Oral Cancer Screening
According to research conducted by the American Cancer society, more than 30,000 cases of oral cancer are diagnosed each year. More than 7,000 of these cases result in the death of the patient. The good news is that oral cancer can easily be diagnosed with an annual oral cancer exam, and effectively treated when caught in its earliest stages.
Oral cancer is a pathologic process which begins with an asymptomatic stage during which the usual cancer signs may not be readily noticeable. This makes the oral cancer examinations performed by the dentist critically important. Oral cancers can be of varied histologic types such as teratoma, adenocarcinoma and melanoma. The most common type of oral cancer is the malignant squamous cell carcinoma. This oral cancer type usually originates in lip and mouth tissues.
There are many different places in the oral cavity and maxillofacial region in which oral cancers commonly occur, including:
- Deep pits and fissures on the chewing surfaces of teeth
- Exposed and sensitive root surfaces
- Fair to poor oral hygiene habits
- Frequent sugar and carbohydrate intake
- Inadequate exposure to fluorides
- Inadequate saliva flow due to medical conditions, medical treatments or medications
- Recent history of dental decay
Reasons for oral cancer examinations
It is important to note that around 75 percent of oral cancers are linked with modifiable behaviors such as smoking, tobacco use and excessive alcohol consumption. We are happy to provide literature and education on making lifestyle changes and smoking cessation.
When oral cancer is diagnosed in its earliest stages, treatment is generally very effective. Any noticeable abnormalities in the tongue, gums, mouth or surrounding area should be evaluated by a health professional as quickly as possible. During the oral cancer exam, the dentist and dental hygienist will be scrutinizing the maxillofacial and oral regions carefully for signs of pathologic changes.
The following signs will be investigated during a routine oral cancer exam:
- Red patches and sores – Red patches on the floor of the mouth, the front and sides of the tongue, white or pink patches which fail to heal and slow healing sores that bleed easily can be indicative of pathologic (cancerous) changes.
- Leukoplakia – This is a hardened white or gray, slightly raised lesion that can appear anywhere inside the mouth. Leukoplakia can be cancerous, or may become cancerous if treatment is not sought.
- Lumps – Soreness, lumps or the general thickening of tissue anywhere in the throat or mouth can signal pathological problems
Oral cancer exams, diagnosis and treatment
The oral cancer examination is a completely painless process. During the visual part of the examination, we look for abnormalities and feel the face, glands and neck for unusual bumps.
If abnormalities are found, we may perform a VELScope exam or a biopsy. VELscope is a handheld instrument that emits a safe blue light into the mouth. Healthy tissue reflects the light back, and appears pale green and fluorescent to the observer, while developing tumor cells appear dark. Since oral cancer is a very aggressive cancer, and in its early stages there are frequently no signs or symptoms, a VELscope can save critical time in the cancer diagnosis, greatly enhancing the chance of survival.
Oral cancer is deemed to be present when the basement membrane of the epithelium has been broken. Malignant types of cancer can readily spread to other places in the oral and maxillofacial regions, posing additional secondary threats. Treatment methods vary according to the precise diagnosis, but may include excision, radiation therapy and chemotherapy.
During bi-annual check-ups, the dentist and hygienist will thoroughly look for changes and lesions in the mouth, but a dedicated comprehensive oral cancer screening should be performed at least once each year.
Oral Cancer Brush Biopsy
The OralCDx BrushTest is a painless laboratory test for oral precancer and cancer. Our dentists often use the BrushTest to evaluate “everyday” unexplained small white and/or red oral spots. The BrushTest can accurately determine if a common oral spot contains abnormal (dysplastic) cells that if left alone, may develop into oral cancer. If you are a smoker or have other risk factors for developing oral cancer, we may recommend a brush biopsy of suspicious lesions.
VELscope® Oral Cancer Screening
Since oral cancer is a very aggressive cancer, and in its early stages there are frequently no signs or symptoms, early detection can save critical time in the cancer diagnosis, greatly enhancing the chance of survival. Early detection raises the oral cancer survival rate to 90%. A revolutionary hand-held device, called VELscope (Visually Enhanced Lesion Scope) offers a painless early detection option.
Our mission is to keep current with all state-of-the-art dental technology. Our practice prides itself on being one of the first Dental offices in the area to invest in the VELscope technology. We will be offering VELscope screening to all of our patients in the high risk category for oral cancer. Since 25% of newly diagnosed cases do not fit the high-risk profile, if you feel that you would like to be screened please let us know.
How does the VELscope® work?
The VELscope® uses Fluorescence Visualization (FV) in an exciting new way. Essentially, bright blue light is shined into the mouth to expose changes and lesions that would otherwise be invisible to the naked eye. One of the biggest difficulties in diagnosing oral cancer is that its symptoms look similar to symptoms of less serious problems. The VELscope® System affords the dentist important insight as to what is happening beneath the surface.
The healthy soft tissue of the mouth naturally absorbs the VELscope® frequency of blue light. Healthy areas beneath the surface of the soft tissue show up green, and the problem areas become much darker.
Here are some of the advantages of using the VELscope® System:
- Detects lesions, white and red patches
- Detects problem areas that cannot be seen under white light
- Exposes precancerous and cancerous tissue
- Helps dentists check that diseased soft tissue is completely removed
- Helps diagnose oral cancer in its earliest stages, exponentially increasing the chance of survival
- Quick, painless examinations
How is the VELscope® examination performed?
The VELscope® examination literally takes only two or three minutes. It is a painless and noninvasive procedure that saves many lives every single year.
Here is a brief overview of what a VELscope® examination is like:
Initially, the dentist will perform a regular visual examination of the whole lower face. This includes the glands, tongue, cheeks and palate as well as the teeth. Next a pre-rinse solution is swilled around the mouth for slightly less than a minute. The dentist provides special eyewear to protect the integrity of the retinas. The lights in the room are dimmed to allow a clear view of the oral cavity.
The small VELscope® is bent to project blue light inside the mouth. Lesions and other indicators of oral cancer are easily noticeable because they appear much darker under the specialized light.
If symptoms are noted, our oral surgeon may take a biopsy there and then to determine whether or not this is oral cancer. The results of the biopsy dictate the best course of action from there.
If you have any questions or concerns about oral cancer, please ask us!