Oral ulcers are the most common oral mucosal disease in dentistry, with a very high incidence rate both domestically and internationally. Statistics show that one in five people has experienced at least one episode of oral ulceration. However, under specific circumstances, a small percentage of oral ulcers may undergo malignant transformation, potentially leading to oral cancer.Oral cancer refers to malignant tumors occurring in the oral cavity, with most cases being squamous cell carcinoma—essentially, a mutation of the mucosal cells.
Data reveals that over the past 40 years in China, the incidence of oral cancer has shown an upward trend. The prevalence rate has surged dramatically from 8 cases per million people annually in the past to 20 cases per million people annually today, with nearly 20,000 deaths attributed to oral cancer each year.Early-stage oral cancer may present as oral mucosal ulcers or lumps. Once oral cancer progresses to advanced stages, the chances of cure are extremely low. So, can common oral ulcers develop into oral cancer? How can oral cancer be detected early? What are the high-risk factors for oral cancer? 39 Health has invited Professor Li Jinsong, Chief Physician of the Department of Stomatology at Sun Yat-sen Memorial Hospital, Sun Yat-sen University, to explain the early detection and prevention of oral cancer.
Oral ulcers persisting beyond one month warrant vigilance for cancerous changes
Generally, oral ulcers do not progress to oral cancer. However, if an ulcer recurs in the same location and fails to heal within a month, it may indicate potential cancerous changes. "Early symptoms of oral cancer include pain and the formation of hard lumps at the ulcer site," explains Professor Li Jinsong.
Beyond pain and hard lumps, early oral cancer symptoms include tongue numbness, restricted tongue movement, and oral bleeding. If left untreated until the intermediate stage, cancer cells may locally infiltrate upward into the tongue body and adjacent oral tissues, causing tissue adhesions, impaired tongue movement, pain, and invasion of surrounding oral structures—leading to symptoms like numbness and pain.Advanced oral cancer can metastasize to lymph nodes, causing swelling and metastasis in the neck lymph nodes.
"Drinking herbal tea cures oral ulcers" is a major misconception.
Oral ulcers fall into several categories, primarily three types: recurrent aphthous stomatitis, herpes simplex, and cancerous ulcers.Many people mistakenly attribute persistent oral ulcers to "internal heat" when they fail to heal. Professor Li Jinsong points out that Guangdong residents often broadly define oral ulcers as "heat" and self-medicate with herbal teas or traditional Chinese medicine to "reduce heat." This is a significant misconception. When oral ulcers persist for extended periods without healing, there is a risk of malignant transformation. Due to neglect, oral cancer can progress to the middle or late stages.
A critical timeframe exists for oral cancer: If an ulcer persists in the same location for over four weeks (one month), or if the ulcer feels soft or hard upon touch, seek prompt examination at a specialized hospital for oral screening or precancerous diagnosis.
Smoking and alcohol consumption are major risk factors for oral cancer.
According to the World Health Organization, individuals who smoke and drink heavily over extended periods, regularly consume irritating foods, suffer from chronic oral inflammation, or have oral mucosal diseases are high-risk groups targeted by oral cancer.
Professor Li Jinsong explains: "Additionally, dental caries—commonly known as cavities—can become a major cause of oral cancer. Their sharp edges repeatedly irritate tissues, leading to chronic inflammation or even malignant transformation." Oral leukoplakia is now recognized as a "precancerous lesion." Poorly fitted dental restorations and recurrent ulcers also irritate oral mucosa, posing a certain risk of cancerous changes.
Finally, Professor Li Jinsong urged the public to prioritize oral hygiene and cleanliness in daily life. Maintaining good oral hygiene habits is key to preventing oral cancer. He recommended eating more fruits and vegetables while avoiding fried, greasy, excessively hot, and other irritating foods. He emphasized avoiding smoking and alcohol consumption, advising current smokers to reduce intake or quit entirely. Additionally, he suggested supplementing with B vitamins and vitamin C as appropriate.