When Should I Be Concerned About Oral Lesions?

Nine signs that may be indicative of oral cancer include:

1. Oral lesions cause severe or persistent pain.
2. The area around and over the lesion is numb.
3. Symptoms do not improve within two weeks of home treatment.
4. Lesions are associated with bleeding or recurrent fungal infections.
5. There is a lump formation or thickness due to lesions.
6. There is an appearance of white, red, or mixed white and red patches on the tongue or gums or inside the mouth that doesn’t go away.
7. Lesions worsen or grow with time.
8. Lesions cause difficulty opening the mouth, chewing, swallowing, or moving the tongue.
9. Lesions are associated with other symptoms such as hoarseness, loss of weight or appetite, or swollen neck glands.

Oral lesions are a blanket term for ulcers, sores, growths, or other abnormalities inside the mouth. They may appear anywhere within the oral cavity including the inside of the cheeks or on the tongue, gums, palate (roof of the mouth), or upper part of the throat (oropharynx). 

Most oral lesions are noncancerous and can be easily managed at home. If, however, you have any symptoms that suggest cancerous oral lesions, you must contact your doctor. 

Early diagnosis of oral cancer ensures higher cure rates.

Some of the common oral lesions include:

• Canker sores (mouth ulcers or aphthous ulcers): They are the most common type of oral lesions. They are noncontagious and appear as shallow, red ulcers with a white, yellow, or gray center. They generally go away within a week or two.
• Oral thrush (oral candidiasis): It is caused by yeast (Candida) infection and typically appears as creamy white lesions that can be wiped, leaving a reddish area underneath.
• Cold sores: They are caused by herpes virus infection and are highly contagious. They appear as tiny, painful blisters on the lips and around or inside the mouth.
• Hairy tongue: It is a harmless condition that generally affects older people. The hairy tongue appears as an abnormal coating on the upper surface of the tongue that gives the tongue a furry appearance.
• Oral lichen planus: It is a chronic condition that causes white, lacy patches or red, swollen lesions inside the mouth. It is an autoimmune condition and is not contagious.
• Leukoplakia: It refers to thick, white patches inside the mouth. Unlike oral candidiasis, these white patches cannot be wiped or scraped off. They may be precancerous and thus need medical attention.
• Oral cancer: It refers to cancer that starts inside the mouth. Oral cancer can affect anyone although people who use tobacco or have excessive alcohol or have a family history of oral cancer are at high risk. Cancer can affect any part of the oral cavity and cause lesions that worsen or do not go away.

Doctors diagnose oral lesions based on your detailed medical history and physical examination, particularly the examination of the oral cavity.

They may order certain tests to confirm the diagnosis, which may include:

• Brush biopsy (scrape biopsy or exfoliative cytology) the doctor gently scrapes the lesions and examines the collected sample under the microscope
• Staining (special stains are used to differentiate cancerous or precancerous areas from noncancerous areas)
• Incisional biopsy (your doctor will take a small piece of the lesion for examination under a microscope)
• Laryngoscopy and pharyngoscopy (to examine the inside of your throat)
• Imaging studies (computed tomography scans, magnetic resonance imaging, etc. to know about the spread of cancer)