Mouth Cancer Diagnosis: Examination, Biopsy, Scans and What Happens Next

It starts with a dentist or doctor looking inside your mouth and feeling the area, the jaw and the glands in the neck. They ask how long the change has been there, whether it hurts or bleeds, and whether you use tobacco or areca nut. Sometimes the cause is plain, such as a broken tooth, and the first step is to remove it and look again after a short interval.

An examination can show whether a change is doubtful, but it cannot say what it is. That takes a sample, which is why you may be referred even when nobody is sure there is a problem. Our guide on what a dentist can do explains this stage.

A biopsy is the only way to confirm mouth cancer or rule it out. A small piece of the affected tissue is taken, usually under local anaesthetic so the area is numb, and sent to a pathologist who looks at it under a microscope. Results usually take some days, and you will be told how and when you will hear.

Many people fear a biopsy. It is a routine, brief procedure, and being asked to have one does not mean the result will be bad. It is also how the harmless causes of a persistent sore, such as the ones in our guide on the difference between a mouth ulcer and cancer, are separated from the rare one.

If a biopsy shows cancer, scans such as CT, MRI or PET may be used to see how far it has gone, and whether the glands in the neck are involved. These are done to plan treatment, not to make the diagnosis.

Treatment is planned by a team of head and neck surgeons, oral and maxillofacial surgeons and oncologists, who explain the options to you. A dental check beforehand is often part of that planning.

The most useful thing you can do is go to every appointment promptly after a referral. Waiting for a sore to settle before getting it tested only delays an answer, and the answer is often reassuring. For the signs that should start the process, see our guide on mouth cancer first stage.