Short answer: Gum cancer is the form of oral cancer that develops in the gums, and it is usually a squamous cell carcinoma. The most important risk factors are tobacco and alcohol use. A sore that does not heal within two to three weeks, a white or red patch, unexplained swelling, bleeding and loose teeth are signs to watch for. A definitive diagnosis is made by biopsy; treatment can include surgery, radiation therapy and drug therapies.
Gum cancer is the form of oral cancer that appears in the gums, and the vast majority are squamous cell carcinomas that develop from the surface cells lining the inside of the mouth. Because its early signs can often be confused with gum inflammation, a denture sore or a simple canker sore, it may be noticed late. Yet in oral cancers, early diagnosis significantly affects treatment options and outcomes. In this article we provide general information about the symptoms of gum cancer, its risk factors, the diagnostic process and treatment options; this information is not a substitute for a diagnosis.
What is gum cancer?
Gum cancer is the uncontrolled growth of cells in the tissues that make up the gums, forming a malignant tissue, and it belongs to the group of oral cavity cancers. Oral cancers can occur on the tongue, the floor of the mouth, the inside of the cheeks, the palate, the lips and the gums. Because tumors that develop in the gums are close to the underlying jawbone, they can also affect the bone as they progress; this can lead to signs such as loose teeth.
Oral cancers are generally more common in middle and older age; however, depending on risk factors, they can also appear at younger ages. The vast majority of lesions seen in the mouth are benign. Even so, some white or red patches may contain changes that can be precancerous and need to be monitored.
Risk factors
The most important risk factors for oral and gum cancer are any form of tobacco use and alcohol consumption; using the two together significantly increases the risk.
- Tobacco products: Cigarettes, cigars, pipes, hookah (water pipe) and smokeless tobacco products directly damage the tissues of the mouth. The risk of lesions increases in the gum and cheek area where smokeless tobacco is held.
- Alcohol: Regular, heavy alcohol consumption is an independent risk factor; combined with tobacco, its effect is multiplied.
- Chewing betel and areca nut: This habit, common in some regions, is a significant risk factor.
- HPV infection: Certain types of HPV in particular are associated with oropharyngeal cancers, which mostly involve the base of the tongue and the tonsil area.
- Older age
- A suppressed immune system: Medications used after organ transplants or diseases that weaken immunity can increase the risk.
- Sunlight: Prolonged unprotected sun exposure is a risk especially for lip cancer.
- Diet: A diet low in vegetables and fruit has been associated with risk.
- Chronic irritation: Constant rubbing of broken tooth edges or ill-fitting dentures against the same area is not considered a strong cause on its own, but it is among the factors being studied, and it is recommended that such sources of irritation be eliminated.
Having a risk factor does not mean that cancer will develop; cancer can also occur in people without risk factors. That is why paying attention to changes in the mouth is important for everyone.
Early symptoms
Early symptoms of gum cancer include a sore that does not heal within two to three weeks, a white or red patch on the gum, unexplained swelling or thickening, bleeding and unexplained loosening of the teeth. Most of these symptoms can also have other, simpler causes; however, any change that does not go away should always be evaluated by a doctor or dentist.
- A sore on the gum or inside the mouth that does not heal within two to three weeks
- White patches that cannot be wiped off (leukoplakia) or red, velvety patches (erythroplakia)
- Thickening, hardness, a bump or a growth with an irregular surface on the gum
- Unexplained bleeding, either with brushing or on its own
- Loosening or shifting of teeth without gum disease
- An extraction site that does not heal after a tooth is removed
- A denture that used to fit suddenly no longer fitting
- Numbness in the lip, chin or tongue
- Difficulty chewing, swallowing or speaking
- A lump in the neck that can be felt and does not go away
In the early stages, pain is usually not pronounced. The absence of pain does not mean that a lesion is insignificant. Once a month, checking your lips, gums, the inside of your cheeks, the top and sides of your tongue and the floor of your mouth in a mirror under good light can help you notice changes early.
