I'm a 34 year old male. I have a small (maybe .5 CM) white rough / raised area inside my mouth on my cheek, towards the back of my mouth. It blanches when I press on it. I wouldn't say it's a hard bump - more of a slightly raised area than an actual bump and when looking at it it doesn't appear like a bump rather it feels that way. It is along - slightly above my bite line but to my knowledge I dont bite my cheeks. I first felt it with my tongue, randomly a little over 4 weeks ago. After it didn't go away after two weeks, I called and made an appointment with my dentist to have him look at it and that appointment is early next week. I know there isn't anything else I can do about it now but by that time, it will have been five weeks since I first felt it. Everything I read says when you have a nonhealing sore (even though it isnt actually sore) for more than 2 weeks to get it checked but by the time I made my appointment and was able to get seen over a month will have passed.

There is no pain at all, no soreness, no bleeding and it hasn't gotten any larger or smaller from what I can tell over the last 4 weeks. It's just stayed the same with no noticeable change. Given the length of time it's been so far, it has me slightly worried. Thinking the worst, if it were to be an oral cancer, would this still be considered "catching it early?". It makes me feel somewhat better knowing there is no pain and it doesnt appear to be growing but anxious at the same time because it isn't going away.

Given all of this, is my general dentist the best first option to take a look at this? If he wants it to be biopsied than I assume I'll have to make an appointment with an oral surgeon which means waiting more time for an appointment. I've come to learn from my limited research, how valuable time is when it comes to oral cancer. Is there anything else I should be doing?

Also, can lichen planus show as a small patch rather than white lines? Are there other benign conditions that would appear white and not go away with time?

Thanks so much!

Hi, welcome to the forum.

I believe you have taken an important first step, which is to get an appointment with your dentist to look at the area. Like you said, it is possible that your doctor will refer you to an ENT to have it biopsied. Or, it may be nothing you need to worry about. Here we are just patients and caregivers who have gone through or are going through the treatment process. We are not medical professionals and do not have the training to diagnose (you wouldn't want us to do that anyway). I know it is worrying when something does not seem to be right but it would not help matters if you spend the next week or so worrying. Hang in there until you have your doctor's opinion. In the meantime, focus on the positives in your life and not the scary thoughts.

Welcome to OCF, NIL82ball!

There are many different noncancerous lesions that someone can have in their mouth. Just seeing whats on the surface does not necessarily mean its that size. More could be beneath the "spot". Hopefully, this "spot" is nothing serious and you wont need our site. If it would be cancerous then you are in the very best place for up to date and correct medical info and support.

Are you able to skip the dentist and make an appointment with an ENT? Some insurances require a referral so make certain you wont need one if you cancel your upcoming dentist appointment. Many dentists have gone their entire careers without ever seeing someone with oral cancer. Sadly, many dentists do not even do oral cancer screenings. You may need a biopsy to help determine exactly what the spot is.

You sound like a very logical type of person. Try to keep yourself extra busy with things that hold your attention and require concentration. This will help you from worrying too much. You do not need any extra stress right now so avoiding going there is the best aid to being less stressed. No matter if its caught early or late, it still needs professional attention (of course that is IF its cancerous) to find out what it is and make a game plan to eliminate it. Not all cancerous lesions hurt or bleed which is why many arent found until its been there for a long time. You are only waiting a few weeks from the date you originally found the spot to getting it checked. For most patients, that amount of time isnt enough to make a big difference is growth. Ive been here for 9 years and have seen lots of patients come and go, some who didnt have much of a chance are now thriving. So you see, you just never know what the future holds.

Hang in there and please keep us updated.

Thank you! I really appreciate your comments.

I'm not sure if I can just skip the dentist and go right to the ENT. That's an interesting thought and one that didn't even cross my mind. At this point, my appointment with the dentist is Monday so I suspect having that first and then going from there is probably the best course of action?

Assuming there is a need for a biopsy, is an ENT the best option versus an Oral Surgeon?

Lastly, is there any benefit to me making an appointment with an ENT today just to get on the schedule - knowing they are likely busy and if the dentist isnt concerned I can always cancel it plus that would give me time to check with my insurance on a referral? I've gone to the ENT in the past and just made an appointment directly without being referred in and it was covered - not sure if that would be the same here.

Thanks again!

