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A Comprehensive Guide to Oral Cancer Screening

A dentist holding a tablet stands in front of a patient at a dental center.

The significance of oral cancer screening cannot be overstated. Out of those who are diagnosed with oral cancer, 57% live for five years after receiving the diagnosis. While oral cancer is not inherently challenging to diagnose, its fatality rates remain disproportionately high due to frequent late-stage detection. Therefore, timely detection is imperative.

Keep reading to learn more about oral cancer and what to expect during oral cancer screening at a dental center, as well as some tips on how to conduct a monthly self-examination routine.

What Is Oral Cancer?

Oral cancers include different types:

  • Mouth cancer.

  • Jaw cancer.

  • Tongue cancer.

Mouth cancer affects the oral cavity which includes the lips, first two-thirds of the tongue, gums, floor of the mouth, lining of the inside of your cheeks, and the first part of the roof of the mouth (palate).

Additionally, mouth cancer can extend to the throat. When oral cancer affects the oropharynx (parts of the tongue, the roof of the mouth, and the middle part of the throat), it is known as oropharyngeal cancer.

Predominantly, oral cancer originates from squamous cells in the oral cavity. They become cancerous due to DNA mutations.

What Are the Risk Factors for Oral Cancer?

Tobacco Use

The consumption of tobacco in various forms constitutes a chief risk factor for oral cancer. Whether through smoking cigarettes, cigars, or pipes, or utilizing smokeless tobacco products such as chewing tobacco, dip, or snuff, individuals expose themselves to carcinogens. The habitual inhalation or ingestion of toxic substances causes cellular mutations, predisposing individuals to the development of malignancies.

Excessive Alcohol Consumption

Regular and excessive alcohol consumption is a significant contributor to the incidence of oral cancer. Chronic alcohol abuse inflicts deleterious effects on oral tissues, exacerbating inflammation and fostering a microenvironment conducive to carcinogenesis. When coupled with tobacco use, the synergistic impact further amplifies the risk of oral cancer.

Prolonged Sun Exposure

Individuals who spend considerable time in the sun without adequate protection for their lips are susceptible to developing oral cancer. Unprotected exposure to ultraviolet (UV) radiation heightens the risk of lip cancer. Therefore, it’s important to diligently apply sunblock to shield against harmful solar radiation and mitigate the risk of malignancies.

Human Papillomavirus (HPV) Infection

Some strains of the human papillomavirus (HPV), for example, HPV-16, have been linked to higher risks of infected individuals developing oral cancer. Transmission of HPV can instigate cellular changes conducive to malignancy.


Inherited genetic mutations and familial history of oral cancer underscore the interplay of genetic factors in augmenting an individual's risk of developing the disease.

Dietary Factors

Consuming a diet deficient in fruits and vegetables deprives individuals of essential nutrients and antioxidants vital for cellular health and immune function. A lack of fruits and vegetables in the diet compromises the body's defense mechanisms against oxidative stress and inflammation, thereby fostering an environment conducive to carcinogenesis and increasing the risk of oral cancer.

What Does Oral Cancer Screening Include?

A dental hygienist wearing a face mask performs an oral cancer screening.

Let’s take a closer look at two important procedures involved in oral cancer screening.

Extra-Oral Examination

Dental hygienists conduct extra-oral examinations through sight, sound, and touch to detect abnormalities beyond the patient’s mouth. Dental hygienists meticulously examine the head, face, and front and back of the neck, including obscured areas behind eyeglasses and beneath the hairline and ears.

Moreover, they listen to the patient’s voice, discerning any signs of chronic hoarseness that might hint at underlying issues. Utilizing palpation, a tactile technique, dental hygienists systematically feel the head and neck, assessing for abnormalities. This involves examining neck nodes and glands, scrutinizing the temporomandibular joint (TMJ) for swelling or lumps, and comparing the symmetry between the right and left sides of the face.

Intra-Oral Examination

During an intra-oral examination, which is a critical component of oral cancer screening, dental hygienists visually inspect the oral cavity for mucosal abnormalities. Additionally, they employ tactile sensation to palpate for signs of swelling or enlargement, particularly in the salivary glands.

During this examination, dental hygienists are vigilant for ulceration or crust formation. Furthermore, changes in texture or coloration, such as the presence of white, red, or mixed red and white patches, are meticulously examined.

Next Steps If a Dental Hygienist Flags Anything Suspicious

If a dental hygienist identifies anything suspicious during an oral cancer screening, the next steps are crucial for ensuring timely diagnosis and appropriate treatment. While dentists often conduct oral cancer screenings during routine exams, it's essential to understand that these screenings are not diagnostic cancer tests. Instead, they help identify signs of potential oral cancer.

If abnormalities are detected, the dental provider will typically refer the patient to an oncologist for further evaluation. The oncologist will conduct additional tests, such as biopsies or imaging scans, to confirm or rule out cancer diagnosis.

How to Conduct a Monthly Self-Examination Routine for Oral Cancer

To conduct a monthly self-examination routine for oral cancer, you will need a few supplies, including a flashlight, a small mirror (optional), a piece of gauze, and a wall mirror. The first step is to familiarize yourself with the normal, healthy condition of your mouth so that you can promptly detect any abnormal changes and report them to a dental or medical professional.

Begin by examining both sides of your face and neck in the mirror, ensuring that they look symmetrical. Pay attention to the skin on your neck and face, noting any changes in color, moles that have changed, or the presence of lumps or sores.

Next, gently feel both sides of your neck with your fingertips to detect any lumps, bumps, or sore spots. If you have one, note the way your "Adam's apple" moves when you swallow. If it moves to the side instead of up and down, this is a concerning sign. If you experience persistent hoarseness that doesn't improve within two weeks, report it to your healthcare provider.

Remove any dentures or oral appliances from your mouth before proceeding. Use a flashlight to illuminate the inside of your mouth, and if possible, use the small mirror to get a better view. Check the roof of your mouth for changes in color or lumps, and gently press with your index finger to feel for any abnormalities.

Examine the floor of your mouth, feeling for changes in texture, swelling, or changes in shape. With a piece of gauze, pull out your tongue and examine all sides, feeling it with your fingers for any irregularities.

Inspect your gums for changes in color, lumps, bumps, or tenderness. Any sores that have not healed after 14 days should be reported. Pull your upper and lower lips up and down, checking for any abnormalities, and gently squeeze your lips and cheeks to feel for lumps, bumps, or tenderness.

Finally, run your index finger over your upper and lower gums. If you detect anything concerning, report your observations to a dental or medical professional promptly. Dental hygienists collaborate with physicians, dermatologists, and oncologists to address such matters effectively. Regular self-examinations can aid in the early detection of oral cancer, improving treatment outcomes and prognosis.

At The Family Dental Center near Coralville, we offer comprehensive oral cancer screenings. Schedule an appointment today.

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