What is an Oral Cancer Screening?
An oral cancer screening is an exam that may help detect cancers inside the mouth. Your dentist may perform this screening as part of a routine dental checkup. It involves thoroughly checking all tissues inside the mouth, including the gums and tongue. Your dentist may also examine other parts of your head and neck, such as your ears and nose.
What is Oral Cancer?
Oral cancer refers to cancers that start in the mouth. These cancers may affect the gums, lips, tongue, roof of the mouth, the floor of the mouth, or the insides of the cheeks.
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Most oral cancers are what’s known as “squamous cell carcinomas.” This means they develop in the squamous cells: the thin, flat cells that make up the lining of the mouth and throat.
What Does Mouth Cancer Look Like?
Mouth cancer doesn’t always cause pain or noticeable symptoms, especially in the early stages. This is why oral cancer screening is so important.
Some possible signs and symptoms of oral cancer include:
- A sore in your mouth that doesn’t heal
- A white or red patch on the inside of your mouth
- A lump inside your mouth
- Mouth pain that doesn’t go away
- Trouble moving your tongue or jaw
- Numbness inside your mouth
- Loose teeth or pain around your teeth
- A change in the way your dentures fit
Oral Cancer Risk Factors
Certain lifestyle habits may increase the risk of developing mouth cancer. For people with oral cancer risk factors, regular screening may even be more important.
- Tobacco use – It’s estimated that 75% to 90% of all oral cancers are associated with cigarette smoking. Other forms of tobacco use, such as smoking cigars or chewing tobacco, have also been linked to oral cancer.
- Drinking alcohol – Moderate to heavy drinking has been linked to a greater risk of oral cancer. Compared to non-drinkers, heavy drinkers have five times the risk of mouth and throat cancer. The risk is higher for people who use both alcohol and tobacco.
- Poor diet – There is some evidence that dietary factors affect your oral cancer risk. People who eat a diet rich in fruits and vegetables may have a lower risk than people with low intake levels.
- Sun exposure – The sun’s harmful ultraviolet rays may cause cancer in the lip area. This type of oral cancer is more common in people with fair skin.
Why is Oral Cancer Screening Important?
Oral cancer screening aims to identify mouth cancer at an early stage before the cancer spreads to surrounding tissues. Cancer is often easier to treat when it’s found early.
Less than one-third of oral cancers are found at an early stage. For these cancers, the survival rate is very high. Overall, 85% of people diagnosed with early-stage oral cancer are still alive five years later. The five-year survival rate is even higher for some types of oral cancer, such as lip cancer.
Unfortunately, about half of oral cancers aren’t diagnosed until the cancer has spread to nearby tissues or lymph nodes. Cancers diagnosed at this stage are harder to treat, and the overall five-year survival rate is 67%. When oral cancers spread to distant parts of the body, such as the lungs, the five-year survival rate drops to 40%.
Oral Cancer Screening Steps
The main screening test for oral cancer is a thorough visual examination of the inside of the mouth. This examination is straightforward and can be completed in less than five minutes. It involves examining the following areas:
- Inside of the Cheeks – Your dentist will gently move your cheeks away from your teeth and gums. They’ll examine the cheek for any unusual sores, textures, or colors. While your cheeks are pulled away from your teeth, your dentist will examine your gum tissue.
- Tongue – Your dentist will ask you to stick out your tongue and move it from side to side. To get a better look at the sides of your tongue — a common site for oral cancer — they’ll grip your tongue with gauze and roll it from side to side. They may use a small dental mirror to examine the base of your tongue.
- The floor of the Mouth – The floor of the mouth is one of the most common sites for oral cancer. To examine this area, your dentist will gently lift your tongue and move it from side to side. They may press on the floor of your mouth with a gloved finger to feel for lumps.
- The roof of the Mouth – The roof of the mouth is known as the hard palate. To check this area, your dentist will ask you to open your mouth and tilt your head backward.
- Throat – Oral cancer may develop in the tonsils or other tissues in the throat. To examine this area, your dentist will ask you to open wide and say “ahh.” They may press down on the back of your tongue to get a better view.
Oral Cancer Screening Devices
In addition to the visual examination described above, dentists may perform tests with specialized oral cancer screening devices. These may include:
- Screening dye – A special screening dye, called toluidine blue, can help dentists identify oral cancer. Your dentist may ask you to swish with a toluidine blue mouthwash. Abnormal or cancerous cells in your mouth may stain blue, making them easier to see.
- Screening light – Some dentists use a light-based device to screen for oral cancer. This handheld device emits blue light and can help your dentist see abnormal tissue that’s not visible to the naked eye.
- Oral brush – To test an abnormal area for cancerous cells, dentists may perform an oral brush biopsy. They’ll gently scrape the tissue with a small oral brush to remove a cell sample.
- Saliva test kit – A saliva test may be used as part of an oral cancer screening. Your dentist may ask you to rinse your mouth and provide a saliva sample. The sample is analyzed in a laboratory for cancer biomarkers.
How Often Should You Have Oral Cancer Screening?
Many health organizations recommend routine oral cancer screenings. The National Institute for Dental and Craniofacial Research recommends a thorough oral cancer screening at each dental visit, while the Oral Cancer Foundation recommends annual screenings. The American Dental Association also supports routine oral cancer examinations, especially for people who use alcohol or tobacco. To learn more about how often you should have an oral screening for mouth cancer, talk to your dentist.
Additional Exams Related to Oral Cancer
Cancers that start inside the mouth may spread to nearby tissues. As part of a thorough oral cancer screening, your dentist may examine other parts of your head and neck. These additional exams may include checking the following issues.
- Face – Your dentist may carefully inspect your face for lesions or discolored areas. They may gently press on your face and scalp to check for swelling or abnormal lumps.
- Eyes – Your dentist asks you to look in various directions to check your eye movement. They may visually inspect your eye area, looking for swelling or excessive watering.
- Ears – Your dentist may use a tool called an otoscope to look inside your ears. As they talk to you during the exam, they may make a general assessment of how well you can hear.
- Nose – A thorough oral cancer screening may include evaluating your nose. Your dentist may press on the outside of your nose. They may use an otoscope to check for tumors inside your nostrils.
- Neck – A painless lump in the neck may be caused by oral cancer. To check for lumps, your dentist may press on the sides and front of your neck.
- Thyroid – The thyroid gland is located at the base of your neck. Your dentist will press on this area to inspect the gland for lumps or other abnormalities. They may ask you to swallow, which makes the thyroid gland easier to feel.
- Lips – The edge of the lip is a prime location for oral cancer. Your dentist will check this area for abnormalities, such as color or texture changes. They’ll also retract your lips to inspect their inner surfaces.
Oral Cancer Screening Cost
The cost of an oral cancer screening varies. Some dentists may offer an oral cancer screening at no additional cost when you receive a comprehensive dental examination. This examination generally costs around $70 to $90, depending on your location.
Other dentists may charge an additional fee for an oral cancer screening. In this case, you can expect to pay around $10 to $35 for an annual screening. Dentists who use specialized oral cancer screening devices may be more likely to charge additional fees. Talk to your dentist to learn how much you’ll pay for your screening.