Mouth Cancer Referral GUIDELINES for dentists

Question 1

What are the 3 types of referrals?

Answer 1

• Urgent (within 2 weeks)
• Prompt
• non-urgent

Question 2

Give examples of lesions that will require an urgent referral

Answer 2

• unexplained oral ulceration or mass persisting for more than 3 weeks
• unexplained red or white patches that are painful, swollen or bleeding (if not painful swollen or bleeding then referral can be made non-urgently)
• unexplained one sided pain in the head and neck area for more than 4 weeks, associatedw ith ear ache but with a normal otoscopy
• unexplained recent lump in the neck or previously undiagnosed lump that has changed over a period of 3-6 weeks
• unexplained persistent sore or painful throat
• signs and symptoms in the oral cavity presisting for mor than 6 weeks that cannot be definitively diagnosed as a benign lesion
• unexplained tooth mobility persisting for more than 3 weeks that cannot be attributed to a dental cause
• hoarseness persisting for more than 3 wees especially in smokers aged over 50 and heavy drinkers

Question 3

How would you refer a hoarseness persisting for more than 3 wees especially in smokers aged over 50 and heavy drinkers ?

Answer 3

• chest x ray
• if positive refer urgently to a team specialising in lung cancer
• if negative refer to a team specialising in head and neck cancer

Question 4

Who can urgent referrals made to?

Answer 4

• local maxillofacial surgery
• oral medicine
• oral surgery
• plastic surgery unit

Question 5

How can urgent referrals be made?

Answer 5

• telephone
• fax
• filling out a 2WW (2 week wait form)

Question 6

Give examples of lesions that require prompt referrals

Answer 6

• Lichen planus
• white patches with no redness or ulcerations
• chronic hyperplastic candidiasis/pseudomembranous candidosis
• oral submucous fibrosis
• painful traumatic ulcers
• recent unilater salivary gland swellings
• mucocitis

Question 7

Give examples of lesions that require non-urgent referrals

Answer 7

• polyps
• mucoceles
• pyogenic granulomas
• areas of lichenoid reactions
• amalgam tattoos
• recurrent oral ulcers

Question 8

How are prompt and non-urgent referrals made?

Answer 8

• written referral to a specialist unit