Worried about oral cancer, brown spots on gums below teeth - I chew tobacco!

Ryan from Pennsylvania asked this question about brown spots he has noticed on his gums.  

Oral cancer is definitely something to be concerned about.  Though it most often occurs on the floor of the mouth and sides of the tongue, it can occur anywhere in the mouth and is more likely for those who chew tobacco.

Ryan's question:

I know that I have gum loss, occasionally my gums get sore from chewing tobacco I have done it for 20 years!

I now notice two recessed brown spots along the gumline where I chew.

I haven't chewed in a couple days and it doesn't hurt very much anymore but I am scared senseless that this is mouth cancer?

I am done chewing.

I quit!  

But I want to know if this is a symptom of oral cancer.

I have no other pain, inflammation, etc. and I've looked over and over but this scares me so much I can barely move!!!

My reply:

Hi Ryan, 

It's great that you have quit! 

You should see definitely your dentist so you can have a definitive answer and quit worrying. 

Any sore or unusual area that doesn't heal in a few days should be checked by your dentist or physician.

Most oral cancer or pre cancerous lesions are white or red.  Melanoma is one exception and can rarely occur in the mouth but most often occurs in sun exposed areas. This article from the Oral Cancer Foundation website explains more about oral melanoma.

Brown spots are most often pigment and are less worrisome than white or red spots but considering your history of chewing tobacco use, getting them checked is important.

The brown color that you are seeing could be stain on your teeth near the gums. It is not unusual for teeth to have brown stain from tobacco products.

The brownish color of the gums in this picture are an example of both pigmented areas and possible stain from tobacco products.

brown spots on gums

Both the teeth and gums are stained and what appears to be dark pigment (a freckle or nevus) on the lower gum area.  Though it is impossible to know what any unusual spots are without a biopsy, dark pigment is  often benign.  

Dark pigmented gum tissue is more common in those with dark pigmented skin.  

If you chew tobacco, it is very wise to keep an eye on your cheek tissue.  Pull your lip down and look in the folds of tissue where you put the tobacco.  If the tissue looks white or red and irritated or has a rough texture compared to the other side.  You should quit putting it in that spot and allow the tissue to heal.  

If it doesn't heal and disappear completely after a week, you should see your dentist to have it evaluated.

This article published by the American Cancer Society explains more about oral cancer.

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