What criteria should I use to determine whether a patient with oral lesions requires urgent referral to maxillofacial surgery?

Criteria for urgent referral of a patient with oral lesions to maxillofacial surgery include:

• Unexplained ulceration in the oral cavity lasting more than 3 weeks, which warrants a suspected cancer pathway referral urgently.
• A persistent and unexplained lump in the neck associated with oral lesions should prompt urgent referral.
• The presence of a lump on the lip or in the oral cavity consistent with oral cancer, as assessed by a dentist, requires urgent referral within 2 weeks.
• Oral cavity red or red and white patches consistent with erythroplakia or erythroleukoplakia also require urgent referral for assessment by a dentist and possible suspected cancer pathway referral.

These criteria are aimed at identifying possible oral cancers or other serious pathology requiring specialist assessment and intervention.

Summary: Urgent referral is indicated for unexplained oral ulceration >3 weeks, persistent unexplained neck lumps, lumps consistent with oral cancer, and suspicious red or red and white patches in the oral cavity ¹.