This document provides a guide for healthcare professionals on detecting oral cancer. It details that oral and pharyngeal cancer results in 30,000 new cases and 8,000 deaths annually in the United States, with a 5-year survival rate of 50% if detected early. It describes common warning signs, risk factors, and types of potentially cancerous oral lesions. The guide outlines the process for conducting an oral cancer screening exam, including extraoral and intraoral inspection of tissues and lymph nodes. It emphasizes focusing screening efforts on high risk areas of the tongue, floor of mouth, and lips and educating patients on signs and symptoms of oral cancer.

1. Detecting
Oral
Cancer
A Guide for Health Care
Professionals

2. Oral & Pharyngeal Cancer
Deaths
8,000
New Cases
30,000
5 Year Survival Rate = 50%

3. Early
Detection
Erythroplakia
Saves
Leukoplakia
Lives

4. Warning Signs
Lump or Soreness or Difficulty
thickening of “lump” in chewing or
oral soft tissue throat swallowing
Difficulty
Ear pain Hoarseness
moving jaw or
tongue
Numbness of
Swelling of the
tongue or
jaw
mouth

5. Tobacco
Use
Alcohol
Race
Use
Risk
Factors
Sunlight
Gender
Exposure
Age

6. Examination Preparation
• Head & neck exam should be routine
• Review history of alcohol and tobacco use
• Follow-up on suspicious signs
Overview
• Proper lighting
• Dental mouth mirror
• Gauze squares
• Disposable gloves
Armamentarium • 5 minutes of time

7. Extraoral Examination
Examine
Face, head and neck – note
asymmetry or changes
Lymph nodes – palpated
bilaterally

8. Lips
Labial Mucosa

9. Labial Mucosa
Buccal Mucosa

10. Buccal Mucosa
Gingiva

11. Dorsum of Tongue
Left Margin of
Tongue

12. Right Margin of
Tongue
Ventral Surface of
Tongue

13. Floor of Mouth
Hard Palate

14. Oropharynx
Floor of Mouth -
Bimanual

15. Suspicious Oral Lesions
Homogenous
Leukoplakia
Leukoplakia
with Early
Squamous Cell
Carcinoma

16. Suspicious Oral Lesions
Nodular
Leukoplakia with
Severe Epithelial
Dysplasia
Erythroleukoplakia
with Candida
Infection

17. Points To Remember When Screening for Oral Cancer
Most oral cancers are located on the lateral borders of the tongue, floor
of the mouth and lips – special attention should be focused in these areas.
Tell your patient what you are doing with each procedure and why.
Always note any changes in color and texture of all soft tissues or any
swelling. If you detect an abnormality, determine the history of the lesion; if
the abnormality has been of more than 2 weeks’ duration, take appropriate
action to obtain a biopsy.

18. Points To Remember When Screening for Oral Cancer
Follow up to ensure a definitive diagnosis of an abnormality.
Teach your patients about the signs and symptoms of oral cancer.
If a patient uses tobacco products, provide appropriate counseling or
refer patient for counseling.
Remove all removable prostheses before starting the examination.

19. Photographs for this program were provided by:
Joseph Konzelman, DDS
Jens Jorgen Pindborg, DrOdont
Slide series revised by Visual Dynamics
www.visualdynamics.us
For more information:
National Institute of Dental and Craniofacial Research (NIDCR)
National Oral Health Information Clearinghouse
1 NOHIC Way
Bethesda MD 20892-3500
nohic@nidcr.nih.gov
www.nidcr.nih.gov