Oral Cancer Update

Oral Cancer, what should dentists be doing?

Sometimes, dentists can unfortunately fail to pick up on the signs of oral cancer, and as a result, they misdiagnose or miss the condition completely, which can lead to serious problems

If spotted and treated early, oral cancer generally has a good outlook or prognosis, but if overlooked or treated as something else, it can lead to gross disfigurement and even  death in some cases, it’s really important that it is spotted as early as possible.

recent report by the Oral Health Foundation in the UK has revealed that new cases of oral cancer in the UK have increased by 49% in the last decade. In 2017, over 2,700 people lost their life to oral cancer in the UK and only 8% of people responding in the study said that they were confident in their knowledge of the disease.

The study shows that early diagnosis is one of the key challenges in confronting mouth cancer, so raising awareness of the risk factors, as well as of the early signs and symptoms, is vital.

In canada, About 6% of oral cancers occur among persons under 40 years of age. Although the overall ratio of males to females with oral cancer in Canada is 2:1, the ratio is almost 1:1 in patients under 40. The overall incidence in Canada is about 12 per 100,000 per year in men and 5 per 100,000 in women.

The main symptoms of mouth cancer include:

  • Long lasting mouth ulcers (lasting longer than three weeks)
  • Red or white patches in the mouth
  • Lumps and bumps in the mouth, or head and neck area

The main risk factors of mouth cancer include:

  • Those who smoke
  • Those who drink alcohol to excess
  • Those with HPV (human papillomavirus), which is now usually vaccinated against in youth
  • Those who chew tobacco
  • Those with an unhealthy diet that lacks vitamins & minerals
  • Those using sunbeds, or exposed to too much sunlight without protecting the skin and lips
  • Those with a previous history of cancer – especially previous oral cancer, skin cancer, cervical cancer, penile cancer or anal cancer
  • Those with a family history of cancer

How can you check yourself for signs of oral cancer?

You can do some simple checks yourself for signs of mouth cancer, and you should always consult your dentist or a medical professional if you think that there is something wrong.

Your dentist should also perform many of the below when you visit for a check-up.

Check your head and neck – look for signs, lumps or bumps on one side of the face. Do both sides look the same? This is the expected standard of care for practicing dentists. Feel along the sides and front of your neck for any tenderness or lumps, that’s how I spotted my own thyroid cancer.

Check the inside of your lower and upper lip for any sores or changes in colour. Check for lumps, bumps or changes in texture

Check your cheeks with your finger for any lumps, tenderness or ulcers or any patches that seem to have changed

Check the roof of your mouth with a finger (or your dentist will check visually) for signs of lumps of changes in colour

Check your tongue for changes in colour, texture, swelling or ulcers. These could be along the sides, on the top or the underside of the tongue

Check the floor of the mouth with a finger to see if there are any bumps, lumps or swellings

Non healing ulcers are definitely something that should always be checked.

Even though people don’t like to have x-rays taken, it is necessary. I cannot tell you how many space occupying lesions within the bone I have found and diagnosed. Cysts and bone cancer should be screened for too – and cannot be seen without x-rays. A scan is however is generally considered to not be necessary inside 5 years or so.

Check with your dentist as their clinical judgement may be directed by administrators at insurance companies or regulatory body guidelines, by people who will never see the inside of a mouth!

ALWAYS have areas that are not healing professionally checked, and if appropriate, biopsied. I have been involved in two cases where traditional treatments were repeated performed , despite treatment not resolving the disease – in one case for several years without considering cancer. Both resulted in major jaw surgery and use of bone and muscle from other parts of the body.

This article illustrates the value of a review before leaping headlong into a legal case. A good lawyer will generally consult a dental Expert Witness for advice.

Author – Stephen Bray DDS

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