About Oral Cancer

Oral cancer is the sixth most common cancer and has the worst five-year survival rate of all major cancers. Yet with early diagnosis it can be cured. This disease often goes unnoticed because it usually starts painlessly. But it can be observed and we dentists are in a unique front-line position to catch it early through painless oral cancer checkups during each of your regular examinations.

I routinely conduct a 5-Minute Dental Protocol where I examine and evaluate your mouth including lips, cheek, tongue surface, floor of the mouth, hard and soft palate, the area of the throat at the back of the mouth including tonsils, and the base of your tongue.

What am I looking for? Any sore in your mouth that bleeds easily or does not heal, a color change of the oral tissue, a lump or thickening in the cheek, a painless white or red patch, rough spot, crust, or small eroded area, pain, tenderness, or numbness on the gums, tongue, tonsil, or lining of the mouth. In short – any change that appears to be suspicious. The vast majority of abnormal sores are not cancerous. Still, if I do see anything irregular, I’ll recommend follow-up testing and that you visit your doctor, especially if you have any persistent difficulty with chewing, swallowing, numbness, and unintentional weight loss.

I also routinely monitor for gum disease. I am absolutely committed to its prevention and management for all of my patients, and not only because it leads to tooth loss and has been linked to systemic diseases. In a study of roughly 14,000 participants conducted by the University of Buffalo at New York, patients with serious periodontal disease – the advanced form of gum disease – were found to be at double the risk of having a precancerous lesion and four times the risk of having an oral tumor of any kind, as compared to people with healthy gums. In addition, oral cancer has been linked to tobacco consumption which in turn is linked to periodontal disease.

Although aging and alcohol consumption are primary risk factors, tobacco use is responsible for more than 90% of oral cancer tumors among men and 60% among women, and is responsible for 90% of oral cancer deaths in males. (The cessation of cigarette smoking is associated with a 50% reduction of risk of developing oral cancer within 3-5 years and a return to normal level of risk for development of oral cancer within 10 years.) All forms of tobacco including cigarettes, pipes, cigars, and smokeless tobacco have been implicated in the development of oral cancers, and when alcohol and tobacco use are combined, the risk of oral cancer increases by fifteen times. You can’t do much about ageing, but you can change your lifestyle!

Having said that, I must point out that health professionals are becoming increasingly alarmed by a shift in the populations at risk. Recently, more than 25% of oral cancer victims have been younger than 40, without any known lifestyle risk factors like tobacco, alcohol use, diabetes, or HIV. Experts postulate a link between sexually transmitted HPV and oral cancer. (Although there are 130 strains of HPV, to date, only HPV 16 has been associated with oral cancer.) Because HPV is so prevalent, mass screening may be the only viable choice to find oral cancer at precancerous or very early high-survival stages.

We should all – dentists included – be alert to signs of oral cancer, and check ourselves for symptoms. Here is the 1-Minute Home Protocol that I conduct on myself and that I recommend to my patients. Every month, look at your lips and mouth for the signs I mentioned earlier: a sore that bleeds easily or does not heal, a color change, a lump, thickening, rough spot, crust, or small eroded area, pain, tenderness, or numbness.

Contact me or your physician immediately if you have any of these, and even if you don’t find anything, please keep your regular dental checkups.

How else can you help yourself? Avoid using all tobacco products, minimize alcohol, avoid prolonged exposure to sunlight, apply lip balm with sunscreen, and eat plenty of fruits and vegetables which provide anti-cancer vitamins and antioxidants.

And don’t be nervous – you needn’t rely only on yourself. I’m proud that I can serve as your first line of defense.

© Patient News

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