Regular dental checkups are vital for spotting early signs of mouth cancer.
But experts fear that difficulties getting an appointment may be behind a nearly 50 per cent surge in deaths from the disease because of tell-tale symptoms being missed.
To take matters into your own hands, dentists recommend performing a self-examination at home, especially if you are overdue a routine check-up.
Dr Michael Ho, a face, neck and mouth cancer consultant at the University of Leeds, shares his step-by-step guide of the signs to check for.
One of the best ways catch mouth cancer early is to perform self-examinations at home. Checking your mouth for ulcers and wobbly teeth can help catch cancer early
Ulcers that last longer than a fortnight
Ulcers — broken areas in the lining of the mouth — that do not heal within three weeks can be a sign of mouth cancer.
Ulcers are common and shouldn’t be a concern if they heal quickly.
However, ulcers that persist longer than three weeks, keep grow back bigger or near the back of the throat should be checked by a GP or dentist, according to the NHS.
‘The commonest sign of mouth cancer is a persistent ulcer that lasts more than three weeks,’ says Dr Ho.
That’s because most ‘inflammatory and traumatic ulcers’ tend to heal within a fortnight while cancerous ulcers persist for longer, he explains.
Mouth cancer that appears in the oropharyngeal — an area that includes the tonsils, base of tongue and soft palate — is increasing in instance and can be caused by human papillomavirus (HPV), says Dr Ho.
Eight in 10 people are infected with this virus at some point in their life and the vast majority won’t suffer long-lasting affects.
However, in some people, the virus triggers changes in the mouth and throat that may become cancerous in the future.
‘It is hoped that in the decades ahead, with HPV immunisation of boys and girls this will change,’ he told MailOnline.
The jab is routinely offered to 12 and 13-year-olds.
Swelling or lumps
Unexplained swellings and lumps around the mouth or jaw can be a sign of cancer.
The lump can appear on the tongue, mouth, lips or gums and may be painful.
Less commonly, cancerous lumps can appear on the salivary glands, tonsils and the pharynx — the part of the throat connecting the mouth to the windpipe.
These lumps can also show as a thickening in the mouth or on the lip, the charity Macmillan warns.
Dr Ho urges anyone who notices these symptoms to visit their dentist or GP, who may refer them for urgent suspected cancer assessments.
Those who are referred this way can expect to be seen within 14 days of referral to exclude or confirm a cancer diagnosis.
Red or white patches
Cancerous changes in the mouth can appear as red or white patches.
Although the patches — which may be tender or painful — are not cancer, they can potentially lead to the disease if left untreated, according to Cancer Research UK.
The white patches, known as leukoplakia, and the red patches, called erythroplakia, should be assessed by a doctor or dentist.
However, seeing the dentist regularly has proven to become increasingly difficult, which experts fear could lead to more mouth cancer deaths.
Since the start of the pandemic there has been an estimate of 40million postponed or cancelled dental appointments.
Dr Ho said: ‘As dentists are best placed in the primary care to assess the mouth, there is genuine concern that difficulty accessing NHS or affordable dental care can and will lead to delayed diagnosis of mouth cancer, leading to poorer treatment outcomes and potentially affecting survival from this disease.’
However, red and white patches can also be caused by a fungal infection called thrush. In this case, the white patches usually rub off, leaving a sore red patch underneath, says Cancer Research UK.
If anti-fungal treatment sees the patches to disappear, they are not linked to cancer.
Overall, 18.1million adults saw their dentist in the two years to June 2023, up from 16.4million in the 24 months to June 2022. But it is still well below the 21million seen in the two years to June 2020
Loose teeth
Wobbly teeth can be a sign of cancer and should not be ignored.
Tumours can cause the teeth to become loose and the tooth socket to struggle to heal properly after extractions, according to the NHS.
Dr Ho explains: ‘When [cancer] invades the jaw bone, it can result in wobbly teeth.
‘In these situations, assessment by a dentist to assess the area of concern and a jaw X-ray can help provide more information.’
However, wobbly teeth can be caused by gum disease, which is common in the general population, according to Dr Ho.
Even if it is not mouth cancer, medics advise those with loose teeth to speak with a doctor or dentist.
Chronic sore throat
A sore throat or hoarseness lasting more than six weeks could be a sign of cancer.
A person’s voice may become huskier or quieter — similar to how it sounds when they have a cold — if they have mouth cancer, according to Cancer Research UK.
This can be a sign of hypopharynx cancer, which affects the back of the throat and potentially the vocal chords.
Swelling in the mouth due to a tumour can also cause a lisp, make it difficult to say particular words or cause slurring.
If the cancer is on the tongue it can also restrict movement and affect speech. This can also cause you to slur certain words or have trouble pronouncing some sounds.
Numbness
Numbness around the mouth or tongue could be a warning sign of mouth cancer.
It may be felt in patchy areas or throughout the mouth and lips and it can feel numb or tingly, says Mouth Cancer Foundation.
This tingling and numbness can happen because the cancer cells cause nerve blood vessel damage in the mouth, experts say.
