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.