Maria Ambra, RDH
The Importance of Oral Cancer Screening
As health care providers, during a patient’s initial dental visit, we ask if they would like to have an oral cancer screening in addition to their dental evaluation. Unfortunately, a vast majority of the time, the patient’s answer will be “no” or “I don’t have cancer and never have” or “I’m too young and I don’t smoke, therefore, I don’t need one today”. As Registered Dental Hygienists in today’s ever changing health care demands, how can we approach such an important discussion and answer these types of questions?
In the early stages of most forms of oral cancer, the cancer can’t be detected only visually and may not manifest as painful or cause any discomfort. It is possible for perfectly healthy patients of any age to have pre-cancer or oral cancer and be asymptomatic. Oral cancer is considered an epidemic disease in which over the past 6 years, research shows that this epidemic disease is not caused primarily by traditional risk factors any longer such as smoking, drinking or chewing tobacco.
Unfortunately, 40% of our young population (nonsmokers), especially among high school athletes, makes for the majority of new cases of cancer in the oral cavity and pharynx and more that 50% are detected in late age causing death.
In the population of patients over 40, as age increases, the likely hood of disease tends to develop due to the fact that their immune system becomes less efficient and also an excessive amount of unprotected exposure to the sun can increase lip cancer (the most common undetected oral cancer that is often mistaken for chapped lips). People, who live in areas with poor access to health care or don’t visit a dentist or doctor regularly, are considered to be increased risk for malignancies.
In younger adults under 40, a higher risk is contributed by the exposure to the HPV-16 and the HPV 18 viruses known as the human papilloma virus, leading to an increase each year of about 39,000 new cases of cancer which are found in areas of the body where HPV is found. Cervical cancer is the most common HPV associated cancer among women and oropharyngeal cancer which is often located in the back of the throat, on the base of the tongue and tonsils are the most common among men. It can be spread and contract as easy on intimate contact including kissing through saliva or skin-to-skin contact. The CDC (Center for Disease Control) recommends conducting an oral cancer screening at least once a year for all patients age 17 and beyond. Due to the fact that the naked eye may miss even early signs of oral malignancies, we, as dental practitioner’s, must introduce to our patients the state of the art, new technologies such as IDENTAFI, ORAL-ID or VELSCOPE.
All three are revolutionary devices that use multi-spectral technology to identify early morphologic and biochemical changes of the cells in the mouth, throat and tonsil. During the examination, the patient is also educated by the providers to self- examine often at their own. Some of the early indicators are red or white discoloration of tissues or any sore that doesn’t heal within 14 days, with that, advanced indicators such as sensation of something being stuck in the throat, any numbness in the oral cavity or ear or jaw pain, a lump or thickening in their neck need to be reported immediately to professionals to be examined and evaluated forward. Early detection means early treatment and cure of 90% of cases. EARLY DETECTION SAVES LIVES!
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www.oralcancerfoundation.com. Edited on March 2013
Hocking, Stein A,Regan D et.al. Head and neck cancer show increasing incident of potential HPV-associated oropharyngeal cancer.2011 MAR 1
http://www.cancer .org. Can oral cavity and oropharyngeal cancer be found early?