk of lip cancer

The number of people diagnosed with mouth and throat cancers has been rising over the last several years, though it isn't clear why. An increasing number of these cancers are associated with the sexually transmitted infection human papillomavirus (HPV).

If you're concerned about your cancer risk, talk to your doctor about ways you can reduce your risk and which screening tests might be appropriate for you.

Risks

Oral exams for oral cancer screening have some limitations, such as:

• Oral cancer screening could lead to additional tests. Many people have sores in their mouths, with the great majority of these sores being noncancerous. An oral exam can't determine which sores are cancerous and which are not.

  If your dentist finds an unusual sore, you may go through further testing to determine its cause. The only way to definitively determine whether you have oral cancer is to remove some abnormal cells and test them for cancer with a procedure called a biopsy.

• Oral cancer screening can't detect all mouth cancers. It can be difficult to detect areas of abnormal cells just by looking at your mouth, so it's possible that a small cancer or precancerous lesion could go undetected.
• Oral cancer screening hasn't been proved to save lives. There's no evidence that routine oral examinations to look for signs of oral cancer can reduce the number of deaths caused by oral cancer. However, screening for oral cancer may help find cancers early — when cure is more likely.

How you prepare

Oral cancer screening doesn't require any special preparation. Oral cancer screening is typically performed 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 red or white patches or mouth sores. Using gloved hands, your dentist also feels the tissues in your mouth to check for lumps or other abnormalities. The dentist may also examine your throat and neck for lumps.

How you prepare

Additional tests

Some dentists use special tests in addition to the oral exam to screen for oral cancer. It's not clear if these tests offer any additional benefit over the oral exam. Special tests may involve:

• Oral cancer screening dye. Rinsing your mouth with a special blue dye before an exam. Abnormal cells in your mouth may take up the dye and appear blue.
• Oral cancer screening light. Shining a light in your mouth during an exam. The light makes healthy tissue appear dark and makes abnormal tissue appear white.

Results

If your dentist discovers any signs of mouth cancer or precancerous lesions, he or she may recommend:

• A follow-up visit in a few weeks to see if the abnormal area is still present and note whether it has grown or changed over time.
• A biopsy procedure to remove a sample of cells for laboratory testing to determine whether cancer cells are present. Your dentist may perform the biopsy, or you may be referred to a doctor who specializes in oral cancer diagnosis and treatment.