All dentists and hygienists at the practice undertake a cancer check every time we see a patient.

Rob Banks is a Consultant working in the Oral and Maxillofacial department of South Tyneside and Sunderland NHS Foundation Trust undertaking surgical treatment for patients, some of whom have had cancer.

Ajay Wilson is a consultant working in the Oral and Maxillofacial department of South Tyneside and Sunderland NHS Foundation Trust undertaking surgical treatment for patients, some of whom have had cancer.

Matthew Gill is a Specialty Doctor working in the Oral and Maxillofacial department of South Tyneside and Sunderland NHS Foundation Trust undertaking advanced restorative treatment for patients who have had mouth cancer.

All staff at the practice undertake annual updates on oral cancer

Statistics show there is an increase of oral cancer year on year.

Should you think that you have mouth cancer you should be referred urgently to your local hospital by your Doctor or Dentist. The referral guidance from the National Institute for Health and Care Excellence for Head and neck cancers is below.

Who can be affected by mouth cancer?

Anyone can be affected by mouth cancer, whether they have their own teeth or not. Mouth cancers are more common in people over 40, particularly men. However, research has shown that mouth cancer is becoming more common in younger patients and in women. There are more than 640,000 cases of mouth cancer diagnosed each year worldwide and it is the eleventh most common cancer. In the United States there are around 43,000 cases each year.

In some countries there is an increased risk because of problems such as tobacco chewing - in India, for example - and the rates are even higher. There are, on average, almost 7,800 new cases of mouth cancer diagnosed in the UK each year. The number of new cases of mouth cancer is on the increase, and in the UK has increased by over half in the last decade alone.

Do people die from mouth cancer?

Yes. More than 2,300 people in the UK die from mouth cancer every year. Many of these deaths could be prevented if the cancer was diagnosed early enough. As it is, people with mouth cancer are more likely to die than those having cervical cancer or melanoma skin cancer.

What can cause mouth cancer?

Most cases of mouth cancer are linked to tobacco and alcohol. Cigarette, cigar and pipe smoking are the main forms of tobacco use in many parts of the world. However, the traditional habits in some cultures chewing tobacco, betel quid, gutkha and paan are particularly dangerous.

Alcohol increases the risk of mouth cancer, and if tobacco and alcohol are taken together the risk is even greater.

Over-exposure to sunlight can also increase the risk of cancer of the lips.

Many recent reports have linked mouth cancer to the human papillomavirus (HPV). HPV is the main cause of cervical cancer and affects the skin that lines the moist areas of the body.

HPV can be spread through oral sex, and research now suggests that HPV could soon rival smoking and drinking as one of the main causes of mouth cancer.

Practicing safe sex and limiting the number of partners you have may help reduce your chances of getting HPV. Many people get HPV during their lives and for most this does not cause a problem.

There are now HPV vaccines for both girls and boys. They were developed to fight cervical cancer, but it is likely that they will also help to reduce the rates of mouth cancer. These vaccines are given at age 12 to 13 before sexual activity starts.

What are the signs of mouth cancer?

Mouth cancer can appear in different forms and can affect all parts of the mouth, tongue and lips. Mouth cancer can appear as a painless mouth ulcer that does not heal normally. A white or red patch in the mouth can also develop into a cancer. Be aware of any unusual lumps in your mouth or jaw area and any persistent hoarseness. It is important to visit your dental team or doctor if these areas do not heal within three weeks. If you aren't sure, go for a check-up anyway.

How can mouth cancer be detected early?

Mouth cancer can often be spotted in its early stages by your dental team during a thorough mouth examination. If mouth cancer is diagnosed early, then the chances of a cure are good. Many people with mouth cancer go to their dentist or doctor too late.

What is involved in a full check-up of the mouth?

The inside of your mouth and your tongue will be examined with the help of a small mirror. The examination will also look at your neck and underneath your jaw. Dentists will carry out this examination as part of a routine dental check-up. Remember, your dental team can see parts of your mouth that you cannot see easily yourself.

What happens if my dentist finds a problem?

If we find something unusual we will refer you to a consultant at the hospital, who will carry out a thorough examination of your mouth and throat. A small sample of the cells may be gathered from the area (a biopsy), and these cells will be examined under the microscope to identify if there is a concern.

What happens next?

If the cells are cancerous, more tests will be carried out. These may include overall health checks, blood tests, x- rays or scans. These tests will decide what course of treatment is needed.

