How to Get Checked for Oral Cancer

Open up and say ahhhh. Ever wonder why your dentist might ask you to stick out your tongue at a checkup? Your regular dental checkup is also supposed to serve as an oral cancer screening. That’s because the earlier oral cancer is detected, the more effective treatment is. 

Here’s what you need to know about oral cavity cancer, how dentists check for it, and what you can do to detect oral cancer on your own. 

What is oral cancer?

Oral cancer is a type of head and neck cancer that occurs in the mouth or back of the throat. More than 50,000 people in the U.S. are diagnosed with it every year. The average age of diagnosis is 64, and it’s twice as common in men than in women. Cancer cells may develop on different tissues and areas of your mouth and throat, such as:

• The lining of your mouth

• The lining of your gums

• On, under, and at the base of the tongue

• The throat, at the back of the mouth

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How is mouth cancer detected?

An added benefit of seeing your dentist regularly is that you can get an oral cancer screening. Your dentist or the dental hygienist who cleans your teeth should examine you for signs of oral cancer. This happens when you’re asked to stick out your tongue, so they can look at it from side-to-side.

They will do this at a routine checkup in several ways, according to guidelines from the American Dental Association (ADA). The screening usually includes the following steps.

A medical history

You may be asked if you’ve noticed any changes since your last visit. Is there anything new that’s been bothering you with your teeth or mouth? You can mention anything in your face or throat, such as a lump in your throat that won’t go away, unexplained ear pain, or a hoarse voice.

Visually checking your mouth

The dentist will examine your: 

• Lips

• Cheek lining

• Gums

• Tongue

• Floor and roof of your mouth

• Throat

• Tonsils

• Base of your tongue

During this screening, they’ll ask you to stick out your tongue. And they’ll likely move your tongue around to look under it and on its sides. They’re looking for gray or white patches (called leukoplakia) or a flat or slightly raised red area (called erythroplakia).

Feeling your jaw and neck

Some dentists will also check your jaw and neck for any potential oral lumps. 

Using other tools

Some dentists will use other tools, such as light-based devices that are supposed to highlight cancers more. But the ADA practice guideline panel found there isn’t enough evidence to recommend them.

Can cancer screening help?

Oral cancer screenings are recommended for all people. The purpose of regular screening is to find cancer when it’s early (or precancer), which can sometimes make it more treatable. 

Yet there’s not enough research showing that screening will lower your risk of dying from oral cancer. That’s likely because when mouth or throat cancer is detected, over half the time the cancer has already spread. 

Still, several studies suggest that dentists are often the first professionals to catch lesions that are (or become) cancer. 

It’s best to catch oral cancer in the early stage (considered localized, before it spreads). In those cases, the 5-year survival rate is about 85%. That rate is more than halved, to 40%, when the cancer has metastasized — meaning it has moved to other parts of the body, such as the lung. 

When oral cancer is detected early, people usually require less aggressive cancer treatments and have fewer complications.

Do dentists screen for oral cancer routinely?

Not necessarily. Whether or not the screening is done may depend on the individual practices of your dental office. One study asked people over age 30 if they were screened for oral cancer at their dental visit. Only about 40% said they did. Underserved people and those with lower socioeconomic status were less likely to be examined.

So, here’s what you can do: At your next appointment, ask your dentist or dental hygienist if they’re going to screen you for oral cancer. At the very least, it can serve as a good reminder to have this done.

Keep in mind that anyone can get oral cancer. This is why screening is recommended for everyone, no matter your health history. However, some people are at higher risk of oral cancers, and screening may be even more important. Risk factors include:

• Drinking alcohol: Heavy drinkers are at greater risk of oral cancer than lighter drinkers. 

• Using tobacco: Another risk factor is being a current or former tobacco user, meaning you’ve smoked cigarettes or cigars, chewed tobacco, or vaped. 

• Drinking and smoking: Doing both — drinking alcohol and using tobacco — puts you at even higher risk for oral cancer. 

• Having HPV: Having human papilloma virus (HPV) is also a risk factor for throat cancer.

Can I check for oral cancer myself?

Many cancers can’t be seen or felt — but you may be able to spot signs of oral cancer at home. If you want to screen at home, take the following steps using a mirror in a well-lit room. You’re looking for gray or white patches, or a flat or slightly raised red area: 

• Lips: Lift your upper lip and pull down your lower lip with your fingers to look on the inside of your lips.

• Gums: Use your fingers to feel around your gums for any lumps or lesions

• Cheeks: Pull your cheeks out to look inside. 

• Tongue: Lift your tongue up and to the sides and look all around your tongue and beneath it.

If you see any signs in your mouth and throat, contact your dentist, who can do an exam. If your dentist sees a suspicious spot, they should perform an oral cancer biopsy. This means they’ll take a sample of suspicious tissue. The sample will be sent out for additional testing. They’ll also refer you to a specialist for further evaluation.

Early signs of oral cancer

Early signs of mouth cancer may appear in your mouth or around your face, such as:

• Numbness in the mouth

• Swelling in the mouth

• A sore, lump, or thickening on the lip or mouth that doesn’t heal

• Trouble chewing, swallowing, or moving your jaw or tongue

• White or red patch in the mouth

But mouth cancer symptoms can also show up in other parts of your body, like:

• Ear pain

• Lump in the neck or back of throat

• Persistent pain in the mouth, jaw, or teeth

• Persistent sore throat

• Unexplained weight loss

• Voice changes

If any of these signs don’t go away after 2 weeks, see your doctor or dentist for an evaluation. 

Some of these early warning signs are also symptoms of other conditions, and they don’t mean you’ll get an oral cancer diagnosis. (For example, ear pain can be from an ear infection.) The first step before assuming what’s going on is getting help.

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Written by:

Jessica Migala

Jessica Migala has been a full-time freelance health journalist for over a dozen years. She specializes in health, medical, nutrition, fitness, and lifestyle.

Edited by:

Laurie Tarkan

Laurie Tarkan is a senior health editor for general health and well-being at GoodRx. She has an extensive background in health journalism, and wrote regularly for The New York Times for a decade.

Reviewed by:

Shari L. Grigsby-Young, DDS

Dr. Grigsby-Young is a general dentist who was born and raised in Dayton, Ohio. She completed her undergraduate studies at Xavier University of Louisiana.

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