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October 2009 | Dental Products Report The take-aways Shine a light on oral cancer Most dentists still don’t routinely screen for oral cancer, but the technology is available, and providing this potentially life-saving service should be a standard procedure.  Click on Image to see additional figure slideshow Photo: trimira clinical image library “As a profession, dentistry prides itself on our emphasis on prevention. We spend countless hours educating our patients on proper diet, home care and the importance of regular preventive care. Why then, when it comes to oral cancer, are we content to not do thorough screenings? And it’s not only about ‘The Big C.’ Proper screenings done with multiple wavelengths of light can help us identify and treat other soft-tissue diseases and conditions as well. We have the means at our disposal, now it’s up to us to use the tools. Read Chris’s article and let it sink in. Then get out there and do the right thing!”—Dr. John Flucke, Team Lead How do you kick an entire profession in the rear end to wake it up so it will stop neglecting this most serious and deadly health issue? Where is the leadership that should be putting pressure on all dentists to either perform advanced oral cancer screenings or turn in their licenses? There are wonderful new technologies available to us now for the early oral cancer screening (see “How oral cancer screening products work” sidebar on next page), but to talk about that is kind of like putting the cart before the horse. You see, by and large, the vast majority of dentists do not do oral cancer screenings, or at least they don’t do effective oral cancer screenings. Some practices may use the naked eye to identify something that appears abnormal, and maybe they reschedule those patients for another look in a few weeks. Maybe. But what if that patient doesn’t return for a follow up? What if the practice doesn’t remember to check that abnormality at the next hygiene visit? This “let’s watch it” method has been obsolete for quite some time now. Even the best specialists can’t identify a small cancerous lesion from a non-cancerous lesion with their naked eye. If the lesion is big and obvious and it is cancer, then at that point it may be so far advanced it could be too late. So we should stop using the naked eye, grab a hold of some of the new technologies that allow us to see what the naked eye can’t see and start giving our patients the best chances of surviving this deadly disease, as well as avoiding its disfiguring consequences. We have better means to screen—so let’s start using them. Depressing status quo Oral cancer is one of the few forms of cancer that has not seen a significant reduction in its mortality rate in the past several decades. Would you like to know why? According to the Oral Cancer Foundation, it is because effective screening just isn’t being done. Cancers are advancing and people are either dying or becoming disfigured and losing their ability to speak, swallow, breathe and chew. Late detection of this disease is the primary reason the number of new cases and the death rate just keep climbing. Oral cancer is killing someone in North America every hour of every day. Yes it’s time to pull our profession out of the dark ages, update our skills and use the best tools to screen for this insidious scourge that does not discriminate its victims. Oral cancer can attack almost anyone. Currently up to one-third of the victims are women who don’t fall into the usual at-risk profile, which is men older than 40 who are heavy tobacco and alcohol users. This change appears to be connected to strains of the human papilloma virus (HPV) that have been shown to lead to oral cancer. This discovery means oral cancer can be a sexually transmitted disease. In fact, there are as many cases of oral cancer caused by HPV as there are HPV-related causes of cervical cancer. While this news gives us one more reason to sound the alarm over the importance of new screening methods, it unfortunately is not yet common knowledge. If it is commonplace for women to get a yearly Pap smear screening, why is it not just as common for these same women to get an oral cancer screening? The cost for a cervical cancer screening Pap smear can range between $50 and $200. Wouldn’t you expect patients to pay just as much to screen for oral cancer that kills three times as many people? However, practice management experts tell me that up to 80% of dentists never perform these screenings. Why such a lackadaisical approach? Well, historically, dentistry has never been much about life and death. In fact, that is why in years past many college students chose this profession (me included). But thankfully, that is now changing. Thanks to the mounting evidence in the oral systemic realm that has stimulated a new focus on periodontal health, dentists are becoming the new life-enhancing and life-extending physicians of the mouth. Our efforts to detect oral cancer at its earliest occurrence are right in line with this new movement, and screenings should be a part of the routine care we provide to our patients. CONTINUED ON NEXT PAGE
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