The first time it happens as part of your dental checkup, you might be caught unaware because it definitely feels odd to have somebody tugging on your tongue. It's part of a routine screening for early detection of oral cancer that should be happening every time you visit the dentist. As for many cancers, early detection is key to survival.

The first time it happens as part of your dental checkup, you might be caught unaware because it definitely feels odd to have somebody tugging on your tongue. It's part of a routine screening for early detection of oral cancer that should be happening every time you visit the dentist. As for many cancers, early detection is key to survival.

Medford dentist Dr. Brandon White describes the 90-second physical exam he performs on patients, looking for a lingering sore or a lump that might signal cancer. "There's basically six areas: we check the neck, the floor of the mouth, the lips and the cheeks, the tongue, the roof of the mouth, the back of the mouth, throat and tonsils."

Anyone can get mouth cancer. Risk factors do include family history. Tobacco use in all forms (cigarettes, pipes, chewing tobacco and snuff) is a major cause. "Eighty percent of the people who get oral cancer are tobacco users and people who use both alcohol and tobacco are at highest risk," warns Dr. Keith Ogawa of Eagle Point. "The scary thing is that 20 percent [of those who develop oral cancers] have done neither of those things." And more people under the age of 40 are showing signs of oral cancer.

"Increasingly, oral cancer is becoming more prevalent in younger adults because the human papilloma virus (HPV) is a risk factor," notes Dr. Ogawa. He adds that "oral cancer kills one person every hour in the United States, almost 29,000 people every year."

There are early warning signs of oral cancer. Dr. White ticks them off on his fingers: "A sore in your mouth that won't heal, bleeding in your mouth, loose teeth, difficulty or pain when swallowing, dentures that won't sit down where they belong, a lump in your neck or an earache."

"A fever blister on your lip, or if you bite your tongue, or cut your cheek on a chip — [all of these] will generally heal up within a few weeks," says Dr. White. But if the sore lasts more than a few weeks, you should be concerned that something's going on and get your dentist to check it out.

If your dentist finds something suspicious, you'll need to rule out cancer. The first step would be a brush biopsy to collect surface cells that are examined by a pathologist. "If the cells on the brush are malformed, or cancerous or precancerous, we'll do a formal biopsy on the tissue," explains Dr. White. A surgical biopsy involves snipping out all or part of the lesion for a fuller examination. Treatment may include surgery, radiation therapy or chemotherapy.

Dr. Ogawa stresses that with early detection and treatment, about 80 percent of those who are diagnosed with oral cancer will survive, but only 30 percent of oral cancers are diagnosed in the early stages.

Reduce your risk of oral cancer by avoiding tobacco in all of its forms, especially if you have additional risk factors. Increase your chance for early detection and treatment, and make sure that screening is a routine part of your regular dental checkup. It may feel strange to have someone pull your tongue, but it's for your own good.