Can mouth cancer be cured?

If mouth cancer is spotted early, the chances of a complete cure are good, and the smaller the area or ulcer the better the chance of a cure. However, too many people come forward too late because they do not have regular mouth examinations.

How can I make sure that my mouth stays healthy?

Stop smoking, and cut down on the amount of alcohol you drink.

Eat a balanced, healthy diet with at least five portions of fruit and vegetables a day. This can also help protect against many other cancers.

Visit your dental team regularly, as often as they recommend.

\Head and Neck Cancer statistics

• There are around 12,200 new head and neck cancer cases in the UK every year, that's 34 every day (2015-2017).
• Head and neck cancer is the 8th most common cancer in the UK, accounting for 3% of all new cancer cases (2017).
• In females in the UK, head and neck cancer is the 13th most common cancer, with around 3,800 new cases in 2017.
• In males in the UK, head and neck cancer is the 4th most common cancer, with around 8,500 new cases in 2017.
• Incidence rates for head and neck cancer in the UK are highest in people aged 70 to 74 (2015-2017).
• Each year more than a fifth (22%) of all new head and neck cancer cases in the UK are diagnosed in people aged 75 and over (2015-2017).
• Since the early 1990s, head and neck cancer incidence rates have increased by a third (33%) in the UK. Rates in females have increased by more than two-fifths (43%), and rates in males have increased by almost a quarter (23%) (2015-2017).
• Over the last decade, head and neck cancer incidence rates have increased by a fifth (20%) in the UK. Rates in males have increased by a sixth (17%), and rates in females have increased by around a quarter (24%) (2015-2017).
• More than 6 in 10 head and neck cancer cases are diagnosed at a late stage in Northern Ireland (2010-2014).
• Most head and neck cancers occur in the larynx.
• Head and neck cancer in England is more common in people living in the most deprived areas.
• An estimated 62,500 people who had previously been diagnosed with head and neck cancer were alive in the UK at the end of 2010.

Carcinoma of the tongue and floor of mouth and lip

Tumours found within the oral cavity may originate on the mouth floor or on the underside or sides of the tongue. They can appear as reddened or white patches that extend outwards or look ulcerated.

Click here to see a photo of carcinoma of the tongue

Click here to see a photo of carcinoma of the lip

Leukoplakia

Leukoplakia is a white lesion affecting the oral mucosa, which cannot be attributed to any other specific condition. Although leukoplakia can be idiopathic, it has been associated with use of tobacco or with chewing betel quid (areca nut) either with or without added tobacco. The condition can be classified as homogenous (uniform patch of raised mucosa) or non-homogenous based on colour and morphological characteristics. Homogenous lesions, which are uniformly flat and thin, and typically exhibit shallow cracks of the surface keratin, are associated with a lower malignant potential.

Click here to see a photo of leukoplakia of the tongue

Click here to see a photo of leukoplakia of the floor of the mouth

Erythroleukoplakia and erythroplakia

Erythroplakia is a well-defined, irregular red lesion which cannot be attributed to another condition or pathology. Erythroplakia is usually flat with a smooth or granular surface and typically affects the buccal mucosa, soft palate and floor of mouth. Erythroleukoplakia is similar to erythroplakia, but it consists of a mixture of red and white lesions.

Click here to see a photo of erythroleukplakia of the floor of the mouth

Click here to see a photo of erythroleukplakia of the cheek

This is the referral guidance from NICE (National Institute for Health and Care Excellence) for Head and neck cancers

Laryngeal cancer

1.8.1 Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for laryngeal cancer in people aged 45 and over with:

• persistent unexplained hoarseness or 
• an unexplained lump in the neck.

Oral cancer

1.8.2 Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for oral cancer in people with either:

• unexplained ulceration in the oral cavity lasting for more than 3 weeks or 
• a persistent and unexplained lump in the neck.

1.8.3 Consider an urgent referral (for an appointment within 2 weeks) for assessment for possible oral cancer by a dentist in people who have either:

• a lump on the lip or in the oral cavity or
• a red or red and white patch in the oral cavity consistent with erythroplakia or erythroleukoplakia. 

1.8.4 Consider a suspected cancer pathway referral by the dentist (for an appointment within 2 weeks) for oral cancer in people when assessed by a dentist as having either:

• a lump on the lip or in the oral cavity consistent with oral cancer or
• a red or red and white patch in the oral cavity consistent with erythroplakia or erythroleukoplakia.