Oral cancer signs and risk factors: Dental assisting

Oral cancer includes cancers that affect the mouth, tongue, lips, gums, and back of the throat. Because most oral cancers aren’t painful in the early stages, early detection is critical to improving survival rates, patient outcomes, and quality of life. As a dental assistant, your understanding of oral cancer is key to providing safe and effective patient care.

Okay, first let’s begin by reviewing some of the benign, or non-cancerous, oral lesions that are common in dental practice. These include mucoceles, which are fluid-filled, saclike swellings that form due to trauma or blockage of salivary glands; a fungal infection called candidiasis, also known as thrush, that present as white or yellow patchy areas in the mouth; and aphthous ulcers, commonly called canker sores, which are small, painful lesions that appear on areas like the tongue, cheeks, lips, or the inside of the mouth. You may also see patients with white patches, called leukoplakia, which are often seen on the gums, tongue, or inner cheeks and may have a roughened appearance. Although leukoplakia is usually benign or non cancerous, it has the potential to become cancerous. It is important to bring any abnormality to the dentist’s attention and document it in the patient’s chart to ensure appropriate treatment or follow-up is provided, if needed.

Typically, benign lesions have a clear trigger like trauma, irritation, infection, or injury, and they usually improve over a short period of time either with or without treatment.

Now, in contrast to benign lesions, oral cancer is unexplained and persistent. Common early signs of oral cancer include red patches, called erythroplakia, that have a bright red and velvety appearance, and can appear on the tongue, floor of the mouth, or soft palate; and ulcers, which are crater-like sores that can be either painful or painless, and may bleed easily.

The development of a mass is another common sign of early oral cancer. Papillary masses look like raised bumps or elevations above the surrounding tissue, while other masses can be embedded deep within the oral tissues and can only be identified by palpation. Lastly, abnormally pigmented areas in the oral cavity, such as black, brown, or white lesions, can also be a sign of early oral cancer.

Okay, so what are some risk factors for oral cancer? One of the biggest risk factors is tobacco use, both smoked and smokeless. Smoked tobacco involves tobacco that’s burned and then inhaled, like cigarettes or cigars, while smokeless tobacco includes chewing tobacco and snuff, both of which are particularly harmful because they involve direct, prolonged contact between the tobacco and oral tissue. Both forms of smokeless tobacco have been associated with high rates of precancerous leukoplakia and oral cancer.