As a dental professional, it makes sense to be aware of oral cancer and the symptoms to look out for as a means of detection. Rachel pointer explains why you need to promote vigilance when it comes to oral cancer.
There are almost 6,500 new cases of mouth cancer diagnosed each year (www.dentalhealth.org, 2014) and, sadly, the five-year survival rate is around 50%, a statistic that has not seen much of an improvement (www.mouthcancerfoundation.org, 2014) despite raised awareness. In fact, in the UK one person dies every three hours because mouth cancer is spotted too late; (www.mouthcancerfoundation.org, 2014) so the key to survival is early detection. As well as a full soft tissue examination, a full medical and family history should be taken during dental appointments. At this point you will be able to determine any lifestyle factors that may contribute to the patient being at a higher risk of contracting mouth cancer, such as smoking or alcohol consumption.
Most cases of oral cancer are linked to lifestyle and approximately 90% of those affected are tobacco users (www.mouthcancerfoundation.org, 2014). Smokeless tobacco is also a factor to bear in mind. Some cultures practise chewing tobacco, areca nuts, betel nuts, paan and gutka, all of which can also increase the risk of oral cancer (www.mouthcancerfoundation.org, 2014). An estimated 30% of oral and pharyngeal cancers in the UK are linked to alcohol (Parkin, 2011). Most people believe that they will only be at risk of cancers if they indulge in binge drinking or regular high intakes of alcohol. This is why it is important to discuss alcohol intake with patients as part of their medical history – just one drink a day could be a risk factor and definitely worth taking note of and monitoring.
The Human Papilloma Virus (HPV) is another leading cause of oral cancer. HPV infects the epithelial cells of skin and mucosa, which includes areas such as the mouth, throat, tongue, tonsils, vagina, penis, and anus. Infection occurs when these areas come into contact with a virus, allowing it to transfer between epithelial cells (www.mouthcancerfoundation.org, 2014). The most dangerous strains of HPV are 16 and 18, which are transmitted by sexual contact; these are now being linked to mouth cancer via oral sex. We are seeing more and more younger adults being affected by mouth cancer, who don’t have a history of smoking or alcohol consumption.
Ensuring patients understand the risks of mouth cancer and raising awareness among the public is key for promoting early detection. Dental professionals should make patients aware of the signs and symptoms to look out for, such as ulcers that don’t heal within three weeks, red or white patches in the oral cavity, difficulty swallowing or chewing, and any lumps in the mouth.
Ensuring patients have a thorough home care regime for their oral hygiene will ensure that they will not only maintain excellent health but they are more likely to notice any of the warning signs or symptoms of mouth cancer. The use of interdental aids can be a great tip for patients to keep their oral health in top condition. Using floss or interdental brushes to remove food particles and plaque is a good way to keep the teeth clean and the gingiva healthy and it promotes the attention to detail that is necessary to ensure patients spot any changes within the mouth.
The right direction
Tandex is a manufacturer of interdental brushes, dental floss and tape, and toothpicks. The company has a long-standing history of creating specialised products for the dental industry, a range that reflects both tradition and development.
Regardless of whether the topic is one of the GDC’s CPD recommendations, the early detection of oral cancer should be on every dental professional’s radar as an ethical consideration. Incorporating mouth cancer screening into every dental check-up and remaining vigilant for even the most subtle changes could contribute to saving a life. This should be coupled with making patients aware of the risks factors that can contribute to causing the disease and changes in the mouth to be aware of. Promoting vigilance through attention to detail will not only help patients to spot the warning signs early but will also aid excellent oral health.
Parkin DM (2011) Cancers attributable to consumption of alcohol in the UK in 2010. Br J Cancer 105(S2): S14-S18
https://www.dentalhealth.org/tell-me-about/topic/mouth-cancer/mouth-cancer Retrieved 23/11/14
http://www.mouthcancerfoundation.org/get-info/learn-about Retrieved 23/11/14
http://www.mouthcancerfoundation.org/patients-guide/smoking-tobacco Retrieved 23/11/14
http://www.mouthcancerfoundation.org/patients-guide/areca-betel-nut Retrieved 23/11/14
http://www.mouthcancerfoundation.org/patients-guide/hpv-risks Retrieved 23/11/14
Rachel Pointer qualified from Guys Hospital as a dental hygienist and began work in general dental practice in Hertfordshire. After working as a staff hygienist for Professor Naylor she was appointed tutor dental hygienist at Guys Hospital before working in Australia. Rachel has experience in hospital, specialist periodontal practice and in the private sector as well as setting up a PDU within a cerebral palsy home in Essex. Working for 10 years for the British Dental Hygienists Association as its information officer plus membership and careers co-ordinator, she presently works at Addenbrookes Hospital and in general dental practice and a few years ago branched out to teach in a Montessori school setting.
*This article was originally published in DH&T magazine.