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Mouth lesions and oral cancer screening

Any ulcer, patch or lump in the mouth that has not healed within three weeks should be looked at. Most are harmless, caused by a sharp tooth, an infection or an immune condition. Screening is quick and painless. Where something needs certainty we take a small biopsy under local anaesthetic and send it to a laboratory.

The three week rule

The mouth heals fast. A bitten cheek, an ulcer from a rough edge, a burn from coffee: all gone within a week or two. Something still present after three weeks is no longer part of normal healing, and the sensible response is to have it looked at rather than watch it for another month.

That is the entire rule, and it is worth knowing because it is simple.

What to look for

  • An ulcer that has not healed
  • A white patch that does not rub off
  • A red patch, or a mixed red and white area
  • A lump or thickening anywhere in the mouth or on the lip
  • An area that bleeds without obvious cause
  • Persistent numbness or an odd sensation
  • Difficulty swallowing, or a feeling of something catching
  • A loose tooth with no dental explanation

What the appointment involves

A systematic look at the whole mouth: the lining of both cheeks, under and on the tongue, the floor of the mouth, the palate, the gums and the lips, plus feeling the neck and under the jaw. It takes a couple of minutes and it does not hurt.

If the cause is obvious and mechanical, for example a sharp edge rubbing, we deal with that and review in two weeks to confirm it has resolved. Confirming is part of the process, not an optional extra.

When a biopsy is the right answer

Where the diagnosis is not certain from looking, or where a lesion has not resolved after removing the obvious cause, a biopsy gives a definite answer. It is a short procedure under local anaesthetic, and the sample goes to a laboratory.

Waiting for a result is uncomfortable, and we will tell you honestly how long it takes rather than leaving you to wonder.

The risk factors, plainly

Tobacco in every form, including shisha and chewed forms, is the biggest single factor. Alcohol combined with tobacco multiplies the risk rather than adding to it. HPV is associated with cancers towards the back of the mouth and throat.

None of this is said to lecture anybody. It is said because knowing it changes how soon someone comes in, and how soon someone comes in is the thing that matters most.

Questions people ask

Because ordinary damage to the mouth heals well within that. A bite to the cheek, an ulcer from a sharp filling or a burn from hot food is gone in a week or two. Something still there at three weeks has stopped being ordinary healing and deserves an explanation.

The area is numbed with local anaesthetic, so you feel pressure rather than pain. A small sample is taken and usually one or two stitches placed. It is sore for a day or two afterwards, comparable to a mouth ulcer, and ordinary painkillers are enough.

Tobacco in any form is the largest single risk factor, and combining it with alcohol multiplies rather than adds. HPV infection is associated with cancers at the back of the mouth and throat. Age and previous head or neck cancer also matter. Plenty of people with none of these still develop lesions worth checking.

You are told directly and quickly, and referred to the appropriate specialist without delay. Most biopsies come back as something benign or as a condition that needs monitoring rather than treatment. Where it is more than that, speed of referral is what matters, and that is within our control.

A check of the soft tissues takes about two minutes and happens at every routine examination here whether you ask or not. It is not a separate appointment for most people. Asking for it specifically makes sense if you smoke, drink heavily, or have noticed something.

Appointments

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