Small carcinomas of the oral cavity may be painless or associated only with mild irritation. Such lesions may be discovered as an incidental finding during routine dental examinations. The importance of routine dental examinations, which include rigorous examination of the oral soft tissues cannot be over-emphasised.
Most patients delay seeking professional advice for more than three months after becoming aware of an oral problem. When patients finally seek consultation, the most frequent main complaint is that of a 'sore' or 'irritation' in the mouth. Squamous cell carcinoma of the tongue tends to present as a non-healing ulcer, or as an outgrowth of tissue. Due to movement of the tongue during speech and mastication, pain is a common presenting symptom.
There are a number of oral symptoms of which patients may complain:
- Any white, red or speckled patch
- A non-healing ulcer or sore
- Any lump or thickening
- Persistent soreness or discomfort
- Ulceration of the oral mucosa
- Swelling of any part of the mouth which may cause dentures to fit poorly or become uncomfortable
- Difficulty moving the tongue or jaw
- Difficulty chewing or swallowing
- Numbness of the tongue or other part of the mouth
- A lump under the lower jaw or in the neck
Alteration in normal anatomy or function clearly requires an explanation. Therefore, where there is objective evidence of sensory or motor disturbance, slurring of the speech, or difficulty in chewing, further investigation is warranted.