Risk Factors for Mouth Cancer and How to Reduce it.

Know the signs and be proactive to allow for early diagnosis and treatable disease.


“Historically the death rate associated with this cancer is particularly high not because it is hard to discover or diagnose, but due to the cancer being routinely discovered late in its development.” - oralcancerfoundation.org/facts

Cancer can develop in any of the parts that make up the mouth, also called the oral cavity. Mouth cancers can occur on the lips, gums, tongue, inside lining of the cheeks, the small area of the gum behind the wisdom teeth, as well as the roof and floor of the mouth.

Tobacco and excess alcohol consumption are two of the biggest risk factors of mouth cancer. People who use both tobacco and alcohol are at greater risk of developing these cancers than people who use either tobacco or alcohol alone. Smoke from cigarettes, pipes, and cigars all increase the risk of getting these cancers. Some studies have also found that long-term exposure to second hand smoke might increase the risk of these cancers. Pipe smoking is linked to a very high risk for cancer in the part of the lips that touch the pipe stem. Oral tobacco products such as snuff and dip are linked with cancers of the cheek, gums, and inner surface of the lips. Using oral tobacco products for a long time is linked to a very high risk. These products also cause gum disease, dental caries, destruction of the bone around teeth, and tooth loss.


Alcohol abuse (Please see the blog on alcohol and cancer risk) is the second largest risk factor for the development of oral cancer. Alcohol works with tobacco to increase the risk of developing cancer. The dehydrating effect of alcohol on mouth cells enhances the ability of tobacco carcinogens to permeate mouth tissues; and alcohol abuse causes nutritional deficiencies that can lower the body’s natural ability to use antioxidants to prevent the formation of cancers.


“Oral cancer happens only to smokers and alcohol drinkers.” No, about 25% of oral cancers occur in people with no history of tobacco or alcohol use.

Infection with certain types of HPV or the human papillomavirus (Please read the blog on viruses and cancer risk) can cause some forms of mouth cancers, especially in the back of the throat. HPV type 16 (HPV16) is the type most often linked to cancer of the mouth and throat, especially those in the tonsil and base of tongue. The human papillomavirus (HPV) is predicted to become the leading cause of mouth cancer in the coming years due to its ability to be transmitted via oral sex. HPV is thought to cause 70% of oropharyngeal cancers in the United States.

“Oral cancer occurs only in the elderly.” Although the risk of oral cancer increases with age, it can occur at any age and seems to be increasing in patients less than 40 years of age.

Oral cavity and oropharyngeal cancers are twice as common in men than in women. Cancers of the oral cavity and oropharynx usually take many years to develop, so they're not common in young people. Most patients with these cancers are older than 55 years when the cancers are first found. HPV-linked cancers however tend to be diagnosed in people younger than 50 years of age. Cancers of the lip are more common in people who have outdoor jobs where they are exposed to sunlight for long periods of time. Other less common risk factors for mouth cancer include a diet low in fruits and vegetables, a weakened immune system and certain genetic syndromes, such as Fanconi anemia.

Here are the signs and symptoms that you should watch out for. Make it a habit to look out for these signs as you brush your teeth daily. If you see any of these signs, immediately reach out to your dentist or physician for further evaluation:

  • An ulcer or sore that does not heal within 2-3 weeks

  • A red, white, or black discoloration on the inner parts of your mouth

  • Difficult or painful swallowing. A sensation that things are sticking in the throat when swallowing

  • A swollen but painless tonsil. When looking in the mouth, tonsils on both sides should usually be symmetrical in size

  • Pain when chewing

  • A persistent sore throat or hoarse voice

  • A swelling or lump in the mouth

  • A painless lump felt on the outside of the neck, which has been there for at least two weeks.

  • A numb feeling in the mouth or lips

  • Constant coughing

  • An earache on one side (unilateral) that persists for more than a few days.


A few things you can actively do to lower your risk of oral cancers:

  • Quit smoking and chewing tobacco.

  • Lower your alcohol intake or if possible stop drinking alcohol.

  • When used consistently and correctly, condoms and dental dams can lower the chance that HPV is passed from one person to another and thus lower risk of some types of oral cancers.

  • Get HPV vaccine for males and females - (2 doses, 6 to 12 months apart starting at age 11 or 12 years. Vaccination is recommended for everyone through 26 years of age if not adequately vaccinated when younger.

  • Do not use tanning beds and avoid extended periods of time in the sun, remembering to protect your lips along with your skin.

  • Schedule regular check-ups with your dentist, particularly if you do use tobacco or drink heavily. Many mouth cancers are found during routine dental check-ups.

  • Maintain a healthy diet with lots of fresh fruits and vegetables that are powerful antioxidants and important in cancer prevention.

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Reason to Hope

There is new research from Brigham and Women’s Hospital that indicates a Western-style diet that is rich in red and processed meat, sugar and refined grains/carbohydrates is tied to higher risk of colorectal cancer through the intestinal microbiota.  Gastroenterology, 2022;DOI:10.1053/j.gastro.2022.06.054