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How To Self Check For Oral Cancer

Updated on June 16, 2016

Oral Cancer Self-Examination

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Oral cancer is something that most people don't think about, and, unfortunately, that includes many doctors and other health professionals. The death rate is higher for oral cancer than for other cancers, such as malignant melanoma, Hodgkin's lymphoma, cervical, and thyroid cancers.

This high death rate isn't because oral cancer is hard to catch or necessarily difficult to remove, but because it's often only caught when it has already reached an advanced stage.

Unfortunately, over-scheduled doctors are often too busy paying attention to the clock rather than to their patients. As a result, life-saving advice often isn't passed on. Too often, too, we as patients take a back seat and trust others with our health--and our lives.

Disclaimer: This article is in no way a substitute for regular dental check-ups and dental cleanings. However, it can help you keep watch for anything abnormal. Talk with your hygienist about oral cancer the next time you go in, and be sure s/he does oral cancer screenings at each six-month recall appointment. If your hygienist or dentist does not do oral cancer screenings as a matter of course, I believe that says something.

Screening for oral cancer takes roughly 2-3 minutes.

Oral Cancer Facts

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Oral Cancer Photo

Oral carcinomas (advanced)
Oral carcinomas (advanced) | Source
  • Oral cancer is usually completely painless in its early stages.
  • The death rate for oral cancer is higher than for malignant melanoma, Hodgkin's lymphoma, laryngeal cancer, cancer of the testes, cervical, or thyroid cancers.
  • 8,000 people in the US will die of oral cancer this year.
  • 40,000 Americans will be diagnosed with oral or pharyngeal cancer this year.
  • Of the 40,000 people diagnosed, only 57% will still be alive in 5 years.
  • Approximately $3.2 billion is spent on oral cancer in the US per year.
  • Worldwide, 640,000 people will be diagnosed with oral cancer this year.
  • Late stage discovery of oral cancer is not the exception; it is the "norm."
  • Discovery of oral cancer at a late stage usually means it has already spread to the larynx and other secondary locations.
  • When discovered in a late stage, the chance of a recurrence is multiplied 20-fold for the next 10 years.
  • Anyone can get oral cancer, though factors such as smoking, chewing tobacco, chewing betel nut, heavy drinking (alcoholism), HIV/AIDS, HPV-16 (virus), and aging increase the likelihood.
  • Screening for oral cancer takes roughly 2-3 minutes

What's Normal?

Before diving into what's abnormal, it would be good to know what's normal so you can easily spot what's not.

Oral health is a complex subject, and I can't touch on everything here, but I will give you a good start and will cover all the key things to look out for.

Click on the links for images (they open in a new window.)

Linea alba
Linea alba | Source
Parotid papilla
Parotid papilla | Source
Fordyce granules
Fordyce granules | Source
Aphthous ulcer
Aphthous ulcer | Source
Circumvallate papillae
Circumvallate papillae | Source
  • Linea alba: Thin white lines inside your cheeks. This is a normal, hyper-keratinized area where you bite your cheeks, or where your cheeks rest between your teeth. The thin line will follow the biting plane, or the area where your teeth meet.
  • Parotid papillae: (Stensen's duct) Inside your cheeks, toward the front, you might notice there is a bump of extra tissue by each corner of your mouth (you may sometimes bite them by accident.) These bumps are an outlet for the saliva glands and are completely normal, unless you notice they are particularly hard.
  • Fordyce granules: These are tiny (1 mm) white or yellowish-white spots on the inside of your cheek or lips. These are just ectopic sebaceous glands and are completely normal.
  • Swollen lymph nodes: These are often associated with illness or inflammation. If the swelling doesn't go away within a week or two, go in to get them checked out. Lymph nodes are located on the front and back of your neck, in front of and behind your ears, in the cheek area, and on top of the shoulders. When swollen, they will often be sensitive or sore, and may be visible and/or palpable (they feel hard or lumpy.)
  • Exostoses: Extra bone growth (single = torus; plural = tori) is commonly found under the tongue along the bony ridge, or on the hard palate. These growths may bulge out, and are often rounded, sometimes involving a few bony lumps in one mass (lobulated.) The ones under the tongue are often bilateral (one on each side of the face) while the ones on the hard palate are often single or lobulated.
  • Aphthous ulcer: Also known as a canker sore. This is a small to medium, round ulcer, usually with a white interior and bright red border. They are very sensitive and sore and can affect oral hygiene and eating. They should go away within a week or two. Taking zinc will help speed this process, and will also help prevent them. If the ulcer does not go away within two weeks, you should go to the dentist to have it examined.
  • Circumvallate papillae: Large, protruding bumps (taste buds) on the back of the tongue, arranged in a line forming a "V" shape across the dorsum (top) of the tongue. These can also sometimes be seen when looking at the side of the tongue toward the base of the tongue in the back. They are the largest of the 4 types of taste buds, and most people have about 10-14 of them.

