Oral health checks and visual examinations – everything you need to know

Household budgets are tight for many people at the moment.  Offering patients or local groups an afternoon of free mouth cancer examinations is a great way to support your local community.  It’s a good way to promote awareness of the illness, and at the same time help develop the goodwill of your practice.

The more you can do to raise awareness, recognise the symptoms and identify the risk factors, the better the chance we have of early diagnosis and saving lives.  Promoting better lifestyle choices can reduce significant threats and make a huge difference, especially amongst young people.

So whether it’s for the whole month, a week, a day, or one afternoon, your participation is crucial and can make a difference.

Why should I take part?

Latest figures show more than 6,500 people in the UK were diagnosed with mouth cancer – that’s 18 people every day. It is one of the few cancer variations on the rise – cases have increased by almost 50 percent over the last decade – and it still claims more lives than cervical and testicular cancer combined. Early detection is so important – it transforms the five year survival rate from 50 per cent up to 90 per cent. Oral health checks and visual examinations are the best way to identify suspicious lesions, so do get involved.

Who should I pay particular attention to?

By talking to your patients about their lifestyle habits, you will get a better idea about their potential mouth cancer risk. Smokers, heavy drinkers, older people and those who use chewing or smokeless tobacco are likely to be higher risk groups, although we know the human papillomavirus (HPV) means younger people are now developing mouth cancer.

Where should I look?

The mouth is examined in a methodical way to detect any abnormalities of the oral mucosa. Facial tissues that seem to be abnormal, as well as the submandibular and cervical lymph nodes, are palpated.

For the intra-oral examination two mouth mirrors are used. It should not be forgotten that one of the mirrors may cover small lesions during the examination.

The lips are examined both with the mouth closed and with it open, noting colour, texture and surface abnormalities of the vermilion border.

Lower labial mucosa and sulcus are examined with the mouth partially open, observing the colour and any swelling of the vestibular mucosa and gingival.

The upper labial mucosa, sulcus, vestibule and frenum are examined, again with the mouth partially open.

Using the mouth mirrors as retractors and with the mouth wide open the entire buccal mucosa extending from the commissures and back to the anterior tonsillar pillars are examined, noting any change in colour and mobility of the mucosa. It is important to ensure that the commissures are examined carefully and are not covered by the mouth mirrors during the retraction of the cheek.

The alveolar ridges, including gingivae, are examined from all sides both buccally and lingually.

With the mouth partially open, the dorsum of the tongue is inspected for any swelling, ulceration, coating or variation in colour or texture. Any changes in the pattern of the papillae covering the surface of the tongue are noted.

The patient is then asked to protrude the tongue and any abnormal mobility is noted. The ventral surface of the tongue is then examined.

Next, the patient is asked to push the tongue into the left cheek and then into the right cheek to obtain good views of the posterior part of the lateral borders of the tongue.

With the tongue elevated, the floor of the mouth is carefully examined for ulcerations and colour changes. Together with the alveolar-lingual sulcus, the floor of the mouth is in an area where good visibility is difficult to obtain. As a high proportion of cancers arise in this region a thorough examination is important.

Finally, the hard and soft palates are examined. With the mouth wide open and the patient’s head tilted backwards, the base of the tongue is gently depressed with a mouth mirror. The hard palate and the soft palate are then examined.

How do I tell people about what I’m doing?

Year-on-year the largest amount of coverage for Mouth Cancer Action Month comes from the local press – newspapers, radio and even television – and it’s purely down to the fantastic efforts of local organisers putting on the events.

It is something that can easily be overlooked but gaining this local media coverage is so important simply because it makes it so much easier for nearby residents to reach you. There’s no better promotional opportunity that can tap into your audience, drum up some interest in your event and ultimate, help save more lives.

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