Ive had biopsies done by both an ENT and an oral surgeon. For insurance purposes a biopsy and OC are medical not dental. Call your insurance company and find out what your best option would be. Just make sure you find an ENT that specializes in OC patients and not the type that primarily puts tubes in kids ears. If you are going to an oral surgeon, same thing. You want one who treats OC patients and not just TMJ or removing wisdom teeth. And yes, ENTs can get backed up with appointments. Since you are already an established patient and because of the nature of your office visit you shouldnt have to wait too long for an appointment with your ENT.

My concern or seeing a dentist is what I stated in my previous post. In my opinion, seeing a dentist seems like an extra step in getting the sore checked by the right person. Many dentists have not even encountered OC in their day to day exams and fillings, they focus on the teeth and tend to ignore the surrounding tissue in the patients mouth. Putting it another way... I wouldnt want a small engine mechanic who fixes my lawn mower changing the brakes on my car. They simply arent qualified for the job. Most dentists also do not preform biopsies but a very small percentage will do them.

Main OCF site --- Diagnosis/Discovery

Hope this helps!

Thank you again - very helpful.

So then, based on your comments regarding a dentist - which make perfect sense - if my dentist looks at the spot and isn't concerned, would you still go have an ENT or Oral Surgeon who specializes in OC take a look at it?

Is there a resource for finding what ENT's out there do just that or is it simply a matter of just asking them the question?

Thanks!

Absolutely!!!

Not all dentists do continuing education like doctors. Thats why many who have gone thru dental school where they only briefly touched on diseases of the mouth tissue. Dentists primarily look at teeth and ignore everything else. Only in recent years (much thanks to OCF's efforts) has attention been paid to even do an OC screening. I dont mean to sound negative about dentists Ive just seen far too many patients come to OCF because their dentist never noticed something in their mouths for years and now its Stage IV. This is why I am cautious about telling OCF members to see their dentist. Please dont overthink what I just said and dont put yourself into that category!!!! You are aware of the spot and have paid close attention to any changes which makes you a strong advocate for yourself. Im still hoping what you have going on is nothing serious and will somehow resolve itself.

Good luck!!!!

Again - thank you! This is really insightful and helpful to me.

I just called and made an appointment with the ENT. Unfortunately they aren't able to see me until September 7th, unless there is a cancellation. I am going to keep my appointment with my dentist for Monday - I have no idea what his training and background is with oral cancer but he seems good and thorough and does always do an oral cancer screen at my 6 month cleaning visits.

I'm still concerned that by September 7th, it will have been 7+ weeks since I first noticed the growth / spot. It makes me feel like thats a really long time and if it is something bad, I'm missing the boat on getting rid of it sooner.

I have no idea if another ENT would be able to see me any sooner but if you were me would you look for another and try to get seen more quickly?

It's going to be tough to find someone on a Friday afternoon. If I were you, I'd keep the September 7th appointment, & just go see the dentist on Monday. If he or she sees something of potential concern, maybe they can help escalate your case or suggest an alternate ENT that might be able to see you in a shorter timeframe.

I suggest calling the ENT next week and asking to be put on the cancellation list. Its fairly common to get bumped up when another patient cancels.

I agree with keeping your upcoming dental appointment. Your dentist sounds competent which is great to hear. Im very glad they do the OC screenings!!! If anything appear "off" ask your dentist to make a phone call to your ENT. That phone call could expedite your appointment as most doctors always will squeeze someone in who really is in need. Honestly waiting until Sept 7th isnt too bad. Its only a couple weeks and it shouldnt make much of a difference in your sore.

I should have asked you a couple questions before. If you use Listerine, stop using it. Any strong mouthwash that has alcohol in it should be avoided. I would also advise you to avoid alcoholic drinks and any tobacco use (even cigars, pipes, e-cigs, etc). Basically Im saying to avoid anything that will irritate your mouth. At your dental appointment ask your dentist what is the best mouth rinse to use when you have a sore in your mouth. Ive been using prescription peridex since I was diagnosed with OC in 2007. Its a little strong for me so I mix it with water but it still works great for me.