Symptoms of Oral Cancer

If you have any one of these symptoms, go to your dentist immediately.

When caught early, many oral cancers respond well to treatment.

  • Sores that don't heal within 2 weeks (on your lip, side of your tongue, hard palate, gums, etc.).
  • White, red, black, or discolored patches that persist (and are not listed as normal findings).
  • Swelling, lumps, bumps, or odd new growths that are not bilateral (not found on both sides of the face).
  • Excessive or spontaneous bleeding or puss coming out of a lesion or open sore.
  • An open sore or lesion that persists for more than two than 2 weeks and turns and becomes painful.
  • Difficulty or pain when swallowing.
  • Difficulty moving the jaw or tongue, or pain when moving the jaw or tongue.
  • A constant feeling that something has gotten stuck in your throat.
  • Continuous pain in the ear or a persistent headache.

How To Examine & Palpate

Visual inspection - Methodically look around the mouth for oral cancer. You will need a mirror and a light you can shine into your mouth. If you find something that looks or feels abnormal, look for it on the other side of the mouth in the same area. Most of the time if something is paired, it's meant to be there.

Everything that you palpate you should be visually inspecting as well.

Bidigital palpation - Use your thumb and forefinger to feel for lumps and hardened areas on the lips, cheeks, and tongue.

Bimanual palpation - Use the forefinger of one hand and a few fingers of the other hand to feel for lumps and hardened areas used on the floor of the mouth.

Bidigital palpation
Bidigital palpation | Source
Bimanual palpation
Bimanual palpation | Source

How To Check For Oral Cancer At Home

1: Lips: Use bidigital palpation to feel your lips. Put your forefinger (pointer finger) with the pad against the inside of your lip, with your thumb directly lined up with it on the outside of the lip. Apply a moderate pressure, pressing the lip tissue between your finger and thumb. Feel for any hard lumps or areas of soreness.

2: Cheeks: Use bidigital palpation to feel your cheeks. Use the same method as described in #1. Feel for any hard lumps or areas of soreness.

3: Floor of the mouth: Use bimanual palpation to feel the floor of your mouth, which is the area under your tongue. Place the pointer finger of one hand under your tongue, while pressing up with the other hand on the outside of the jaw, directly opposite the finger in your mouth. Feel for any hard lumps or areas of soreness. Press firmly.

Video: How To Self Check For Oral Cancer

4: Tongue: Use bidigital palpation to feel your tongue. Stick your tongue out, and palpate the body of the tongue, feeling for lumps or areas of soreness.

5: Lateral tongue: Stick your tongue out, grab the tip, and look at each lateral side of your tongue for anything out of place. The sides of the tongue are the most common place to find oral cancer. Don't confuse varicosities (veins) for something abnormal in this area. There will also be circumvallate papillae, noted above in the "What's Normal" section.

6: Oropharynx: Stick your tongue out, say "Ahh" and look at your oropharyngeal area (your tonsil area) for any inflammation or sores. It is normal for some people's tonsils to have indented pockets in them; look for something that looks inflamed and out of place.

