You may not normally associate your visit to the dentist
with the possibility of oral cancer, this is in fact a reality and
we are in the best position to screen you. Before we go into details
of our screening process and protocols, here are a few facts you should
know about oral cancer:
Oral Cancer is three times more prevalent than
cervical cancer and, every year, twice as many people die from Oral
Cancer as opposed to cervical cancer.
Treatments for Oral Cancer have not changed – or improved – over
the past 30 years and survival rates remain relatively low.
Survival rates for Oral Cancer are entirely dependant on early
detection. Quite simply, the earlier it is discovered, the better
the survival rate.
Although the highest risk patients are those over 40 years of age
with a history of chronic tobacco and alcohol use, the patient
segment with the fastest diagnosis rate, are those 18 to 50 years
without any apparent risk factors. In fact, where we
would see one oral cancer patient every 10 years, lately, we have
seen as many as 2 per year!
In addition to alcohol and tobacco usage, high risk categories
- Genetic predisposition/family history to Oral
- Excessive exposure to sunlight
- Human Papilloma Virus* (This sexually transmitted
virus is present in more than 20% of the population and is a
known factor in Cervical Cancer. It is felt that this is one of
the major factors in the unusual increase of oral cancer among
middle-aged university-educated professionals.)
If you are a new patient, your examination
will start with a review of your head and neck region.
This will include palpation (to examine by touch) of all the structures
around your jaws and will include lymph node palpation in the soft
areas just under your lower jaw as well as along the anterior parts
of your neck. (Please let us know if you have
any unusual lumps, especially if they are relatively new). From the external palpation,
we will visually inspect your facial skin as well as all areas of your
mucosa (the moist skin in your mouth and throat) for any unusual lumps
or changes in the surface characteristics of your mucosa.
What happens if we find something unusual?
Well, this is a lot more
common than you may think and oral cancer is not the first thing that
comes to mind. If we do find something that is unusual, we implement
our Soft Tissue Protocol (STP), which may include
any of the following:
- Obtain a history for the lesion (an area of abnormal appearance).
quite possible that it’s a result of biting trauma (taco chips,
hard foods, etc) or due to a burn.
- See if it’s bilateral (on both sides). This
would make it more likely a dermatological condition.
Associate it with other dermatological conditions such as exzema,
psoriasis, lichen planus, etc.
- Photo-documentation and Visual Fluorescence imaging
- Staining with a diagnositc dye, e.g. Toluidine Blue.
- 14 to 30 day follow up depending on the nature of
- Referral to a relevant specialist: Oral Surgeon,
Oral Medicine specialist, Dermatologist, ENT, or the BC Cancer Agency.
It’s important to note that our protocols are not open-ended.
This means that until the protocol is ‘closed’ you remain
in our system until we are satisfied that the lesion has resolved,
been identified or passed on to an appropriate specialist. Please
note that it is not our role to diagnose oral diseases such as Oral
Cancer but to screen for any abnormalities. The good news is that
over 99% of all detected lesions either disappear or are considered
What can you do to reduce the risk of oral
Aside from the
obvious such as quitting tobacco usage, moderation in alcohol consumption
and avoidance of excessive sun exposure, you should also maintain optimal
dental health as well as maintain your regular visits to our office.
Statistics clearly indicate that those with the lowest survival rate
are those that do not visit the dentist on a regular basis. Remember,
early detection is the key to improving survival.
Once you are a Patient of Record, you will be returning to our
practice for ongoing evaluation. During each visit, you will undergo
the normal visual and palpation examination as per the normal recall
examination protocol. In addition to this, we would advise a yearly
Velscope examination of your oral soft tissues. As this entails additional
equipment and personnel, there will be an additional fee for this procedure.
For more information on the topic of Oral Cancer, you may wish to follow
Oral Cancer Prevention Program