Oral cancer
Recognise persistent ulceration, induration, masses, red or white lesions and unexplained neck nodes; use the appropriate urgent referral pathway.
Understand
Oral squamous cell carcinoma may present as an ulcer, mass, red or white patch, or unexplained neck node. Early disease may be painless.
Assess
Inspect and palpate lesion and nodes, record chronology, tobacco and alcohol exposure without assuming these are required, and assess swallowing, speech and sensation.
Apply
Use the appropriate urgent suspected cancer pathway for concerning findings. Do not await a trial of repeated empirical therapies when the lesion is clinically suspicious.
Key distinctions
Oral cancer management depends on histological diagnosis and staging, but the dentist's first role is recognition, clear referral and avoidance of delay. Neck nodes, dysphagia, dysarthria, altered sensation and weight loss may accompany an oral lesion. Record the site in enough detail for the receiving team; the absence of conventional risks does not rule out malignancy.
Think through a case
A painless fixed tongue mass with an ipsilateral neck node is urgent regardless of whether the patient smokes. Record function, sensation and site and refer appropriately.
The distinction to remember
Do not delay a suspicious lesion with repeated antifungal or steroid trials without a clear response and review plan.
Test your recall
What is the immediate priority for a suspicious fixed tongue lesion?
Show answer
Prompt specialist assessment and tissue diagnosis.