Oral Cancer: What Your Dentist Is Checking For and Why It Matters

Oral cancer is one of those conditions most people never think about until they're sitting in a dentist's chair and being asked to stick out their tongue. Yet it is among the more serious health threats that a routine dental visit can uncover — and in many cases, your dentist may spot the earliest signs before any symptoms appear.

April is Oral Cancer Awareness Month, which makes this a good moment to understand what this disease actually involves, who is most at risk, and why showing up for a checkup twice a year is about more than just clean teeth.

Oral cancer refers to malignant growths that develop in the mouth and the connected upper throat region, including the oropharynx — the part of the throat directly behind the mouth. Around 90% of oral cancers are squamous cell carcinomas, meaning they originate in the flat cells lining the surfaces of the mouth and throat.

The disease is more common than most people realize. In 2025, an estimated 59,660 new cases of oral cavity and pharynx cancer are expected to be diagnosed in the United States alone, with approximately 12,770 deaths projected.

Globally, the World Health Organization classifies oral cancer as the 13th most common cancer worldwide, and its incidence continues to rise.

Oral cancer can appear in any of the following areas:

• The lips
• The tongue (most commonly the sides and underside)
• The floor of the mouth
• The roof of the mouth (hard and soft palate)
• The inner lining of the cheeks
• The gums
• The back of the throat (tonsils, base of tongue, oropharynx

The location matters clinically because it affects how the cancer is staged, treated, and followed up. A lesion at the base of the tongue behaves differently from one on the lip — and both require specialist evaluation.

Several factors are known to significantly increase a person's risk of developing oral cancer. Having one or more of these does not mean you will develop the disease, but it does mean that regular screening is especially important.

• Tobacco use in any form — cigarettes, cigars, shisha, smokeless tobacco, and electronic cigarettes — remains one of the strongest risk factors.
• Heavy or frequent alcohol consumption is independently associated with increased risk, and the combination of tobacco and alcohol creates a compounding effect that raises risk substantially.
• Human papillomavirus (HPV), specifically the HPV-16 strain, is now a recognized driver of oropharyngeal cancers, particularly in younger adults who may not smoke or drink heavily. Oral cancer is more common among those with a history of tobacco or heavy alcohol use, and individuals infected with HPV.

• Chewing areca nut (also known as gutka or betel quid) — a habit practiced across South Asian communities — carries a well-documented link to oral submucous fibrosis and oral cancer.

• Excessive and unprotected sun exposure to the lips is a risk factor for lip cancer specifically.

• A weakened immune system — whether from illness, medication, or other causes — reduces the body's ability to identify and destroy abnormal cells.

Oral cavity and pharynx cancer is most frequently diagnosed among people aged 55 to 64, and it is more common in men than in women. That said, rising HPV-driven rates mean younger adults and women are an increasingly affected group.

One of the features that makes oral cancer particularly dangerous is that its early stages are often painless. A lesion in the mouth can be present for weeks before it causes any discomfort — by which time it may have grown or spread.

The following signs warrant prompt professional evaluation. They do not all indicate cancer, but all of them should be assessed:

• A mouth sore or ulcer that does not heal within two to three weeks
• A red patch (erythroplakia), white patch (leukoplakia), or red-and-white mixed lesion anywhere inside the mouth
• A lump, thickening, or unexplained rough or crusted area on the lips, gums, or inside the cheeks
• Unexplained numbness or loss of sensation in the mouth, face, or neck
• Difficulty swallowing, chewing, or moving the jaw or tongue
• A persistent sore throat or hoarse voice not caused by a cold
• Swelling in the jaw or neck, or a lump that can be felt from the outside
• Unexplained loose teeth, or dentures that have suddenly stopped fitting well
• • Bleeding in the mouth without an obvious cause

If any of these signs are present for more than two weeks without a clear explanation, see a dentist or doctor promptly. Do not wait for your next scheduled checkup.

The stage at which oral cancer is diagnosed has a direct and dramatic effect on the outcome. The five-year relative survival rate for localized oral cavity and pharynx cancer — cancer caught before it has spread — is 88.4%. That figure drops significantly once the cancer has spread to regional lymph nodes or distant tissues.

Of those newly diagnosed each year, only slightly more than half will be alive in five years — a rate that has not significantly improved in decades. This is not because treatment has stagnated, but because too many cases are still found late.

Only 26.2% of oral cavity and pharynx cancers are diagnosed at the local stage — meaning the majority are already more advanced at the point of discovery.

Regular dental visits with a thorough soft tissue examination are the most reliable way to shift those numbers in your favor.

Dubai's population is among the most diverse in the world, drawing together communities from South Asia, the Arab region, Europe, and beyond — many of whom carry different baseline risk profiles for oral cancer.

UAE-based clinical research reflects a pattern consistent with the global picture. A 13-year study of oral squamous cell carcinoma cases at a UAE cancer center found that the anterior two-thirds of the tongue accounted for 57.6% of cases, followed by the cheek at 28.1%, with a mean patient age of 55.38 years and males representing 71.4% of cases. These findings align with global data pointing to the tongue as the most common primary site.

A standard dental checkup at Drs. Nicolas & Asp Centers includes a thorough soft tissue examination as part of every comprehensive exam. This is not a separate procedure — it is built into your regular visit. The examination involves:

• A visual inspection of the lips, tongue, floor of the mouth, roof of the mouth, inner cheeks, gums, and back of the throat, checking for any abnormalities in color, texture, or shape.
• A physical palpation of the neck and jaw area, feeling for any enlarged lymph nodes or unusual lumps.
• Assessment of the tongue — both sides and the underside — which is one of the most common sites for oral squamous cell carcinoma and easy to miss in a self-examination.
• Evaluation of any lesions, patches, or ulcers against clinical benchmarks: size, border regularity, color, duration, and whether they blanch under pressure.

If anything appears abnormal or suspicious, your dentist will not diagnose it on the spot — they will either monitor it at a follow-up appointment in two to three weeks, or refer you to a specialist.

In some cases, a biopsy may be recommended to obtain a tissue sample for laboratory analysis. A referral is not cause for panic; it is exactly the appropriate clinical response.

There is no guaranteed way to prevent oral cancer, but the following measures meaningfully lower your risk:

• Stop or avoid tobacco use entirely — including all forms of smoking and smokeless tobacco products.
• Drink alcohol in moderation or not at all. Heavy consumption is a defined risk factor; light to moderate consumption carries lower but non-zero risk.
• Consider HPV vaccination if you are eligible. The vaccine protects against the strains of HPV most strongly linked to oropharyngeal cancer.
• Protect your lips from unprotected sun exposure. Use a lip balm with SPF when outdoors for extended periods.
• Eat a diet rich in fruits and vegetables. Diets high in antioxidants and low in processed foods are associated with lower cancer risk overall.
• Perform a monthly self-check. Standing in front of a mirror, look and feel your lips, the inside of your cheeks, your gums, the roof of your mouth, and both sides and the underside of your tongue. If you notice anything new or unusual, note it and have it assessed.
• Attend your dental checkup every six months. For most patients, this is the single most important preventive step — because your dentist will do a systematic examination of areas you cannot easily see yourself.

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