What referral criteria should I follow for a patient with a non-healing ulcer in the oral cavity?

Referral criteria for a patient presenting with a non-healing ulcer in the oral cavity:

• Consider an urgent suspected cancer pathway referral for any unexplained oral cavity ulceration that has lasted for more than 3 weeks to be seen within 2 weeks, as this may indicate oral cancer.
• If the ulcer is accompanied by a lump on the lip or in the oral cavity, or a red or red and white patch consistent with erythroplakia or erythroleukoplakia, an urgent referral to a dentist for assessment is recommended.
• If there is a strong suspicion of oral cancer and/or a delay in accessing a dentist is likely, use clinical judgement to refer urgently via a local suspected cancer referral pathway or seek immediate specialist advice.
• For suspected acute necrotizing ulcerative gingivitis, urgent dental assessment is advised, with interim antibiotic and analgesic treatment as appropriate.

These criteria ensure timely assessment and management of potentially malignant or serious oral lesions.

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