What does mouth cancer look like?

From eating and drinking to talking and breathing, you use your mouth constantly. With all that movement, you probably notice when something doesn’t feel right on your tongue, lips, gums or cheeks. 

But what does mouth cancer look like? And when is a growth in your mouth something to worry about?

“Anything out of the ordinary should be shared with your doctor,” says head and neck cancer specialist Neal Akhave, M.D. 

Here, he explains what mouth cancer, also called oral cancer, looks like. Use these insights so you know what to watch for.  

Red or white spots in the mouth could be cancerous

To know what oral cancer looks like, you must first know what a healthy mouth looks like. Akhave points out that the inside of your mouth should be roughly the same color all over. 

“If you notice any abnormal coloring in your mouth, that’s a red flag,” he adds.  

Your care team may use the following medical terms to describe these spots: 

• Leukoplakia: From the Greek word for “white,” leukoplakia are light-colored spots inside the mouth. They can be cancerous or pre-cancerous and may be found on the lining of your gums or your tongue.  

• Erythroplakia: From the Greek word for “red,” these red spots appear on the inner lining of your mouth, tongue or cheeks. 

Akhave suggests getting familiar with what the inside of your mouth looks like, from the roof to under your tongue and from cheek to cheek and along your gums. Cancerous spots may differ depending on their location: 

• Tongue: Look for a lump or ulcer on the top or bottom of the tongue, as well as any discoloration on either side. 

• Cheeks: Watch for small ulcers or tumors, as well as redness or bleeding.

• Salivary glands: Check for bumps on your neck or the outside of the cheeks. These are often found while shaving or washing your face. 

• Gums: Look for redness, bleeding or lumps, especially without any injury to those areas. These can be in the bed of a tooth or on the surface of the gums. 

• Lips: Watch for discoloration, bleeding or bumps on the inside or outside. 

Mouth cancer isn’t usually painful

Although mouth cancer can look like an ulcer or inflamed spot, it usually isn’t painful, especially early on. 

“Tumors in the mouth usually just feel like a bump,” Akhave says. You may also have trouble swallowing if a tumor is deep in the mouth. 

Leukoplakia or erythroplakia anywhere in the mouth may bleed if they’re irritated – but the bleeding isn’t painful either. 

Rather, painful spots in your mouth are often signs of injury or infection. For example, canker sores can be quite painful, but they often go away after about 10 days. 

If you notice anything in your mouth that lasts longer than that, Akhave recommends getting it checked out by a doctor. 

Regular dental exams can screen for mouth cancer

Unfortunately, because mouth cancer doesn’t often cause severe symptoms, it’s often not diagnosed until it’s more advanced. That’s why Akhave stresses the importance of regular dental checkups, which can detect the earliest signs of mouth cancer.  

“Your dentist can take note of any changes they see in your mouth,” he says.  

If there’s anything suspicious, your care team may suggest a biopsy to test for cancer cells. Most cancers found in the mouth are squamous cell carcinoma since squamous cells cover many of the surfaces inside your mouth. 

Reduce your risk of mouth cancer

Tobacco and alcohol use are the most common causes of mouth cancer, so avoiding these products can help reduce your risk.  

Rarely, oral cancers can be caused by the human papillomavirus (HPV), but HPV is the most common cause of tonsil cancer or cancer on the back of the tongue. You should get the HPV vaccine if you are eligible. It’s recommended for everyone ages 9-26. Adults ages 27-45 should talk with their doctor about the potential benefits.

Although regular dental care can help detect oral cancer, Akhave says there’s no clear link between oral hygiene and cancer risk. “We know there are lots of bacteria in our mouths, but we don’t know how or if those bacteria interact with cancer cells.”  

He adds that research is underway to better understand how bacteria affect oral cancers, like the research looking at the gut microbiome’s effect on patients with colorectal cancer. 

“There’s still a lot we don’t know about mouth cancer, but clinical trials are changing that,” Akhave says. 

Request an appointment at MD Anderson online or by calling 1-877-632-6789.