Mouth sores and biopsies
Most mouth ulcers, patches and lumps are harmless and heal or stay the same. A few need a closer look. Mouth cancer is much easier to treat when it is found early, and your dentist is often the first to notice a change. These are the questions we are asked most often.
Looking for an overview, fees and locations? See our Oral Pathology & Biopsy page.
Mouth sores, patches and lumps
When should I get a mouth sore checked?
Use the three-week rule. Any ulcer, lump, or red or white patch that has not healed three weeks after removing an obvious cause (such as a sharp tooth, a rubbing denture or a cheek-biting habit) should be seen by your dentist or doctor, who may refer you for a biopsy.
Which signs need attention without waiting?
- An ulcer with raised, rolled or hard edges
- A red patch, or a speckled red-and-white patch
- A lump in the mouth or lip that is fixed or growing
- Numbness of the lip or tongue without a clear cause
- A loose tooth or a tooth socket that will not heal, without a clear cause
- A lump in the neck that does not go away
See your dentist or GP promptly if you notice any of these.
Who is at risk of mouth cancer?
Smoking and alcohol are the main risk factors, and together they multiply each other’s effect. But mouth cancer also occurs in people who have never smoked and in younger adults, particularly on the side of the tongue. Having no risk factors is not a reason to delay getting a sore checked.
What do white or red patches mean?
Some patches have a higher chance of turning into cancer over time and are called potentially malignant disorders. Studies that pooled results over many years found that the chance varies a lot by type:
| Type of patch | Reported chance of becoming cancer over time |
|---|---|
| Proliferative verrucous leukoplakia (multiple white patches that keep coming back) | about 50% |
| Erythroplakia (red patch) | about 33% |
| Leukoplakia (white patch) | about 10% |
| Oral lichenoid lesion | about 4% |
| Oral lichen planus | about 1.4% |
These figures come from studies with different definitions and follow-up times, so they show which patches carry more risk rather than predicting what will happen to any one person. Regular checks and a biopsy when something changes make the biggest difference.
Which lumps and marks are usually harmless?
Common examples include a small soft lump from cheek biting (fibroepithelial polyp), a fluid-filled blister on the lower lip (mucocele), a grey-blue mark next to a silver filling (amalgam tattoo), a hard bony lump on the palate or inside the lower jaw (torus), and mouth ulcers that heal within two weeks. Your dentist can confirm these, and they may not need a biopsy.
Having a biopsy
What is a biopsy?
A biopsy is a small sample of tissue that a pathologist examines under a microscope to give a diagnosis. For a large or concerning area we take a small sample from the most abnormal part (an incisional biopsy). For a small lesion that looks harmless, we usually remove the whole thing (an excisional biopsy), which often treats it at the same time.
Will I be awake?
Usually, yes. Three-quarters of the biopsies we perform are done under local anaesthetic in our rooms. Larger or multiple lesions, jaw cysts, or biopsies combined with other surgery may be done under general anaesthetic in a private hospital.
Can a brush test or special light replace a biopsy?
No. These tools can help with monitoring, but they cannot give a diagnosis. Only a tissue sample can.
What happens after the results come back?
| Result | What happens next |
|---|---|
| Benign (not cancer) | We explain the result to you and send a report to your dentist. Most need no further treatment. |
| Potentially malignant, with or without dysplasia (abnormal cells) | Removal or regular monitoring depending on the type and site, with a shared plan with your dentist and support to reduce risk factors such as smoking. |
| Cancer | Prompt referral to a specialist head and neck cancer team, following the Australian optimal care pathway. We keep you and your dentist informed. |
If you are diagnosed with a potentially malignant disorder, you will need regular check-ups for life, with photos at each visit so any change is picked up early.
Our results
What do your biopsies usually show?
From September 2023 to October 2026, Dr Jaunay performed 109 biopsies for 108 patients, with an average age of 51. Of the 55 specimens with a recorded diagnosis so far, 51 (93%) were benign. Two showed dysplasia (abnormal cells) and two were mouth cancers.
The most common diagnoses were lumps caused by irritation (such as fibroepithelial polyps), jaw cysts and mucoceles. The cancers were found in patients aged 30–49 and over 80, and the dysplasia in patients aged 50–79, so age alone is not a reason to ignore a change.
Fees
How much does a biopsy cost?
| Fee | Typical amount |
|---|---|
| Oral biopsy (Medicare item 30075) | $475, with a Medicare rebate of $152 |
| Anaesthetist (general anaesthetic only) | $500–$900 |
| Hospital (general anaesthetic only) | $1,350–$2,650 |
The pathology laboratory bills separately for examining the sample. There is no charge for your post-operative review. You will receive a written estimate before treatment.
Getting started
Do I need a referral?
Yes. Ask your dentist (or your GP) for a referral to Dr Tom Jaunay. If you already have a referral, call us and we will book you in.
What should I bring to my consultation?
- Your referral, and any photos of the area your dentist or doctor has taken
- How long the sore, patch or lump has been there, and anything that has already been tried
- Whether you smoke or drink alcohol
- A list of your medicines, especially blood thinners, bone-strengthening medicines (such as Prolia or bisphosphonates), and any history of head and neck radiotherapy
How do I contact you?
Call 02 8513 9810 (8:30am to 4:30pm, Monday to Friday) or email reception@oromaxnsw.com.au. Sydney CBD Level 2, 225 Macquarie St · Hurstville Suite 9.06, Level 9, 288 Forest Rd · Miranda Suite 2, Level 5, 86 Kiora Rd. See our locations.
References
- National Institute for Health and Care Excellence. Suspected cancer: recognition and referral (NG12). nice.org.uk
- Cancer Council Australia. Optimal care pathway for people with head and neck cancers, 2nd ed. 2021. cancer.org.au
- Warnakulasuriya S, et al. Oral potentially malignant disorders: a consensus report. Oral Dis. 2021. doi:10.1111/odi.13704
- Iocca O, et al. Potentially malignant disorders of the oral cavity and oral dysplasia: malignant transformation rate by subtype. Head Neck. 2020. doi:10.1002/hed.26006
Our results come from an audit of all oral biopsies by Dr Jaunay at all Oromax sites (Medicare item 30075), September 2023 to October 2026.
This page is general information to help you prepare for your consultation. It does not replace an assessment and advice about your own situation.