Oral cancer, which includes cancer of the lips, tongue, cheeks, and throat, is a serious condition that affects thousands of people worldwide each year. Early detection is crucial for improving treatment outcomes, and that’s where oral cancer screening tests come into play. These tests aim to identify any abnormal cells or early signs of cancer in the mouth and throat before they progress into more severe stages.

In this guide, we’ll explore the top five oral cancer screening tests you should be aware of, how they work, and why they’re essential for maintaining optimal oral health.

Why Oral Cancer Screenings Are Important

Oral cancer screenings help detect cancer in its early stages, when treatment is most effective. Symptoms of oral cancer can sometimes be subtle, and many patients may not experience noticeable changes until the disease has progressed. Regular screenings, especially for those at high risk, increase the chances of early detection, potentially saving lives.

Risk factors for oral cancer include:

Tobacco use (smoking or chewing).
Heavy alcohol consumption.
HPV infection (particularly HPV-16).
Prolonged sun exposure (risk for lip cancer).
A history of oral cancer or precancerous lesions.

By understanding and utilizing the right screening tests, you can stay proactive about your oral health.

1. Visual Examination by a Dentist or Doctor

The most common and straightforward oral cancer screening is a visual examination performed by your dentist or doctor. This test is often part of a regular dental checkup and involves a thorough inspection of your mouth, lips, gums, tongue, cheeks, and throat for any abnormalities.

How it works:

Your dentist will visually inspect your mouth for any sores, discolorations, or lumps.
They will also check for red or white patches, which can be early signs of cancer.
They may ask you about any unexplained pain or numbness.

What to expect:

The visual exam is painless and takes only a few minutes.
It doesn’t involve any specialized tools or devices, but the dentist may use a small mirror to get a better view of hard-to-see areas.

While a visual exam is effective for spotting noticeable changes, it cannot detect cancer cells below the surface of the tissues. If the dentist notices anything unusual, they may recommend further tests.

2. Tactile Examination (Palpation)

In addition to visually inspecting the mouth, your dentist may perform a tactile examination, also known as palpation. This involves feeling the tissues of your mouth, jaw, and neck for any lumps, thickening, or irregularities that could indicate oral cancer.

How it works:

The dentist or doctor will gently press or feel the tissues in your cheeks, tongue, gums, and neck.
They will also check for hardening or lumps in the lymph nodes around the neck, which can indicate the spread of cancer.

What to expect:

This exam is non-invasive and painless, though you may feel some pressure as your dentist feels the tissues.
It helps detect abnormalities that aren’t visible but can be felt through touch.

Palpation is especially useful in detecting hard-to-see lumps or areas of abnormal tissue growth that might not be apparent in a visual examination.

3. Toluidine Blue Stain

Toluidine blue staining is a simple, non-invasive test often used to identify suspicious areas of the mouth that may require further investigation. It’s particularly useful for detecting precancerous lesions or early-stage oral cancers.

How it works:

A toluidine blue dye is applied to the inside of the mouth.
The dye tends to stick to areas of abnormal cells, making them easier to spot.
After the mouth is rinsed, any areas that retain the blue dye are considered suspicious and may need further testing.

What to expect:

The test is painless and quick, usually taking less than 10 minutes.
The dye may leave a temporary blue discoloration in your mouth, but this fades after a short time.

This screening is often used in combination with a visual and tactile examination to enhance the detection of abnormal cells.

4. Fluorescence Visualization (VELscope)

Fluorescence visualization is an advanced screening method that uses special light to highlight abnormal tissue. The most commonly used device for this purpose is the VELscope, a handheld device that emits a blue light to illuminate the tissues in the mouth.

How it works:

The dentist or doctor shines the blue light into the mouth.
Healthy tissues absorb the light and appear green, while abnormal tissues may appear as dark spots or irregular patches.

What to expect:

The test is non-invasive and painless, taking just a few minutes.
You may feel a slight warmth from the light, but no discomfort is involved.

This screening tool is particularly effective at detecting tissue changes beneath the surface, making it a valuable addition to a standard oral cancer screening.

5. Brush Biopsy (OralCDx)

A brush biopsy is a non-invasive procedure used to collect cells from suspicious areas in the mouth for further analysis. It’s a more advanced test that can confirm whether abnormal cells are precancerous or cancerous.

How it works:

The dentist uses a small, stiff brush to gently scrape or rotate over the suspicious area.
The brush collects cells from the surface, which are then sent to a lab for analysis.

What to expect:

The procedure is quick and relatively painless, though you may experience a mild scraping sensation.
Results typically take a few days to come back from the lab.

If the brush biopsy shows abnormal cells, a more extensive scalpel biopsy may be needed for further examination.

When to Get Screened for Oral Cancer

Regular oral cancer screenings should be part of your routine dental checkups, especially if you have any of the risk factors mentioned earlier, such as tobacco use, heavy alcohol consumption, or a history of HPV. Even if you don’t have risk factors, it’s a good idea to get screened during your dental visits, as early detection significantly improves treatment outcomes.

For those at higher risk, it’s recommended to get screened at least once a year. Speak with your dentist about incorporating these screening tests into your regular oral health routine.

Conclusion

Oral cancer screenings are a critical part of maintaining good oral health, especially for individuals at risk. From visual and tactile exams to more advanced methods like toluidine blue staining and fluorescence visualization, these screening tests can help detect abnormal tissue changes before they become more serious.

Talk to your dentist about scheduling an oral cancer screening as part of your next dental checkup, and take a proactive approach to safeguarding your oral and overall health.

References

American Dental Association. “Oral Cancer Detection and Screening Tools.” www.ada.org
Oral Cancer Foundation. “Early Detection and Screening for Oral Cancer.” www.oralcancerfoundation.org
Mayo Clinic. “Oral Cancer: Screening and Prevention.” www.mayoclinic.org