Diagnosis
A definitive diagnosis of gum cancer is made by biopsy, in which a tissue sample taken from the suspicious area is examined under a microscope; examination and imaging methods support this process.
- Oral examination: During routine checkups, the dentist examines all the soft tissues in the mouth. The size, color, texture and borders of a suspicious lesion are assessed, and the lymph nodes in the neck are examined by hand.
- Monitoring or referral: If a sore is thought to be caused by irritation, the cause can be removed and the area rechecked shortly afterward. If the lesion does not heal or has suspicious features, a referral is made to oral and maxillofacial surgery, ear, nose and throat (ENT) or the relevant specialty.
- Biopsy: Under local anesthesia, a small tissue sample is taken from the lesion for pathological examination.
- Imaging: Once a diagnosis is made, tests such as X-rays, CT, MRI or PET may be requested to determine how far the disease has spread.
This process makes it possible to determine the stage of the disease so that the treatment most suitable for the person can be planned.
Treatment options
Treatment of gum cancer is planned using surgery, radiation therapy and drug therapies alone or in combination, depending on the size and spread of the tumor, whether the bone is affected and the person's general health. Treatment is carried out by teams in which specialties such as head and neck surgery, radiation oncology and medical oncology work together.
- Surgery: The tumor is removed along with a margin of surrounding healthy tissue. If the jawbone is affected, part of the bone may need to be removed, followed by reconstruction. The lymph nodes in the neck are also evaluated.
- Radiation therapy: It can be given on its own or as additional treatment after surgery.
- Drug therapies: Chemotherapy, targeted therapies and immunotherapies may be part of the plan depending on the stage of the disease.
- Rehabilitation: Supportive therapies and prosthetic rehabilitation can be provided to help regain speech, swallowing and chewing functions.
The dentist's role
For patients scheduled for radiation therapy to the head and neck area, it is important to evaluate oral and dental health and complete any necessary dental treatment before therapy begins. After radiation therapy, dry mouth, an increased risk of cavities and healing problems in the jawbone may occur. For this reason, regular follow-up with a dentist during and after treatment is maintained in line with the oncology team's recommendations.
The importance of prevention and regular checkups
The most effective ways to reduce the risk of oral cancer are not using tobacco, limiting alcohol, protecting your lips from the sun, eating a diet rich in vegetables and fruit, and going for regular dental checkups. Routine examinations are an opportunity to evaluate not only the teeth but all the soft tissues of the mouth. Eliminating sources of chronic irritation, such as broken tooth edges or ill-fitting dentures, is also recommended. For other topics you may be curious about, you can visit our frequently asked questions page.
What should you do if there is a change in your mouth that won't go away?
If you have noticed a sore, a color change or swelling that has not healed within two to three weeks, it is advisable to show it to a dentist without delay. At our polyclinic in Park Oran Ofis in Oran, Çankaya, an examination of the soft tissues of the mouth is carried out; when deemed necessary, a referral to the relevant specialty is arranged. To make an appointment, you can contact us.
Frequently asked questions
Does gum cancer cause pain?
In the early stages there is often no noticeable pain. For this reason, the absence of pain does not mean a lesion is insignificant. Any change that does not heal within two to three weeks should be evaluated by a doctor or dentist.
Is a white patch in the mouth cancer?
The vast majority of white patches in the mouth are benign and can be caused by things such as irritation or a fungal infection. However, white patches that cannot be wiped off and do not go away should be examined, and a biopsy performed if necessary, because they may contain precancerous changes.
How is gum cancer diagnosed?
A definitive diagnosis is made through pathological examination of a tissue sample taken from the suspicious area, that is, by biopsy. Once a diagnosis is made, various imaging methods can be used to determine how far the disease has spread.
Is it possible to prevent gum cancer?
To reduce the risk, it is recommended not to use tobacco, to limit alcohol, to protect your lips from the sun and to eat a diet rich in vegetables and fruit. Regular dental checkups help detect changes in the mouth early.
