Children can develop mouth cancer, also known as oral cancer, though it is extremely rare compared to adult cases. Oral cancer refers to malignant growths that form in the mouth and throat area, including the tongue, gums, inner cheeks, and floor of the mouth. The vast majority of lesions and tumors found in a child’s mouth are benign, meaning they are not cancerous. Pediatric oral cancer is distinct from the type seen in adults, having different underlying causes and cellular origins.
The Rarity and Specific Forms
Oral cancer is exceptionally uncommon in the pediatric population, with less than one percent of all oral cancers diagnosed in individuals under 20 years old. Annually, there are only about 0.24 cases per 100,000 people under the age of 20. Over 90 percent of tumors found in children’s mouths are non-cancerous.
The types of oral malignancies affecting children differ fundamentally from the Squamous Cell Carcinomas (SCC) common in adults. Pediatric oral cancers usually originate from non-epithelial tissues, often presenting as soft tissue sarcomas or lymphomas.
The most common soft tissue sarcoma is Rhabdomyosarcoma (RMS), which can arise in the oral cavity. Oral Rhabdomyosarcoma is a fast-growing cancer made up of cells that normally develop into skeletal muscle. Lymphomas, cancers of the lymphatic system, are also commonly encountered malignancies in the pediatric oral cavity.
Unique Causes and Risk Factors
The causes of oral cancer in children are largely unrelated to the prolonged tobacco and alcohol use that drives most adult cases. Risk factors are often linked to complex genetic predispositions that affect how cells repair DNA or control growth. Several inherited syndromes, such as Fanconi anemia and Xeroderma Pigmentosum, impair DNA repair mechanisms and increase risk.
Certain immunodeficiency states also contribute to risk, such as chronic graft-versus-host disease (GvHD) following a transplant, or conditions like HIV/AIDS. These conditions compromise the immune system’s ability to monitor and eliminate abnormal cells. The use of immunosuppressive medications after an organ transplant can similarly increase susceptibility.
Infection with the Human Papillomavirus (HPV), particularly high-risk types like HPV-16, is another factor for oral cavity cancers in children and adolescents. HPV is a known cause of oral and oropharyngeal cancers, and vaccination can reduce the risk. Additionally, prolonged exposure to ultraviolet (UV) light can increase the risk of cancer, particularly on the lips.
Recognizing the Warning Signs
Recognizing the warning signs of oral cancer focuses on identifying persistent changes that do not resolve within two weeks. The earliest and most common sign is a sore, ulcer, or lesion inside the mouth that fails to heal. Unlike common canker sores or injuries, a cancerous lesion often remains unchanged, sometimes becoming painful or bleeding.
Parents should look for unusual lumps, swelling, or thickened areas on the tongue, gums, inner cheeks, or jawbone. These growths may initially be painless but feel hard and fixed to the touch. The presence of red patches (erythroplakia) or white patches (leukoplakia) on the oral tissues should also prompt a medical evaluation.
Other symptoms that require prompt attention include:
- Unexplained bleeding in the mouth.
- Numbness or tingling in the face or mouth.
- Difficulty or pain when swallowing or speaking.
- Swelling in the neck, which indicates enlarged lymph nodes.
Any persistent oral change lasting longer than two weeks should be evaluated by a pediatrician or pediatric dentist.