With April being oral cancer awareness month, we find it to be a timely opportunity to provide information about the symptoms you should be aware of regarding cancer of the mouth and upper throat. The American Cancer Society estimates that 58,450 people will get oral cavity or oropharyngeal cancer this year, and 12,230 people will die of these cancers. From another perspective, oral cancer kills nearly one person every hour of every day of the year. Forty percent of those who are newly diagnosed will not survive longer than five years. Those who do survive have long-term problems such as severe facial disfigurement or difficulties eating and speaking. 

According to the American Academy of Oral Medicine, the death rate is high because the cancers are routinely discovered late in their development. Early detection is key. When oral and oropharyngeal cancers are detected and treated early, mortality and treatment-related health problems are reduced. At Sninski & Schmitt Family Dentistry, we check for oral cancer with all dental checkups. We know the symptoms and signs to look for. In this article, to keep you informed and keep this subject top of mind, we discuss symptoms and the tests used to find cancer early, accurately diagnose oral and throat cancers, and plan the treatment.

Oral and Oropharyngeal Cancer

Oral cavity cancer begins in the mouth and oropharyngeal cancer, also known as throat cancer, is at the base of the tongue, soft palate, tonsils, and the back of the throat. The oral cavity includes the lips, the inside lining of the lips and cheeks, the teeth, the gums, the front two-thirds of the tongue, the floor of the mouth below the tongue, the bony roof of the mouth (the hard palate), and the area behind the wisdom teeth (called the retromolar trigone).

The oropharynx area is the middle part of the throat just behind the oral cavity. It can be seen when your mouth is wide open. It includes the base of the tongue, the soft palate, the tonsils, and the side and back walls of the throat.

Different Types of Oral (Mouth) and Oropharynx (Throat) Cancers

Many types of cells make up the different parts of the oral cavity and oropharynx and different cancers can start in each type of cell. These differences are important as they can determine a person’s treatment options and prognosis.

Squamous Cell Carcinoma

The great majority of cancers in the oral cavity and oropharynx are squamous cell carcinomas, which are also called squamous cell cancers. These cancers start in squamous cells, which are flat, thin cells that form the lining of the mouth and throat. The earliest form of squamous cell cancer is called carcinoma in situ, meaning that the cancer cells are contained in the top layer of cells, called the epithelium, lining the oral cavity and oropharynx. When cancer cells have grown past the epithelium and into the deeper layers of the mouth and throat, it is called invasive squamous cell cancer.

Minor Salivary Gland Cancers

Minor salivary gland cancers can start in the glands in the lining of the mouth and throat. Many types of minor salivary gland cancers exist, including adenoid cystic carcinoma, mucoepidermoid carcinoma, and polymorphous low-grade adenocarcinoma.


The tonsils and base of the tongue contain immune system tissue called lymphoid tissue. Cancer called lymphomas can start here. 

Leukoplakia and Erythroplakia

Leukoplakia and erythroplakia are terms used to describe certain types of tissue changes that can be seen in the mouth or throat. Leukoplakia is a white or gray area that does not come off when it is scraped. Erythroplakia is a flat or slightly raised red area that often bleeds easily when it is scraped. Erythroleukoplakia is a patch with both red and wite areas.

A dentist or dental hygienist is often the first person to find these white or red patches. The patches may be any of these:

  • Cancer
  • A pre-cancer condition called dysplasia
  • Harmless changes

Most cases of leukoplakia do not progress into cancer. Some leukoplakias are either cancer when they are first detected or have pre-cancer changes that turn into cancer if not properly treated. Erythroplakia and erythroleukoplakia are less common but are usually more serious. More of these red lesions, as compared to white lesions, end up being cancer when biopsied or will develop into cancer later.

Symptoms and Signs of Oral or Throat Cancer

As we stated previously, detection in the first stages is critical for getting effective treatments. Here are some of the early signs and symptoms that indicate oral or throat cancers:

  • A sore on the lip or in the mouth that doesn’t heal
  • Pain in the mouth that doesn’t go away
  • A lump or thickening in the lips, mouth, or cheek
  • A sore throat or a feeling that something is caught in your throat that doesn’t go away
  • Trouble chewing or swallowing
  • Trouble moving the jaw or tongue
  • Numbness of the tongue, lip, or other area of the mouth
  • Swelling or pain in the jaw
  • Dentures that start to fit poorly or become uncomfortable
  • Teeth becoming loose or painful
  • Changes in your voice
  • A lump or mass in the neck or back of the throat
  • Weight loss
  • Pain in the ear

Many of these signs and symptoms can also be caused by diseases other than cancer or even other cancers. If you have any of these conditions and they last more than 2 weeks, it’s very important to see a dentist or doctor so the cause can be found and treated, if necessary.

Tests to Find Oral or Oropharyngeal Cancer

A doctor or dentist may find some cancers or pre-cancers during routine exams, but many times they are found because a person has noticed a sign or symptom and brought it to the physician. It is essential to maintain routine dental checkups. If cancer is suspected, other tests are needed. First, the dentist will screen by looking for possible signs of mouth or throat cancer or pre-cancer such as bumps or changed areas on your head, face, and neck, or problems with the nerves of the face and mouth. Other tests may be conducted to check for abnormal areas in your mouth or throat.

Complete Head and Neck Exam

If there is a reason to think you may have cancer, your doctor will refer you to a specialist. These specialists are oral and maxillofacial surgeons or head and neck surgeons, also known as ear, nose, and throat (ENT) doctors or otolaryngologists. The specialist will pay special attention to the head and neck area, searching for abnormal areas through looking and feeling carefully. This exam includes the lymph nodes in your neck. The oropharynx is deep inside the neck and not easy to see, so the doctor may use mirrors or special fiber-optic scopes to look at these areas. These exams can be done in the doctor’s office.


To make certain there are no other cancers in the esophagus or lung, a panendoscopy might be done, especially if the patient has risk factors such as tobacco and alcohol use. A panendoscopy is also helpful to determine where the cancer started or if the lymph nodes in the bottom part of the neck seem abnormal. A panendoscopy involves the use of different types of endoscopes passed down the mouth or nose to do a laryngoscopy/pharyngoscopy, esophagoscopy, and bronchoscopy. This procedure is typically performed in an operating room while the patient is asleep under general anesthesia.


In a biopsy, the doctor removes a small piece of tissue or a sample of cells to look at it more closely in the lab for cancer cells. There are different types of biopsies:

Exfoliative cytology: The doctor scrapes the changed area and smears the collected tissue onto a glass slide, which is then stained with a dye to see the cells. If any of the cells look abnormal, then the area is biopsied.

Incisional biopsy: The doctor cuts a small piece of tissue from the area that looks abnormal. Tijs is the most common type of biopsy used to check changes in the mouth or throat. Depending on where the tumor is and how easy it is to get a good tissue sample, this procedure can be done either in the doctor’s office or the operating room.

If cancer is shown to be present, other tests will be required to determine the full scope and develop a treatment plan. 

Contact Sninski & Schmitt Family Dentistry to Schedule your Dental Check-up

Sninski & Schmitt Family Dentistry is accepting new patients. If you have any symptoms or signs that are worrisome and need to see our dentists for a check-up, don’t wait to contact us. We have a team of hygienists and dentists who can test and properly diagnose your situation at two convenient locations. Reach us at our Holly Springs dentist office at 919-600-6262 and our Cary, NC dentist office at 919-467-2203. Or, you can fill out our contact form to schedule an appointment.

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