Mature teeth themselves do not develop cancer. Cancer is fundamentally a disease of uncontrolled cell growth and division, and the primary structures of a mature tooth lack the cellular environment necessary to support this process. The concern about “tooth cancer” actually relates to the tissues surrounding the tooth, such as the gums, jawbone, and specialized cells left over from tooth development.
The Biological Reason Why Teeth Don’t Get Cancer
The inability of a tooth to develop cancer stems from its unique structural composition, which is largely acellular. The outer layer of the tooth, enamel, is the most highly mineralized substance in the body, consisting of about 96% inorganic material, making it an inert and rigid tissue without any living cells to mutate or divide uncontrollably.
Dentin, which forms the bulk of the tooth beneath the enamel, is also highly mineralized and lacks cell bodies within its matrix. While dentin contains microscopic channels called dentinal tubules that house extensions of cells from the pulp, the tissue is too mineralized to support the rapid cell proliferation seen in tumors. Cementum, the tissue covering the root, is structurally similar to bone and functions primarily to anchor the tooth.
The only soft, cellular part of the tooth is the dental pulp, located in the innermost chamber. This tissue contains specialized stem cells, nerves, and blood vessels. While these cells can proliferate to repair dentin damage, their slow growth rate makes the development of a true, primary carcinoma or sarcoma originating from the pulp cells extremely rare.
Cancer That Affects the Jaw and Gums
The most common form of malignancy encountered in the oral cavity is Squamous Cell Carcinoma (SCC), which accounts for over 90% of all oral cancers. This cancer arises from the flat, scale-like cells that line the moist surfaces of the mouth. It does not originate in the tooth itself, but often affects the surrounding structures like the gums, the floor of the mouth, the tongue, or the lining of the cheeks.
This type of cancer can often mimic common dental issues, causing public concern about “tooth cancer.” For instance, a tumor growing in the gum tissue can cause a tooth to become loose, or a lesion near the jawbone may cause persistent pain or numbness. These symptoms can easily be mistaken for advanced gum disease or a severe toothache, potentially delaying diagnosis.
Primary risk factors for oral SCC include tobacco use in any form and excessive alcohol consumption. Human papillomavirus (HPV) infection, particularly HPV-16, is also a growing cause of cancers in the back of the mouth and throat. Early lesions may appear as persistent, painless white patches (leukoplakia) or red, velvety patches (erythroplakia), which are concerning for malignant change.
Tumors Originating from Tooth-Forming Cells
A unique group of growths, known as odontogenic tumors, arise from the residual epithelial and mesenchymal cells that are left behind after the tooth development process completes. These cells, which form the tooth germ during embryonic development, can become neoplastic later in life. These tumors are distinct from the more common oral SCC because they originate from tooth-making tissues rather than the generalized soft tissues of the mouth.
The most common odontogenic tumor is the odontoma, which is benign and acts like a hamartoma, resulting in a disorganized mass of dental tissues like enamel and dentin. Other types, such as ameloblastoma, originate from the epithelial remnants of the dental lamina. Ameloblastomas are locally aggressive and can be destructive to the jawbone, though they generally do not spread to distant sites.
These tumors primarily occur within the bones of the jaw, particularly the mandible, and often present as a slow-growing, painless swelling. Although they are not true cancers of the tooth structure, their origin from the odontogenic apparatus links them to the dental system. Treatment often involves surgical removal due to their potential for local destruction and recurrence.
Recognizing Warning Signs and Seeking Diagnosis
Prompt evaluation of any unusual changes in the mouth is the most effective defense against oral malignancies. The most serious warning sign is a sore, ulcer, or irritation in the mouth or on the lip that does not heal within a two-week period. This persistence is a key differentiator from common canker sores or minor injuries.
Other concerning symptoms include the appearance of red (erythroplakia) or white (leukoplakia) patches inside the mouth that cannot be wiped away. Any unexplained bleeding, numbness in the mouth or face, or a lump or thickening in the cheek or neck should be examined immediately. A change in the way teeth fit together, or the sudden loosening of a tooth without an obvious dental cause, is another sign that requires professional attention. Dentists play a major role in early detection, as routine checkups include a visual and physical screening of the soft tissues of the mouth and neck.