Can Your Dentist Detect Cancer?
Table of Contents
- What is My Dentist Looking For?
- Risk Factors
- Signs to Report
- What Happens During a Dental Cancer Screening
- Types of Lip & Oral Cancers
- Limitations of Screenings
- What to Expect
- Next Steps
- Frequently Asked Questions
- References
During your dental examination, your dentist (or even your dental hygienist) may discover a growth or signs inside your mouth that look abnormal. The dental professionals may suspect a type of oral cancer, but they will not test for it, nor will they diagnose it.
The only way to confirm a diagnosis of oral cancer is to biopsy the suspicious tissues and to send samples for examination.
Odds are your dentist will refer you to an oral surgeon or to an oncology practice to conduct the biopsies and make a diagnosis.
Medical experts estimated 54,000 U.S. adults to be diagnosed with oral cancer in 2021. The overall five-year survival rate for oral and oropharyngeal cancer is 66 percent, although that rate rises to 85 percent if the cancer is caught in an early stage.
What Is My Dentist Looking For?
As part of a routine checkup, your dentist will check for signs of oral cancer.
The dentist examines the tissues inside your mouth and lips. In addition, your gums are checked carefully for gingivae, as well as the inside of your cheeks and underneath and the sides of your tongue.
The dentist also looks at the roof of your mouth and the floor of your mouth.
Risk Factors Associated with Oral Cancer
There are several risk factors associated with developing oral cancer, and most stem from behaviors that can be avoided. The Centers for Disease Control and Prevention (CDC) considers heavy drinking (two drinks a day or more for men, and more than one drink a day for women), to play a significant role in the development of oral cancer.
Smoking cigarettes is also a significant risk factor in the development of oral cancer. Products such as smokeless tobacco also increase your risks for developing oral lesions.
Other factors that play a role in developing this type of cancer include prolonged exposure to the sun. Lip cancer is the usual result from sun exposure.
Other risk factors to be aware of that could develop into oral cancer:
A diet low in vegetables and fruits
A previous history of oral cancer
Infection with some forms of the human papillomavirus
Signs You Should Report to Your Dentist If You Suspect Oral Cancer
Oral cancer often appears as a sore or growth in or around your mouth and is one that will not away. It can include the floor of your mouth, soft and hard palate, throat, tongue and lips. All types of cancer are serious, and this form can be life-threatening if it is not caught in an early stage and treated appropriately.
You should alert your dentist about a potential cancer issue if you:
Have unexplained bleeding in your mouth
Experience a dramatic weight loss
Notice changes in your bite
Find bumps, lumps, eroded areas, rough crusts or spots on your gums, lips, or other areas in your mouth
Have persistent sores on your mouth, neck, and face that bleed easily and do not heal within two weeks
Have unexplained tenderness, pain or numbness in any area of your neck, mouth, or face
Experience difficulty swallowing, speaking, chewing or moving your tongue or jaw
Have ear pain
Endure chronic hoarseness, sore throat or changes in your voice
See velvety red, white, or speckled white-and-red patches in your mouth
Have a persistent feeling that something is caught in the back of your throat or if you have lingering soreness in the back of your throat
If you experience any of these symptoms, don't wait for your bi-annual checkup. Contact your dentist right away.
If you notice white or red patches, lumps, ulcers or other growths, you should also get to your dentist as soon as possible. These symptoms are not precursors to cancer, but they’re also issues that should not linger without treatment.
What Happens During a Dental Cancer Screening?
Although dentists won’t diagnose oral cancer, they can—and do—screen for it.
If you have an oral cancer screening, it typically begins with the dental hygienist updating your medical history. This history is necessary to learn about any new medications you might be taking or if you have had a recent disease diagnosed. The history will most likely include questions about your lifestyle risk factors for oral cancer and whether (and how much) you smoke and drink alcohol.
The dentist will want to understand your current health status, including whether you have any dental concerns. Refrain from withholding any information that could hinder your evaluation.
The dental cancer screening will include areas inside and outside of your mouth. The screening should also include an exam of your neck and head and an intra-oral exam of your lips, palate, tongue, cheeks, gum tissues, and the floor of your mouth.
The cancer screening performed by your dentist is to look for any irregular tissue changes, sores, lumps, or discoloration in the areas.
If any suspicious areas are detected, your dentist will recommend a biopsy of the area or refer you to an oral surgeon.
Types of Lip and Oral Cancer
More than 90 percent of mouth-related cancers are squamous cell carcinoma. They start out as flat squamous cells in the lining of the throat and mouth, and doctors like to pinpoint where the cancer began. The most common locations are:
On the tongue
On the tonsils
On the oropharynx (the middle part of the throat)
On the gums
On the floor of the mouth
Limitations of Oral Cancer Screenings
Visually detecting premalignant oral lesions is a problem across the globe. There is a vast difference in detecting these lesions versus diagnosing skin lesions such as melanoma.
Melanoma visual screening has a 93 to 98 percent specificity and sensitivity rate. An explanation for the limitations surrounding the detection of oral cancer visually is that this cancer is often subtle and rarely demonstrates clinical characteristics seen in advanced cases.
Besides their clinical differences, premalignant lesions associated with oral cancer are highly varied in how they present. These lesions often mimic common reactive or benign conditions. There is also a growing realization that doctor cannot detect some premalignant cancerous lesions with the naked eye. They need additional screening aids for correct detection.
What to Expect
During the oral cancer screening, the dentist will look inside your mouth and cheeks for white or red patches or sores. They will also feel the tissue in your cheeks and mouth to check for lumps and other abnormalities. The exam will also cover your neck and throat for lumps. Sometimes a dentist will use special tests in addition to the oral exam in their oral cancer screening. Special tests can include:
Oral cancer screening light. The dentist may perform an additional test using an oral cancer screening light. By shining a light into your mouth, it will make healthy tissue appear dark and the abnormal tissue will appear white.
Oral cancer screening dye. The dentist may want to perform an additional test outside the oral exam by rinsing your mouth with a special blue dye. Abnormal cells inside your mouth absorb the dye and appear blue.
Next Steps if Your Dentist is Concerned
If the oral exam raises concerns with your dentist, and they suspect you might have oral cancer, they will recommend a follow-up visit within the next few weeks to check if the abnormal area is still present, whether it has grown, or if there is change in the suspicious area.
The dentist may remove a sample of cells to send to the laboratory for testing to check for cancer cells but more likely you will be referred to your primary care physician or to a lab for more in-depth testing. You should expect to undergo an endoscopy, an X-ray or a biopsy.
You could also undergo:
A test for HPV
A CT scan
An MRI
An ultrasound
A PET scan
Doctors may start with one or two tests and progress to other tests if the earlier ones are inconclusive.
FAQs
A dentist can perform an oral exam of the inside and outside of your mouth area to look for signs of oral and oropharyngeal cancer.
If the dentist thinks an area in your mouth is cancerous, they will remove a small sample of the tissue cells and send it to a laboratory to check if cancer is present. This procedure is called a brush biopsy.