Professor Mike Lewis, Emeritus Professor of Oral Medicine at Cardiff University, is a former dean, past president of key dental societies, internationally published author and lecturer, and serves as both a General Dental Council member and Mouth Cancer Foundation clinical ambassador.

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Mouth cancer continues to be one of the most pressing challenges facing the dental profession. Following a packed session in London, Professor Mike Lewis sat down with us to reflect on why the topic resonates so strongly and what dental teams can do to sharpen their diagnostic confidence.

Why did this year’s session land so powerfully with delegates?

Mike: Mouth cancer is a topic of high interest for all members of the oral healthcare team. A growing awareness of the increasing incidence of mouth cancer and the poor overall five-year survival rate of 50% has highlighted the importance of the subject. Early detection by a dental professional can save a life.

Why is early detection of small, localised tumours so critical?

Mike: The size of the cancer at diagnosis is the single most important factor influencing five-year survival. A tumour under 2cm in diameter with no spread to the neck (Stage 1) can be treated relatively easily and is associated with an 80% five-year survival rate. Larger tumours over 4cm that have spread to the lymph nodes (Stage 4) require far more extensive treatment, impacting on the patient’s quality of life and ultimately resulting in a five-year survival of only 10%.

What clinical presentation patterns are most often overlooked or misinterpreted?

Mike: All dental team members are trained to recognise abnormalities in the mouth and orofacial soft tissues. The challenge arises when there is uncertainty over whether an abnormality represents cancer or a benign condition. Good clinical awareness of tissue changes that strongly suggest malignancy is essential. Misinterpretation of benign conditions and inappropriate urgent suspected cancer (USC) referrals is probably a bigger issue than missing a cancer, but understandably no clinician wishes to risk overlooking one.

Your clinical quiz is always a highlight. Why does this format work so well?

Mike: Including a quiz with high-quality images of malignant and benign tissue changes is critical. It helps clinicians develop the skills needed to decide whether a patient should follow the USC or routine referral pathway.

Were there discussions in London that reflected real-world diagnostic challenges?

Mike: Unfortunately, mouth cancer can present with a wide variety of tissue changes and has no single feature that is universally present. This variability is the main diagnostic challenge. Ultimately, diagnosis relies on biopsy and histopathological examination.

Are you seeing any trends in the abnormalities clinicians are encountering?

Mike: More clinicians are routinely carrying out soft tissue examinations and, as a result, more abnormalities are being identified. Increased uncertainty about the possibility of cancer has led to a rise in USC referrals. Fortunately, 95% of these referrals turn out to be benign. However, the volume of referrals places pressure on secondary care clinics.

How can dental professionals build more confidence in distinguishing higher-risk abnormalities from benign presentations?

Mike: Attendance at live mouth cancer lectures, such as those delivered at the British Dental Conference & Dentistry Show, is invaluable. Seeing real clinical cases of mouth cancer and potentially malignant conditions helps develop essential diagnostic skills. High-quality online education also plays an important role. Supporting the excellent work of the Mouth Cancer Foundation can also help reinforce awareness and encourage professionals to engage more deeply with early detection initiatives.

What developments do you hope to bring to Birmingham next year?

Mike: Dental professionals should feel comfortable raising the topic of mouth cancer with patients. Examination of the orofacial soft tissues should be routine and described openly as a ‘Mouth Cancer Check’. This increases public awareness and may encourage self-examination, helping more cancers be detected at Stage 1. At present, 60% are first diagnosed at Stage 4.

What do you hope delegates will take away from your BDCDS 2026 session?

Mike: Delegates should gain a contemporary awareness of the clinical presentation and detection of mouth cancer. I hope they leave with the confidence to raise the topic with patients and the ability to undertake an effective ‘Mouth Cancer Check’.

Professor Lewis will expand on these themes at BDCDS 2026, where he will continue championing early detection and the vital work of organisations such as the Mouth Cancer Foundation.