Oral Disease and Cancer
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 on the lip and mouth tissues. There are many different places in the oral cavity and maxillofacial region in which oral cancers commonly occur, including: lips, mouth, tongue, salivary glands, tonsils and oropharyngeal region (throat), nasal passage, gums, face, lymph nodes, neck and thyroid.
It is important to note that around 75 percent of oral cancers are linked with modifiable behaviors such as smoking, oral tobacco use and excessive alcohol consumption. 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, we will be scrutinizing maxillofacial, oral, head and neck regions carefully for signs of pathologic (disease) changes.
Some of the following signs are concerns for further investigation during your routine 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/dysplastic or cancerous changes.
- Leukoplakia (white patches) - a hardened white or gray, slightly elevated lesion that can appear anywhere inside the mouth. Leukoplakia can be cancerous, or may become cancerous if treatment is not sought.
- Lumps – soreness, lumps, swelling or general thickening of tissue anywhere in the throat, mouth, neck, side of face 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, the dentist will look for abnormality and feel the face, glands and neck for unusual bumps. Lasers have been used in looking “below the surface” for abnormal signs and lesions which would be invisible to the naked eye, however, they are neither sensitive nor specific enough to ignore findings of a visible or suspect lesion. This technology is met with significant debate and must not replace the benefit of information gained from a biopsy.
If abnormalities, lesions, leukoplakia or lumps are apparent, the dentist will implement a diagnostic impression and treatment plan. In the event that the initial treatment plan is ineffective, a biopsy of the area will be performed. The biopsy includes a clinical evaluation which will identify the precise stage and grade of the lesion.
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, face, head, throat, neck and lymph nodes, but a dedicated comprehensive oral cancer screening should be performed at least once each year.
Dr. Shults works closely with pathologists, oral surgeons, head and neck surgeons, ear-nose-throat (ENT) surgeons, radiologists, radiation oncologists, oncologists, endocrinologists, dermatologists, cosmetic plastic surgeons, pain medicine physicians and your primary health care provider as well as the James Cancer Patient-In-Need Foundation to assist the patient in receiving optimal care and rehabilitation.
There are many disease states that are benign in nature and identified by medical history, visual observation with the head and neck examination as well as incorporating cultures, diagnostic studies & testing if needed. Our intraoral cameras allow us to show you exactly what we see so that we can work together to achieve optimal health. Our belief is education and your active involvement is the key to establishing and maintaining optimal health. Please visit our Oral Systemic Health section and links for more information.