April 22, 2022

Images courtesy of the Oral Cancer Foundation, www.oralcancerfoundation.org

More than 65% of working adults put off essential visits to the dentist. Their reasons vary. Some cite rigorous work schedules or family commitments that absorb much of their free time. Still others blame long, arduous commutes for skipping routine trips to the dentist. However, advances in mobile dentistry, the modernization of house calls, and the rise of teledentistry platforms now give patients more options for resuming regular checkups. Maintaining good oral hygiene is important. Early detection of oral cancer, which is performed only by dentists during screenings, is critical. Because April is Oral Cancer Awareness Month, let’s learn more about the disease and how your dentist can help.

Be Aware of Oral Cancer and Its Risks

“Oral and pharyngeal cancer (cancer of the mouth and upper throat) collectively kills nearly one person every hour of every day of the year,” the American Association of Oral and Maxillofacial Surgeons (AAOMS) explains. “Of the people newly diagnosed with these cancers, only about 60% will live longer than 5 years. Moreover, many who do survive suffer long-term problems such as severe facial disfigurement or difficulties eating and speaking. The death rate associated with oral and pharyngeal cancers remains particularly high due to the cancer being routinely discovered late in its development.”

Last year, an estimated 54,000 cases of oral cancer were diagnosed. About 43% of those individuals were not expected to survive beyond the five-year mark. Unlike other cancers, this disease is less frequently discussed in the media. And with only 35% of adults attending routine dental screenings, the risks are high. That’s why dental associations across the nation attempt to raise awareness of the problem every April during Oral Cancer Awareness Month. 

For 23 years, these organizations have joined the non-profit Oral Cancer Foundation in this campaign. They include the Academy of General Dentistry Foundation, the American Academy of Oral and Maxillofacial Pathology, the American Academy of Oral and Maxillofacial Radiology, the American Association of Oral and Maxillofacial Surgeons, the American Academy of Oral Medicine, the American Academy of Periodontology, the American College of Prosthodontics, the American Dental Hygienists’ Association, and the California Dental Hygienists’ Association. 

Oral Cancer Symptoms and Risk Factors

The Oral Cancer Foundation encourages people to “regularly check for signs and symptoms of oral cancer between dental visits and to see a dental professional if they do not improve or disappear after two or three weeks.” Although the causes of oral and pharyngeal cancer vary, the predominant culprits are tobacco use and/or excessive alcohol consumption. Symptoms include the following.

• Any sore or ulceration that does not heal within 14 days
• A red, white, or black discoloration of the soft tissues of the mouth
• Any abnormality that bleeds easily when touched (friable)
• A lump or hard spot in the tissue, usually on the border of the tongue (induration)
• Tissue raised above that which surrounds it – a growth (exophytic)
• A sore under a denture, which even after adjustment of the denture, does not heal
• A lump or thickening that develops in the mouth
• A painless, firm, fixated lump felt on the outside of the neck, which has been there for at least two weeks

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States – and it can contribute to oropharyngeal cancer. HPV-caused oral cancer generally includes one or more of the following symptoms.

• Hoarseness or a sore throat that does not resolve within a few weeks
• A swollen tonsil on just one side, which is usually painless
• A painless, firm, fixated lump felt on the outside of the neck, which has been there for at least two weeks
• A persistent cough that does not resolve after many days
• Difficulty swallowing – the sensation of food getting caught in your throat
• An earache on one side (unilateral) that lasts for more than a few days

“Research has identified a number of factors that may contribute to the development of oral and oropharyngeal cancers,” the Oral Cancer Foundation said. “Historically, those at an especially high risk of developing oral cancer have been heavy drinkers and smokers older than age 50, but today the cancer also is occurring more frequently in nonsmoking people due to HPV16, the virus most commonly associated with cervical cancer.”

Getting Screened for Oral Cancer

Screenings are tactile and visual in nature. They’re also quick, painless, and non-invasive.

How Often Should You Get Screened?

The Oral Cancer Foundation recommends that patients undergo screenings for oral and oropharyngeal cancers on an annual basis, beginning around age 18. If individuals are smoking or chewing tobacco, screenings should commence at the age they begin using those products. At Blende Dental Group, we include screenings as part of every checkup and cleaning for patients of all ages.

“Oral tissue scanning is standard for every patient, despite their age,” said Dr. Lindzy Goodman. “We perform a soft tissue exam, palpate the thyroid, and check for hard  lumps or abnormalities.”

“Soft tissue exams should take place from the patient’s first experience,” noted Tanvi Obrock, Blende Dental’s head hygienist. “During annual dental exams, extraoral and intraoral screenings are always performed.”

Dr. Debra Chau added that “any time you get a cleaning is a good time to get looked at.”

What’s Involved in a Screening?

Some early warning signs can be observed with the naked eye as visible pre-cancerous changes in tissue, most often for those who smoke or drink heavily. Oropharyngeal cancers are located in the back of the mouth. They occur frequently in the tonsils and at the base of the tongue, where it begins curving down into the throat. These areas can’t easily be detected by sight alone. With cancers resulting from HPV, this area of the mouth is particularly vulnerable. There are a variety of methods dentists use to identify cancer.

• Dialog with your dentist is equally important. Part of detecting whether oral cancer exists involves interviewing patients to determine potential symptoms.
• A visual examination of the mouth, tongue, and throat helps our dentists spot red or white patches along with mouth sores.
• During a tactile examination, the dentist runs his or fingers through the patient’s mouth to feel for bumps or other abnormalities.

“Right now, more oral cancer cases are coming from people with HPV, especially men,” Dr. Goodman noted.

What Happens if the Dentists Suspects Cancer?

“Dentists won’t diagnose cancer,” Dr. Goodman explained. “If something looks suspicious, next steps involve a biopsy or a referral to a specialist. Biopsies are the gold standard for detecting cancer.”

During a biopsy procedure, a sample of cells is removed for laboratory testing to determine whether cancer is present. We also refer patients to an oral or maxillofacial surgeon.

“An oral surgeon is the first referral,” said Dr. Chau. “We may also suggest that patients see a head and neck physician.”

Always remember that early detection can boost your chance of survival from 50% to 90%. That’s why it’s imperative to attend annual screenings and report any symptoms to your dentist if they fail to improve within two to three weeks.