A mouth ulcer, white patch or red patch that has not healed within about two to three weeks after removing any obvious cause should be referred for assessment and biopsy. Red patches carry more risk than white ones. Risk is highest with tobacco in any form, areca nut, alcohol, and in older adults. Induration, fixation, unexplained loose teeth or a neck lump add urgency.
- Persistent ulcer, leukoplakia or erythroplakia beyond about three weeks: refer.
- Ask about smokeless tobacco, gutka and areca nut, not only cigarettes.
- Feel the lesion — induration or fixation raises concern.
- Examine the neck for lymph nodes in anyone with an oral lesion.
Why it matters
Oral cancer is common in India and is still too often found late.
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