Oral Cancer Screening

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Oral cancer represents a significant health challenge worldwide, affecting thousands of individuals each year. The path to successful treatment and recovery heavily depends on the timeliness of diagnosis. Recognizing the disease in its early stages can dramatically improve treatment outcomes and survival rates, making early detection not just beneficial but critical.

What Is Oral Cancer?

Oral cancer (mouth cancer) is the umbrella term for cancer that affects the inside of your mouth. Oftentimes, oral cancer can look like a common problem with your lips or in your mouth, like white patches or sores that bleed. The difference between a common problem and potential cancer is these changes don’t go away. Left untreated, oral cancer will spread throughout your mouth and throat to other areas of your head and neck. 

Who Is Affected by Oral Cancer?

Overall, about 11 people in 100,000 will develop oral cancer during their lifetime. Men are more to develop oral cancer than women. White people are more likely to develop oral cancer than people who are Black. There is a significantly higher risk of oral cancer among people who use tobacco of any kind, those who have had a previous oral cancer diagnosis, a history of significant sun exposure (exposes the risk of lip cancer), or those with heavy alcohol use.

Importance of Early Detection

Early detection of oral cancer is vital because it significantly improves the prognosis and overall survival rates of patients. When oral cancer is diagnosed at an early stage, the treatment can be less invasive, often resulting in a higher likelihood of curing the cancer while, at the same time, minimizing damage to surrounding tissues. This is particularly important in oral cancer, where the functionality and aesthetics of oral structures, including speech and appearance, are at stake.

Benefits of Early Detection on Treatment Outcomes

Enhanced Effectiveness of Treatment

Cancers identified at an early stage are often localized and have not yet spread to distant parts of the body. It being localized allows oncologists to design a targeted, less aggressive treatment plan than would be required for more advanced cancer. Early detection greatly increases the probability of eliminating the cancer completely, which directly contributes to higher long-term survival rates.

Reduced Extent of Surgery

Patients diagnosed with early-stage oral cancer are likely to undergo less extensive surgery compared to those diagnosed at a later stage because the tumor is smaller and more contained. Smaller surgeries are less invasive and carry a lower risk of complications. As a result, patients experience shorter recovery times and fewer surgical complications.

Preservation of Function and Appearance

Early detection of oral cancer is also crucial in preserving important functions and physical appearance. Treatments for less advanced cancers typically involve significant removal of oral tissues, which can lead to noticeable disfigurement and functional impairment. When detected early on, treatment for less advanced cancers have a greater likelihood of preserving speech, swallowing function, and the overall aesthetic appearance of the face and mouth. This aspect is particularly important as it contributes significantly to a patient’s quality of life after treatment.

Decreased Need for Chemotherapy or Radiation

When oral cancer is caught at an early stage, there is often no need for chemotherapy or radiation therapy, which are more commonly required when cancer has spread beyond its original location. Avoiding these treatments can spare patients from a range of side effects, such as fatigue, nausea, and the risk of developing secondary cancers, which are associated with radiation and systemic chemotherapy. 

Impact of Oral Cancer Screening on Survival Rates

Oral cancer screening is a critical component in increasing the survival rates of those diagnosed with it. The importance of detecting the disease early cannot be overstressed, as it considerably influences treatment outcomes. Early-stage oral cancers, typically those identified at stages I or II, have a much higher survival rate compared to cancers diagnosed at later stages.

Early Detection and Survival Rates

Screening for oral cancer allows for the detection of precancerous lesions or early-stage cancers before they metastasize or advance to more severe stages. Studies show that the 5-year survival rate for patients whose oral cancer is detected early and has not spread beyond the site of origin is approximately 83%. This high survival rate is primarily due to the localized nature of the cancer, which can often be effectively treated with less aggressive therapies, which are typically more successful and result in fewer complications or long-term side effects.

Comparison with Late-stage Diagnosis

In contrast, oral cancers diagnosed at later stages, particularly those that have spread to distant parts of the body, have a significantly lower 5-year survival rate. This rate drops to about 32% for cancers that have metastasized to distant sites. Late-stage oral cancers are more challenging to treat effectively. They often require more extensive and aggressive treatment methods, including radical surgery, radiation, and chemotherapy, which can be debilitating and less likely to result in a cure.

Importance of Regular Screening

Oral cancer screening is part of our periodic exams, typically done when you come in for a dental cleaning. The stark contrast in survival rates between early and late-stage oral cancer highlights the critical role of regular screening. Making routine oral cancer screenings a part of regular dental check-ups, especially for individuals at high risk, such as tobacco users, heavy drinkers, or those with a history of oral cancer in the family, plays a pivotal role in diagnosing it in its earliest stage.

Advancements in Screening Techniques

Advancements in diagnostic technologies have improved the effectiveness of oral cancer screenings. Techniques such as fluorescence visualization, brush biopsies, and molecular markers are being integrated into routine dental check-ups to enhance the accuracy of detecting precancerous conditions and early-stage cancers, potentially improving treatment outcomes and survival rates.

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Case Studies

Regular dental check-ups can be lifesaving, as illustrated by numerous success stories and case studies from patients around the world. In our practice, we have discovered signs of oral cancer in a number of patients over the years early on. 

Case Study: Early Detection During Routine Dental Check-Up

One notable case involves a patient who benefited significantly from routine dental visits. During one such visit, we noticed a small, unassuming lesion on the patient’s tongue. Although the lesion was not causing any immediate discomfort or pain, its appearance was unusual enough to warrant further investigation.

