Oral cancer screening: how it is carried out, when and why it is essential

Regular screening significantly increases the chances of survival, as oral cancer is treatable when detected early. The success rate of treatment is much higher in the early stages, and interventions are less invasive and more effective. Early detection is the most powerful ally in the prevention of oral cancer.

Furthermore, early detection of oral cancer means fewer post-treatment complications, a lower recurrence rate and a significantly higher survival rate. Treatments can be limited to the localised removal of the lesion without affecting speech, eating or facial appearance. It is, therefore, a minimal investment for a major benefit. 

A detailed and proactive approach is crucial for the early detection of oral cancer. Here are the key steps involved in a thorough screening. 

Clinical examination and the use of screening technologies

Oral cancer screening begins with a clinical examination carried out by a dentist, which involves checking the oral cavity (tongue, cheeks, gums, roof of the mouth) and palpating the lymph nodes in the neck area. The dentist looks for white or red patches, lesions, ulcers, nodules or other abnormalities.  

Furthermore, at DENT ESTET clinics, we use advanced equipment, such as the Sapphire Plus Lesion Detection and Velscope VX lights, for oral cancer screening. These are fitted with a built-in digital camera, which provides a detailed image of the oral cavity and enables in-depth scanning. This enables the identification of pre-cancerous or cancerous cells that are not visible to the naked eye, as well as various infections, abnormalities or tumours in the oral mucosa.

Further investigations

In addition to the physical examination and the use of screening technologies, further tests may be carried out to detect oral cancer, as follows:

Biopsy – If the oral screening indicates suspicious areas, the doctor will take a tissue sample to be sent to a laboratory for biopsy. Through microscopic analysis of the cells, a biopsy can detect any cancerous or pre-cancerous changes.

Blood tests – Additional analyses, such as immunoglobulin electrophoresis and tests for tumour markers, help to identify abnormalities associated with oral cancer.

Imaging tests – Radiological investigations, such as computed tomography (CT) scans and magnetic resonance imaging (MRI), help the doctor to accurately determine the extent to which cancer cells have spread within the oral cavity.

Oral cancer screening can make all the difference. Find out what signs and risk factors you should be aware of before undergoing such a screening.

Early signs of oral cancer identified through screening

Some of the most common signs detected during screening include:  

• sores that won’t heal
• pain when swallowing
• abnormal patches on the lining of the mouth
• spontaneous bleeding
• changes in the voice or difficulty chewing.  

Detecting these symptoms at an early stage can save lives and significantly reduce the complexity of the treatment required.

Sometimes, the patient may notice mild pain when chewing or persistent discomfort on one side of the mouth. These signs, although seemingly minor, may be the first indications of a lesion. Screening can also detect subtle changes in facial symmetry or tongue movement, which may signal a more serious underlying problem.

Risk factors

Anyone can benefit from an oral cancer screening, but it is essential for people with risk factors. These include: smoking, frequent alcohol consumption, HPV infection, being over 40 years of age, sun exposure (for lip cancer) or poor oral hygiene. For these individuals, annual screening is recommended. For those without risk factors, an assessment every two years is sufficient.

It is important that screening is tailored to the patient’s medical history. People with a family history of cancer, autoimmune conditions or oral viral infections should be monitored closely. Furthermore, patients who have undergone surgery in the head and neck area may benefit from more frequent check-ups. Screening is also recommended for adolescents who engage in risky behaviours, such as early smoking or alcohol consumption. 

“If it doesn’t hurt, it’s not serious”

This myth is extremely dangerous. Oral cancer can develop without any visible symptoms, and pain is not always present. Another misconception is that only smokers are affected – in reality, anyone can develop this condition. Screening is a preventative measure aimed at everyone.

Screening is painful

Another myth is that screening is painful or expensive. In reality, it is quick, painless and, in many clinics, included as part of routine dental check-ups. Furthermore, the absence of symptoms does not mean the absence of disease – oral cancer can progress silently until it reaches advanced stages.