How your dentist can now help detect oral cancer.

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Though hardly welcome news, a diagnosis of oral cancer in the early stages offers patients a fighting chance at treatment and survival. The statistics drive home the importance of a prompt diagnosis: Oral cancer was detected in 3,200 people and was responsible for 1,100 deaths in 2007, according to the Journal of the Canadian Dental Association, which estimates that proper screening could catch up to 84 per cent of cases. More deaths occur each year from oral cancer than from melanoma or cervical cancer, according to the JCDA. Since 25 per cent of all oral cancer patients have no known risk factors, according to the American Dental Association, early detection means those not engaged in high-risk behaviour, such as smoking, can more effectively screen for the presence of cancerous or precancerous cell growth in the mouth, lips, tongue or throat during their annual dental checkup.

Essential Light

Toronto’s Dr. Edward Philips, DDS, says dentists can catch abnormalities in the course of regular exams through sight and touch, but he also relies on LED Dental’s VELscope Vx, a wireless, handheld scope that applies tissue fluorescence visualization—basically, intense penetrating light—to identify oral mucosal abnormalities early on, before they become visible to the naked eye.

Similarly, Zila’s ViziLite Plus with TBlue helps oral health care professionals identify, evaluate, monitor and mark abnormal oral cell lesions that may be difficult to see during a regular visual exam. Both light-based screening tests are painless, take only a few minutes, can be performed by hygienists, cost about $50 and are widely available in dental offices across North America.

“My clinical sense is that oral cancer is on the rise,” says Dr. Philips, noting the link between the human papilloma virus (HPV), a common sexually transmitted virus, and oral cancers located in the upper throat and back of the tongue. He stresses that VELscope and ViziLite are both effective oral cancer screening tools and says he uses the former as a matter of personal preference.

Screening for All

Reetika Prashar, a registered dental hygienist with Toronto’s Dawson Dental Centres, where ViziLite Plus with TBlue has been in use for about a decade, says, “We offer it to every single patient.” Prashar adds that a dentist would likely double-check any positive test results that a hygienist uncovers.

“Basically ViziLite is an oral lesion identification and marking system, so it helps us find abnormal cells,” explains Prashar. “We have the patient rinse with this acidic rinse that dries out the tissue of the mouth and allows us to see the cells more clearly using a chemiluminescent light. If we find a lesion we try and rule out trauma first—things like burns, bites or scrapes from hard foods. This sometimes requires us to bring the patient back after two weeks. If a TBlue test came back positive, we would refer the patient to an oral pathologist for a biopsy.”

Dr. Philips adds that- while light-based testing isn’t 100 per cent reliable, it’s something. And as healthcare professionals, we should be using all the accessible tools we have to detect these things.”

Oral Cancer Detection Tips 

While the exact cause of oral cancer is unknown, the Canadian Dental Association (CDA) identifies risk factors such as smoking, heavy alcohol consumption, prolonged, repeated exposure of the lips to the sun, and oral sex—which leaves practitioners open to contracting human papilloma virus (HPV)—that are linked to cancers in the upper throat and back of the tongue.

1) “Be cognizant of your sexual partners and know that HPV is highly transmittable orally,” says Dr. Philips says.

2) Males are more susceptible to oral cancer, according to the CDA, but vulnerability increases for both genders after age 45.

3) Self-monitoring is vital. “Many medical conditions, including diabetes, show up in the mouth before other symptoms are present,” says Dr. Philips. “Follow the two-week rule: small burns, ulcers or anything that does not heal in 14 days should be checked out.”