Screening

Early detection of oral cancers can significantly reduce the number of related deaths and begins with regular checkups and appropriate screenings. Screening should be done by your dentist or health care provider.

At the time of screening, the practitioner will obtain a relevant medical history and inquire about any tobacco or alcohol use. During screening, the oral cavity is examined for any abnormal changes that may signal the beginnings of cancer. Report any of the following warning signs and unusual symptoms to your provider at the time of your exam:

• Unhealed mouth sores that have persisted for greater than two weeks
  
• Lumps on the lips, mouth, or in the throat; or the feeling that something is caught in the throat
  
• Dentures which no longer fit properly or comfortably
  
• Difficulty chewing or swallowing
  
• Swelling in the neck or the jaw
  
• Prolonged hoarseness or a change in the voice
  
• Pain in the ear
  
• Unusual white or red patches.
  

Examination

The head and neck screening will take approximately five minutes. The following areas of the head and neck will be examined:

• Extraoral examination: observation and palpitation of the outside of the face and neck for the presence of suspicious nodules.
  
• Perioral and intraoral examination: soft tissue examination of the inside of the oral cavity.
  

Perioral and intraoral examination sites:

• External lips and the top and bottom labial mucosa (i.e. insides of the top and bottom lips)
  
• Right and left buccal mucosa (cheeks)
  
• Gingiva (surrounding gum tissue)
  
• Tongue (left, right, top and bottom surfaces will be observed)
  
• Floor of mouth (the base of the mandible immediately behind the teeth)
  
• Hard palate (anterior front of the mouth)
  
• Oropharynx (the back of the tongue, soft palate (rear roof of the mouth) and the tonsils.

During the exam, the practitioner will rule out the presence of two specific precursor lesions, leukoplakia and erythroplakia.

• Leukoplakia: Irregular shaped white patches that may form in the buccal cavity of the cheek, or on the mucous membrane of the tongue. These patches cannot generally be "rubbed off." Individuals using smokeless tobacco and pipe smokers have a high incidence of leukoplakia.
  
• Erythroplakia: An erythymetous (red) lesion in the mucosa of the oral cavity, typically seen in a population of older individuals (ie. age 60 or older).

If either of these types of lesions are present your physician will determine if they are indicative of the presence of early carcinoma, or are benign and related to other diseases such as fungal infections (yeast) or lichen planus (benign inflammatory lesions).