Dr. McFadden recommended a biopsy of the lesion, which was subsequently performed. The biopsy results confirmed the early stages of oral cancer. Thanks to the early detection, the treatment plan was straightforward and less invasive than it would have been at a later stage. 

Treatment and Recovery

The patient underwent a minor surgical procedure to remove the cancerous cells. This early intervention not only ensured a higher rate of complete recovery but also minimized the need for more aggressive treatments like chemotherapy or extensive surgery, which could significantly affect the patient’s quality of life, not to mention, long-term health. 

Post-Treatment Follow-Up

Following the surgery, the patient was monitored through regular follow-ups to ensure that there was no recurrence of the cancer. The proactive approach of regular oral screenings and the prompt action taken after the discovery of the lesion resulted in a positive outcome. The patient returned to their normal life soon after the treatment, with minimal impact on their overall well-being. Because we saw signs of concern at this early stage and the patient acted on it, the cancer was successfully eradicated.

Case Study: Late Detection After Years of Not Having Routine Dental Check-Ups

Sadly, on the other side of that coin, we have seen the opposite happen. In fact, we recently had a patient of record who hadn’t been in to see us in a number of years, who presented with a few small lesions that looked and “felt odd” to her. She called us thinking maybe she had an infection of some sort and needed an antibiotic or possibly a root canal or an extraction. She came in and as part of her exam, we screened her for oral cancer. We immediately saw reason for alarm and got her straight to a dental pathologist. The biopsies taken there showed advanced oral cancer. She began treatment immediately, but unfortunately, passed away before she finished the treatment. 

Routine dental checkups could have possibly avoided this. Oral cancer is serious business. People don’t think of it much because there’s not much talk about it like there is with colon cancer, breast cancer, etc. Periodic exams are the key to catching it early. So, bottom line: Even if you have excellent oral hygiene habits and no dental problems, and you don’t think you need to see a dentist now and then? Please do. 

How is Oral Cancer Screening Done?

Oral cancer screening is a crucial preventive measure taken to detect early signs of cancer in the tissues of the mouth. The goal is to identify cancer before symptoms appear.

Physical Examination

The first step in oral cancer screening involves a detailed physical examination of the mouth. The dentist or hygienist will inspect all areas inside the mouth, including the roof of the mouth, tonsils, gums, cheeks and inner lips. The examination extends to the tongue, both on the top and the underside, and deep into the throat. During this examination, the dentist is particularly vigilant for any signs of abnormality such as sores, unusual lumps and bumps, or patches of discoloration. This visual and physical inspection is painless and only take a minute or two.

Tools and Tests Used in Oral Cancer Screening

Oral Brush Biopsy

When a suspicious lesion is found, an oral brush biopsy may be conducted. This non-invasive procedure involves using a small brush to gently collect a sample of cells from the surface of the lesion. The process is quick and does not require any cutting, making it relatively comfortable for the patient. The collected cells are then sent to a laboratory for analysis to determine the presence of cancerous cells.

Fluorescence Staining

Another technique used in oral cancer screening is fluorescence staining. During this procedure, a special dye is applied to the oral tissues, or a specific wavelength of light is used to illuminate the mouth. This technology enhances the visibility of abnormal cells by making them appear different in color from the normal surrounding tissues under the light. This method helps in identifying potentially dangerous cells that might not be visible to the naked eye during a regular examination.

What to Expect During a Screening Appointment

Review of Medical History

At the beginning of an oral cancer screening appointment, the healthcare provider will start by reviewing the patient’s medical history. This includes asking about any past medical conditions, surgeries, and any family history of cancer. Patients will also be asked about lifestyle habits such as tobacco use, alcohol consumption, and diet, as these can significantly influence the risk of developing oral cancers. This information helps the provider assess any specific risks and tailor the examination accordingly.

Examination of the Inside of the Mouth

Following the review of the medical history, they will conduct a thorough examination of the oral cavity. This exam is critical for detecting early signs of oral cancer. The provider will look over the lips, tongue, cheeks, and gums, checking for any irregularities such as sores, white or red patches, and lumps. They will also palpate the neck and jaw areas to detect any swollen lymph nodes or other abnormalities that might suggest cancer.

Performing Diagnostic Tests

If any unusual lesions or symptoms are noted during the visual and physical examination, the healthcare provider might perform additional diagnostic tests. These could include a biopsy, where a small sample of tissue is taken from a suspicious area and sent to a laboratory for analysis. Other tests might involve special dyes or lights that help distinguish normal tissue from areas that might be undergoing changes at a cellular level.

Quick and Painless Process

Oral cancer screening is a quick and painless procedure. It is often incorporated into a routine dental check-up, taking only a few extra minutes. The screening involves no discomfort, as it primarily consists of a visual and tactile examination. There are no needles, invasive procedures, or pain involved, making it both easy and tolerable.

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Screening Guidelines and Recommendations

Recommended Frequency of Screenings

It is generally recommended that adults have an oral cancer screening during their regular dental visit at least once a year. (Patients with higher risk factors might need more frequent screenings.)

Target Demographics

Screenings are especially crucial for individuals over 40, tobacco users, heavy drinkers, those with a history of oral cancer, and people with extensive sun exposure, which raises the risk of lip cancer. Furthermore, starting screenings at a younger age might be advised for those with specific risk factors, such as a genetic predisposition or exposure to human papillomavirus (HPV).


The conversation about oral cancer consistently underscores a clear message: early detection leads to better outcomes. Regular screenings and awareness of oral cancer symptoms are crucial weapons in the fight against this aggressive disease. By promoting routine oral health check-ups, we can transform the story of oral cancer from one of despair to one of hope, empowerment, and survival.

To learn more about the warning signs, read our blog on the subject.

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