Discovering an oral lesion in the patients’ mouth can be a cause of concern and can provoke fear and anxiety in the patient. Diagnosing the lesion requires a thorough medical and dental history, clinical exam including a possible biopsy, as well as asking appropriate pointed questions about the lesion.
In conjunction with the health history and clinical examination, the clinician can ask the following questions to form a clearer picture of the oral lesion and how to manage it.
When did you first notice the lesion and how long has it been present?
- Look for signs of trauma in the oral cavity and relieve them, if possible.
- Ask the patient if they remember how or when the irritation occurred.
Do you have any oral habits or incurred any trauma to the area, recently?
- Often abnormal appearances of oral tissues can be attributed to denture irritation, tobacco or alcohol use, burns from hot liquids/foods, cheek biting or irritation from a broken or sharp tooth edge and chemical burns (aspirin use).
- Rule out the most common or obvious causes.
Have you noticed a change in the shape, size or colour of the lesion?
- Whitish lesions that have changed to a speckled appearance should be evaluated immediately and may suggest malignancy.
- Has the lesion multiplied in number or size from its original state?
Do you have any pain associated with this lesion?
- What causes pain, when does it occur, when does it dissipate?
- Patients are often unaware that oral cancer does not cause pain.
Are you feeling any numbness or loss of sensation?
- Loss of feeling associated with a lesion can be common with malignant lesions.
Have you noticed any swollen lymph nodes?
- Palpation and examination of lymph nodes for tenderness or enlargement can indicate the presence of infection or inflammation
- Lymph node involvement may also be a symptom of oral cancerous conditions
Do you have any other unexplained symptoms?
- Does the patient have a fever, malaise, nausea, difficulty swallowing?
- How long have these symptoms, if any, been present?
Source: Manual of Minor Oral Surgery for the General Dentist, Wiley, 2006