By Tooth Fairy / www.divinecaroline.com
Oral cancer is a topic that, unfortunately, does not get a lot of press. As I am educating my patients, I tend to get a variety of responses on this.
Anything from: “I have never heard of getting cancer in the mouth” to “I don’t smoke though” and the one I least like hearing, “I have never had that done before.” Eeks. What? So, it is in response to these statements that I feel it is best to address this issue.
So why is this an issue, and is it that serious?
Here are some stats I found from the oral cancer foundation.
“More than 34,000 Americans will be diagnosed with oral or pharyngeal cancer this year. It will cause over 8,000 deaths, killing roughly 1 person per hour, 24 hours per day. Of those 34,000 newly diagnosed individuals, only half will be alive in 5 years. This is a number which has not significantly improved in decades. The death rate for oral cancer is higher than that of cancers which we hear about routinely such as cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, cancer of the testes, endocrine system cancers such as thyroid, or skin cancer (malignant melanoma).”
Pretty scary! Why don’t we here more about this? I don’t know, but this is why I stress this exam. I will walk you through what to expect, and what to look for. If you have not have this done, get it done. Just ask. Most offices do not charge for it.
The exam is called an extra oral (outside of the mouth) and intra oral exam (inside of the mouth). Or you can call it an Oral Cancer Exam/Screening. And quite frankly, I find it the best part of the cleaning appointment. (My second would be when the hygienists cleans my lower front teeth and afterward I can run my tongue behind them, it just feels so good and clean. I love it!) I mean it feels like a little mini massage (the cancer exam) and all I could ask for more would be to have someone massage the feet and my dental appointment would be the best part of my week! So let me walk you through the exam. It is actually quite quick and doesn’t take a lot of time away from the cleaning; and it is way worth it, esp. since sometimes it can be a challenge to see everything in our own mouth.
Extra oral
* Examine the head and neck (check for moles, freckles, discoloration, lumps)
* Note and measure any abnormalities to observe for any changes
* Palpate lymph nodes on/ near cheeks and ears, down the neck, under the chin, and near clavicle, and also back of the neck near the nape of neck or where the head meets the neck
* Note any enlargements and tenderness
* At this time I will also have you open and close this is mainly to check the jaw for any Temporal Mandibular Joint Disorders, checking for popping, grinding, and alignment/deviations. (Tangent: TMJ is the joint of your jaw everyone has a TMJ, but some have a TMJ Disorder
* Discuss any concerns
Intra Oral
* Examine soft tissue for lesions bright red, white, brownish, purplish, or blue in color
* Note and measure any lesions and/or sores in the mouth
* Palpate tissue (cheeks, lips, floor of the mouth, tongue, palate)
* examine tongue, by having them stick the tongue out and examine the borders (sides of the tongue) and base (back of tongue)
* Depress the tongue have patient say “ahhh” (think opera singer) to examine soft palate, tonsils, and uvula
* Measure and note any lesions, lumps, or discolorations
* Check saliva flow, drying each parotid duct (salivary glands) with a cotton 2x2 and then stimulating it, this is found on the inside of each cheek near the molars. may also check sublingual glands located on the floor of the mouth
* Note any abnormalities and discuss
* Some offices will also use a solution and a light to help diagnose as well
* Also x-rays are used, and compared from previous years to see if there are any lesions or changes in the bone that should not be there.
At this point the hygienist/or dentist will decide if they need to refer, or watch, and observe.
If a referral is made they will be referred to an Oral Surgeon or an Ears Nose and Throat doctor (ENT). If This is the case some medical insurances will pay for the ENT, but most will not pay for the Oral Surgeon. But if it is serious, who cares! You will want to get it taken care of. Also if you’re lucky some dentists will do the biopsy right then and there in their own office and send it to the labs. How great, no wait!