Good luck

I had my dentist appointment this morning and it seemed to go relatively well. He gave the area a good look with his light, magnifying glasses and a gloved finger. Here are some of the things he shared:

• After inspection, he believes it to be a fibroma. He even noticed an area of my wisdom tooth (I still have mine!) where when biting down, the area appears to rub against the tooth.
• He said it has a “rubbery” texture to it.
• On appearance, it doesn’t have common pathologic characteristics.
• It measured 2.5mm
• He is “95% certain” it’s “nothing” and he doesn’t think it’s something I should worry about given what he saw.

All that said, he commented that the only way to know for sure is to have it looked at by an ENT or oral Surgeon and likely biopsied. He encouraged me to do that but also reiterated he didn’t want me to worry.

I certainly trust my dentist and his ability to look closer at the area than I can with my own eyes – more than I truest myself – but I also know there are many times where things were missed here. I made an appointment with an ENT I found for Wednesday which can’t come soon enough.

From my limited “research” on oral fibromas, most appear to be round and the color of the cheek. Does anyone know if it’s common for one to be white, at least on the surface?
Should the 2.5mm size give me any assurance that if it were cancerous, I likely caught it early?

It sounds like your dentist did a good job and helped to ease your mind. Im very sorry an exact diagnosis wasnt possible. Your dentist is correct, only a biopsy will determine exactly whats going on. Thats why I suggested to head right to the ENT, so a biopsy could be taken.

Remember, our site consists of OC patients/survivors and caregivers not medical professionals or anyone with a medical background. My knowledge is mainly about oral cancer and not so much about other mouth conditions (like what your dentist mentioned).

As far as the surface measurement goes, Im very sorry but thats not possible to answer either. The size you see may or may not be a true reflection of how big the spot really is as what lies under the surface could be very different than what visible on top. It could be like an iceberg (huge underneath the surface) or it could be the same as what you see. Only a doctor thru either a CT or MRI would be able to determine the exact size or the lesion.

You are on the right path. It takes time to get a complete diagnosis. In my opinion, its unlikely anything has significantly changed since the sore was first discovered. Staying super busy will help the time pass until you find out what your lesion is.

Hang in there!!!

Thank you, I appreciate your kind words. Honestly, I knew heading in today I wasnt going to have a definitive diagnosis but thought it couldn't hurt to have the dentist take a look while I wait for the ENT appointment.

I should be feeling better about things given his confidence that it didn't appear sinister but I don't. Probably because I know there will be a biopsy then more waiting.

Anyway I appreciate all the comments. I know many of the people reading this are dealing with much more serious problems and its not my intent to overshadow that with my own worry.

I was able to get in to see an ENT sooner. I found him online, in my area, accepted my insurance and was with a large medical practice group - seemed reputable, qualified and stated that "oral pathology" was one of his specialties.

I sat in the chair, he asked me to open my mouth so he could take a look. Immediately he kind of did a half laugh and said "is this here waht you're worried about? I can barely even see anything". I then explained to him where it was, how my dentist wasnt concerned but thought I should have an ENT take a look as well as a second opinion. He said it was absolutely nothing to be concerned about, it wasnt cancer and that it was traume related. I feel like he looked for now more than 10-15 seconds at most. I asked him if he was confident in that without doing a biopsy and he kind of laughed again and said yes that wasnt necessary. Honestly, it made me feel like an idiot even being there!

Based on that should I go see another ENT or perhaps an oral surgeon? Or let it go because two, I presume qualified people have looked at it and told me it was "nothing"? I don't want to be paranoid about it and want to trust them but at the same time the white area / spot is still there. No change in size and no symptoms.

Thats not an easy decision. If you feel comfortable in the results of your 2 appointments then relax and go on with your regular life. But... if you still feel anxious about the "spot" then yes, absolutely seek another qualified physicians opinion. Its always better to play it safe than look back and have regrets. One more cant hurt anything. At the same time at what point will you be satisfied your spot is really is exactly what the doctors described? You definitely have a difficult decision to make!!!

I think if it were me and knowing what I do about OC, I would try one more specialist and then let it go if they say the same thing. OC does not always hurt or show symptoms which is why its often not discovered until its later stages. If you choose to try another doc, I advise you to not say a word about being seen by any other doctors. You want to get a completely independent exam and opinion without any preconceived ideas about what the spot is. I would then ask if the doctor if they were 100% sure of what the spot is. If so, are they willing to put it in writing and if not insist on a biopsy.

Im very sorry if my answer was as clear as mud!!!

Thanks for helping everyone ChristineB.