The inside of the mouth is normally lined with a moistened gum tissue that is smooth and coral pink in color. Alterations in this appearance are usually the first warning signs a developing problem. The most serious of these is of course, an oral cancer. The following can be signs at the beginning of a pathologic process or cancerous growth:
- Red patches
- White patches
- A sore that fails to heal and bleeds easily
- A lump or thickening on the skin lining the inside of the mouth
- An open sore or ulcer
These changes can be detected on any of the gum surfaces such as the lips, cheeks, palate (roof of the mouth), gum tissue around the teeth, the tongue and the floor of the mouth. Pain can be a warning sign, but does not always occur. Any patient with unexplained pain may be at risk for oral cancer and should be evaluated immediately.
We recommend that patients perform an oral cancer self-examination monthly looking for anything they perceive as abnormal in their mouth. Of course, your dentist and/or hygienist will evaluate you for any suspicious lesions at your regular cleanings and check-ups. If any abnormalities are detected, it is likely you we be referred to an Oral Surgeon for further evaluation and possible treatment.
Certain small lesions that are not highly suspicious for oral cancer can be investigated non-invasively with a “brush biopsy.” This consists of obtaining cells with a brush from the surface of a lesion, transferring them to a slide and sending this slide to a pathologist to investigate under a microscope. This does not require local anesthesia (Novocaine) and will determine if anything else needs to be done. More suspicious lesions require a “biopsy” This consists of obtaining a piece of the tissue in question and requires the administration of local anesthesia. In certain cases, this can be supplemented with other forms of anesthesia. It is then placed in a jar of tissue preservative and sent to a pathologist for positive identification under a microscope.