Persistent oral lesions (>2 weeks), unexplained ulcerations, or mucosal changes should always be investigated.

While most are benign, early detection of dysplastic or malignant lesions dramatically improves outcomes.

Referral is essential when:

- A lesion doesn’t heal after routine irritation removal.

- The surface appears indurated, ulcerated, or with mixed red-white coloration.

- The lesion bleeds spontaneously or is painful.

An oral and maxillofacial surgeon can perform an excisional or incisional biopsy under local anaesthesia, ensuring accurate margins and pathology submission.

Histopathology reports guide further management or oncology referral if necessary.

When to refer: Any persistent lesion without clear cause, or where biopsy is outside general scope.