7: The roof of the mouth: Tilt your head back and look at the roof of your mouth. Look for sores and inflammation (make sure you rule out pizza burns and food trauma in this area.)

8: Gums: Pull out your lips and look very closely at your gums. Are there sores on your gums, or patches of discolored tissue? Do your gums bleed when you lightly touch them, or when they're not stimulated at all?

Oral Cancer Examination Images

Click thumbnail to view full-size
Lip examination - inspect your lips for ulcers, lesions, lumps, and discolorationsCheek examination - check your cheeks for sores, ulcers, and anything unusualFloor of the Mouth examination - check for pain, ulcerations, discolorations, and hard lumpsTongue examination - the most common site of oral cancer, especially on the lateral surfaces (sides)Oropharynx examination - check the tonsil area for lesions, ulcers, and abnormal tissueGums - check your gums for sores, lesions, ulcers, and areas of spontaneous bleeding
Lip examination - inspect your lips for ulcers, lesions, lumps, and discolorations
Lip examination - inspect your lips for ulcers, lesions, lumps, and discolorations | Source
Cheek examination - check your cheeks for sores, ulcers, and anything unusual
Cheek examination - check your cheeks for sores, ulcers, and anything unusual | Source
Floor of the Mouth examination - check for pain, ulcerations, discolorations, and hard lumps
Floor of the Mouth examination - check for pain, ulcerations, discolorations, and hard lumps | Source
Tongue examination - the most common site of oral cancer, especially on the lateral surfaces (sides)
Tongue examination - the most common site of oral cancer, especially on the lateral surfaces (sides) | Source
Oropharynx examination - check the tonsil area for lesions, ulcers, and abnormal tissue
Oropharynx examination - check the tonsil area for lesions, ulcers, and abnormal tissue | Source
Gums - check your gums for sores, lesions, ulcers, and areas of spontaneous bleeding
Gums - check your gums for sores, lesions, ulcers, and areas of spontaneous bleeding | Source

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Copyright © 2012 Faceless39. All rights reserved.



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    • profile image

      lou 5 weeks ago

      hi i have a small what looks like scratch on my my front gum. i have'nt scratched it and it doesnt hurt...it just appeared...had it a few months...what could it be?

    • profile image

      SBLproductionsYY 6 weeks ago

      hello, im 26 been chewing off an on for about 8yrs i recently quit smoking i smoked for 10yrs, ive noticed weird bumps on the side of my tongue near my wisdom teeth, with lots of pain, swollen tonsil an hurts to move my tongue, could this be a early sign?

    • profile image

      Jeanie 6 weeks ago

      Can oral cancer appear as matching ulcers on both sides of the back of the throat, just before the tonsils?

    • profile image

      Junnie 9 months ago

      Thank you. Because of your article I will be going to my dentist to check for oral cancer. Didn't even know about that. Am always feeling like something is in my throat and always think it will go away.

      Thanks

    • profile image

      nitin 13 months ago

      pain on one side face tabacoo use s form 12years

    • profile image

      Sergio 22 months ago

      Useful information, thank you!

    • Faceless39 profile image
      Author

      Faceless39 2 years ago from The North Woods, USA

      Thanks for the comments, I appreciate them! Elsie, I'm glad you caught it early and happy you went in. Peachpurple, thanks.. the intention is to promote awareness, I guess it worked! :)

    • peachpurple profile image

      peachy 2 years ago from Home Sweet Home

      wonderful tips especially the photos, freaked me out

    • Elsie Hagley profile image

      Elsie Hagley 2 years ago from New Zealand

      Excellent article.

      I have just had a large lump removed from my top lip, (now only half of a top lip), I have had this lump about thirty years, but in the last year it started growing (very quickly) it was ACC cancer, which was very rare growing in the lip 9only twelve cases recorded in the world.

      We should always get lumps checked out.

