Guarding yourself against oral cancer: know your risk

Oral and oropharyngeal (mouth and throat cancers represent about 3% of all cancer diagnoses, and being over 55 puts you at greater risk.1,2 The good news is that early detection can change the outcome, and there are simple things you can do.

Survival rates for oral cancers have improved in recent years, but there is a big difference between cases found early (85 to 90% having a 5-year survival rate) and those found later (just 50%).3 Sadly, early detection rates are low, and about 2 in every 3 oral cancers aren’t found until they are already late stage.

Unlike with early cancers, where treatment is much more straightforward, late detection often means a combination of treatments such as surgery, radiotherapy, and chemotherapy. Rehabilitation afterwards is also more difficult, and your appearance and ability to talk or eat may be permanently and significantly affected. This would have an enormous impact on your quality of life.

But you can take some very simple steps to improve your likelihood of finding oral cancer early, like having regular dental check-ups, monitoring your own oral health, knowing the warning signs and understanding your risk factors.

Regular check-ups for early detection

Often, oral cancer in the early stages doesn’t cause any pain or discomfort. It can also be hard to see, so you may not notice anything yourself. Regular checks of your mouth and throat by a doctor or dentist can help pick up any early signs of changes in the tissues.

The doctor can look for changes in the tissues and any warning signs, which are known as ‘oral potentially malignant disorders’ or OPMDs. Not all OPMDs turn into cancer, but finding them means the doctors and dentists can monitor you and be ready to start treatment early if necessary.

Examples of OPMDs

• Leukoplakia

• Proliferative verrucous leukoplakia PVL - (high risk)

• Erythroplakia

• Oral submucous fibrosis

• Actinic keratosis

• Oral lichen planus

• Oral lichenoid lesion

• Dyskeratosis congenita

• Oral lupus erythematosis

• Oral graft vs host disease

Regular dental check-ups with oral cancer screening are the most effective way to diagnose OPMDs. However, you might be surprised to learn that only around half of the people in Australia visit a dentist regularly!4 That leaves a lot of room for the early signs of oral cancers to go undetected.

Possible signs of oral cancer

• A sore, irritation, lump or change in the thickness of soft tissues

• An ulcer that lasts longer than 2 weeks or returns over and over again

• A blood blister in the mouth that doesn’t heal or repeatedly comes back

• A white or red patch in the mouth

• A continual feeling that something is caught in the throat

• Difficulty chewing or swallowing

• Difficulty moving the jaw or tongue around

• Persistent swelling in the glands or lymph nodes under the jaw

• A sore throat that doesn’t go away

• Difficulty speaking, or a change in the voice

• Numbness in the tongue or other areas of the mouth

• Swelling of the jaw that makes dentures stop fitting properly or become uncomfortable to wear. 5

What are the risk factors for developing oral cancer?

• Being older and male (oral cancer is more common in men)

• Smoking or vaping

• Drinking alcohol

• Chewing betel nuts or betel quid

• Exposing your lips to the sun for a long time

• Having a virus like human papillomavirus (HPV)

• Having a family history of cancer

• Having cancer in the past

• Having a weakened immune system

While all these factors increase your chances of developing oral cancer, the two biggest in Australia are smoking and drinking alcohol. And if you drink and smoke, you’re 17 times more likely to get oral cancer!6

Many people think that vaping is healthier than smoking and carries less risk of oral cancer. However, early research strongly suggests it causes significant cell damage that could lead to cancer.7

The HPV virus, particularly HPV 16, is already known to cause other types of cancer. It’s also been linked to some cancers that develop deep in the tonsils or at the base of the tongue – areas that are hard to see in a routine check-up. To catch these cancers early, it’s important to check your head and neck lymph glands regularly and tell your doctor about any unusual feelings or changes in the back of the mouth.

What can prevent oral cancer?

Eliminating risk factors by changing your tobacco and alcohol consumption is the most significant step you can take to prevent oral cancer. Sun protection of the lips ( with sunscreen and a wide-brimmed hat) will also help, as will having the HPV vaccination.

Maintaining good general health and wellbeing is important in reducing your risk of cancer as it improves the function of the immune system, your major defence against cancer. A well-balanced diet rich in antioxidants and essential vitamins and minerals, adequate hydration, and regular exercise, which all boost your immune function, are equally important for oral health and general health.

How to reduce the risk of oral cancer

• Eliminate tobacco – stop smoking or vaping.

• Significantly reduce your alcohol consumption, or cut it out altogether.

• Protect your lips in the sun with a wide-brimmed hat and sunscreen.

• Keep your mouth clean and healthy to avoid infection and trauma.

• Maintain a healthy diet high in antioxidants and unprocessed foods.

• Undergo regular oral cancer screenings by your dental health professional.

• Discuss your oral cancer risk with your medical and dental practitioners.

• Be alert, and if you think something is not quite right, act!

• Have a HPV vaccination (and encourage eligible family members and friends).

Be aware of your oral cancer risk

Oral cancer is more common than you might think and can be very serious, but detecting it early allows for much better treatment. Know what might be putting you at risk and talk to your doctor and dentist about how to reduce our chances.

Remember, stopping smoking or vaping and reducing or eliminating alcohol intake are by far the most effective ways to reduce the risk of oral cancer. Be alert to any changes in your mouth and throat, and have regular dental check-ups to screen for OPMDs.

Doing all these things will guard you well against oral cancer.

Dr Wayne Sherson [BDS with Distinction Otago MSc (Dent) Sydney] is a registered dentist with 40 years’ experience. His practice interests include oral health and systemic health, periodontics and complex restorative care. Wayne retired from clinical practice in 2023 but continues to provide continuing education to the profession through the Australian Dental Association NSW Centre for Professional Development.

Disclaimer: The information provided on this website is not a substitute for individual health advice from a doctor, dentist or dietitian.