As a registered dental hygienist and former oral surgery assistant, I have always understood the importance of oral cancer screenings. But after becoming a melanoma survivor, these exams have far greater meaning. What was once routine has now become personal, and I have seen firsthand how a five-minute exam can literally save a life.
Cancer by the numbers
Many patients see their dental team more frequently than they see their primary care provider. This places dental professionals on the front line for early cancer detection. According to the American Cancer Society, an estimated 58,000 new cases of oral cavity and oropharyngeal cancers occur annually in the United States, with over 12,000 deaths each year. Survival is strongly linked to stage at diagnosis. Localized disease carries a significantly higher five-year survival rate than regionally or distantly spread cancer.1
Why aren’t patients receiving oral cancer exams?
Despite this reality, screening is often rushed or forgotten. National survey data indicates that only one-third of adults report receiving oral cancer examinations, even among patients with recent dental visits.2
Where to check
Comprehensive screening extends beyond the oral cavity. Extraoral exam of the head and neck is equally critical, including palpitation of lymph nodes, salivary glands, thyroid and temporomandibular joint, and especially the lips. The lower lip is a common site of lip cancer due to chronic exposure to UV radiation. As a melanoma survivor, I am particularly looking for color variation and skin changes.
A thorough intraoral exam must be consistent at each visit. This includes inspection of the labial and buccal mucosa, gingiva, floor of the mouth, hard and soft palate, oropharynx, and all surfaces of the tongue. The lateral borders and ventral surface of the tongue are the most common areas where suspicious lesions develop. Early squamous cell cancer is often painless and accounts for 90% of oral malignancies. It might look like a faint white patch (leukoplakia), a nonhealing ulceration, or a velvety red spot (erythroplakia).3 Patients won’t notice these because they don’t hurt … so if we don’t find them, no one will.
Documentation is vital
Thorough documentation is equally important to create a baseline for monitoring changes over time. If the abnormality persists over two weeks, referral to the oral surgeon for further evaluation and/or biopsy is warranted. My work in oral surgery is a sobering reminder of what happens in late diagnosis. By the time the patient feels pain or has trouble swallowing, the disease has frequently progressed and requires aggressive surgery, radiation, chemotherapy, or all three. I assisted in surgeries that dramatically altered patients’ ability to speak, eat, and function.
The gold standard
The 2026 ADA Living Guidelines recently released that our eyes and hands are our best tools. They have stepped away from light- or brush-based adjuncts and reaffirmed that a thorough manual exam is the gold standard.4
My experience as a melanoma survivor reminds me daily why early detection matters. My journey started with a tiny dark spot, and I now carry a heightened awareness of malignancy and the subtle ways cancer can present. Chairside, this awareness translates into vigilance. Fellow dental professionals, I know our schedules are tight and we feel pressure to keep moving, but the five-minute oral cancer screening should never be rushed or optional. It may be the reason someone lives to tell their own survival story.
Additional reading: Oral cancer screening: Resources for dental professionals
References
- Cancer facts & figures 2025. American Cancer Society. 2025. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/2025-cancer-facts-figures.html
- Macek MD, Tomar SL. Dental care visits among dentate adults with and without oral cancer examinations. J Public Health Dent. 2009;71(4):302-310. doi:10.1111/j.1752-7325.2011.00243x
- Neville BW, Damm DD, Allen CM, Chi AC. Oral and Maxillofacial Pathology. 4th Elsevier; 2016.
- ADA Living Guideline Program releases first set of recommendations on early oral cancer detection. J Am Dent Assoc. 2026;157(3):210-224.