      You are right about the doctor watching the clock instead of looking after the patient, my doctor say's if we have more than one health problem, make another appointment, which of course I never did, that is why this lump slipped by for so many years, (it was picked up because I had skin cancer on my nose), now my only hope is that cancer hasn't spread to other parts of my body through the nerve centre, living each day hoping all is well.

    • Faceless39 profile image
      Author

      Faceless39 2 years ago from The North Woods, USA

      Indeed, all modern hygiensts take multiple in-depth courses in oral pathology, histology, and so forth. However, there is a gap between learning it and putting it into practice. Many offices charge a fee for a cancer screening. My philosophy is that it's my ethical duty to conduct one at each and every appointment--and this includes a full head and neck exam as well. Whether the dentist charges a patient or not is not my concern, and has no bearing on the service that I render to my patients in this regard. Thanks for reading! :)

    • Whatsittoyou profile image

      Whatsittoyou 2 years ago from Canada

      Are all hygienists trained to screen for oral cancer before they graduate or do they need to go for special training for it? If not, they should really make this a part of the training that they originally take.

    • ReviewsfromSandy profile image

      Sandy Mertens 2 years ago from Wisconsin

      Some disturbing photos. But very good information on how to check for cancer.

    • erorantes profile image

      Ana Maria Orantes 2 years ago from Miami Florida

      Hello miss faceless39. I like your article.Visit to the Doctor is important as well the self examination. Your article provides with awareness of a terrible disease. It is sad and scary . The tongue is essential for our existence. I looked it up everyday when I clean my teeth. After looking at the picture in your hub . I am going to be extra careful. I like your hub. Thanks.

    • tirelesstraveler profile image

      Judy Specht 2 years ago from California

      This is a great hub. My dentist does an examine similar to what you suggest every time I go in for a cleaning. Nice work.

    • profile image

      noorudin 2 years ago

      Extra bone growth (single = torus; plural = tori) is commonly found under the tongue along the bony ridge, or on the hard palate.

      i have also this condition

    • cyoung35 profile image

      Chad Young 3 years ago from Corona, CA

      Great hub. If this helps one person you've done a great service to make people aware of oral cancer. Maybe some day we'll have a cure for cancer, but until then we need to be proactive.

    • Sonja Larsen profile image

      Sonja Larsen 3 years ago from Orange County, California

      This was a very-well written and helpful article. Crazy pics too! Thanks so much for sharing.

    • Jodah profile image

      John Hansen 3 years ago from Queensland Australia

      Very helpful and informative article on oral cancer and what to look for.

    • thebiologyofleah profile image

      Leah Kennedy-Jangraw 3 years ago from Massachusetts

      Very informative, easy to follow article. Great use of links, pictures, and stats. Thanks for sharing this information and how-to.

      Voted up and sharing.

    • Glenn Stok profile image

      Glenn Stok 3 years ago from Long Island, NY

      This is a very well-done and very complete explanation of how to check for oral cancer. I'm surprised that doctors don't perform this check in a normal annual physical. It's great that you have made the effort to spread the awareness of oral cancer.

    • Faceless39 profile image
      Author

      Faceless39 3 years ago from The North Woods, USA

      Thank you all for the positive feedback. My goal is to spread awareness of this disease, and it looks like so far it's working. I appreciate your comments!

    • profile image

      Aida Garcia 3 years ago

      Excellent article, well-written and very precise! Follow me!

    • iguidenetwork profile image

      iguidenetwork 3 years ago from Austin, TX

      Very well written and detailed article, quite a handy guide for detecting any possible signs of oral cancer. Up and useful.

    • The Reminder profile image

      The Reminder 3 years ago from Canada

      Nice ways to quickly check out if there are any signs of the cancer. Voted up.

    • leakeem profile image

      leakeem 3 years ago from Earth

      It's the first time I heard of Oral Cancer. Nice to know that there's a quick way to check it. Voted up!

    • Minnetonka Twin profile image

      Linda Rogers 3 years ago from Minnesota

      Very well written and thorough article on checking for oral cancer. The photo's really help make this easy to read and understand. Hit many buttons and voted up.