The Important Oral Cancer Exam

By Sheila Wolf, RDH

More than 30,000 Americans are diagnosed with oral cancer each year. That means that somewhere on the lips, the gums, the linings of the cheeks, the tongue, the floor of the mouth (underneath the tongue), the palates, and that little pad behind the wisdom teeth, there could be something lurking that threatens your well-being. Oral cancer can be deadly. However, if diagnosed early enough, oral cancers can be treated with great success.

Consider your doctor exceptional if, when performing your yearly physical, he looks at more in your mouth than just your tonsils and that little dangly thing in the back of your throat (your uvula). According to The American Cancer Society, a 1992 national survey revealed that only 15% of the population reported ever having had an oral examination.

There seems to be an unspoken agreement in the world of medical professionals, that the mouth is an entirely separate area of the body, its domain belonging to the dental specialist. This reliance on the dentist or hygienist assumes that everyone has dental regular check-ups and that every dental professional performs an oral cancer exam.

It is not yet universally accepted that the health of the mouth has an effect on the rest of the body. However, in his first-ever report on oral health in 2000, the Surgeon General made this statement: "Oral health is integral to general health ... Oral health and general health should not be interpreted as separate entities." You cannot have a healthy body if your mouth is diseased.

Who is most at risk for oral cancers?

• People over the age of 40.
  
  
• People who smoke cigarettes, cigars, and pipes.
  
  
• People who chew tobacco and dip snuff.
  
  
• People who drink alcohol excessively.
  
  
• People who are exposed to too much sun (cancer of the lip).
  
  
• People who both drink and smoke have increased risk.

However, don't be smug if you don't fall into those categories. More than 25% of oral cancers occur in people who do not smoke and have no other risk factors.

I once had a fourteen-year-old boy in my dental chair who "dipped" tobacco. He used to chew it first and then hold it against his lower lip and gums when he played baseball because, he said, it was "cool." When he came in to have his teeth cleaned, I noticed a suspicious-looking white patch between his cheek and gums, which had obviously developed from the constant irritation of a foreign, nicotine-soaked substance being placed there on a regular basis during baseball season. It definitely appeared to be pre-cancerous, and I told him that if he didn't stop "dipping," he would probably lose his jawbone — if not his very life!

He quit ... And lived. Thank goodness he listened.

Here is a list of things to look for in your mouth that could save your life:

• A sore or spot on your lip or in your mouth that bleeds easily or does not heal for 2 weeks or longer.
  
  
• A white or red area on your gums, tongue, or lining of your mouth.
  
  
• A lump, thickening, or crusty spot on your lip, your mouth or your throat.
  
  
• A persistent sore throat.
  
  
• A change in your voice.
  
  
• A pain in your ear.
  
  
• An unexplained swelling of your jaw with difficulty chewing, speaking or swallowing.
  
  
• Any unusual bleeding, pain, or a numb feeling in your mouth area.
  
  
• A change in the way your teeth come together.
  
  
• Any asymmetry on your lips, mouth, face, or neck.

If you have any concerns, always consult your physician or your dentist for a diagnosis.

If your physician or dentist notices something that looks unusual, she will probably ask you to come back in 2 weeks so she can check it again. Most sores heal in that length of time. If it is still there, she may perform a simple, painless test, called a brush biopsy that can detect potentially dangerous cells at an early stage of disease. If your dentist suspects something risky, a biopsy (removal of a piece of the tissue with local anesthesia) will be sent to a pathologist who will examine it under a microscope to check for cancer cells. Either your general dentist will do this or he/she will refer you to a specialist.

What can you do to safeguard your health?

Make sure you have regular dental check-ups. They should include an examination of the entire mouth, which is vital in the early detection of cancerous and pre-cancerous conditions. You could have a very small, but dangerous, oral spot or sore and not be aware of it.

Always ask your doctor, dentist or hygienist to do an oral cancer exam as part of your routine exam. You are entitled to it! It should take just a few minutes and could save your life. Seventy-five percent of all head and neck cancers begin in the oral cavity.

Do a monthly self-examination. Remove any appliances you have in your mouth and use a washcloth or gauze to dry off your tissues. This will enable you to see lumps or bumps easier as well as any changes in the texture of your tissues. The National Cancer Institute encourages people to take an active role in the early detection of oral cancer.

Eat a diet plentiful in fruits and vegetables. Studies show that good nutrition may prevent the development of potentially cancerous lesions.

Remember, frequent self-diagnosis in between dental visits is important.

Here are some organizations that will provide additional information:

• The American Cancer Society: www.cancer.org. 1-800-ACS-2345.
  
  
• The Mayo Clinic: www.mayoclinic.com.
  
  
• The National Institutes of Health: www.nih.gov. 1-301-496-4000.

Article appeared in The Health Plus Letter, August 24, 2004, Vol. 2, No. 28. Copyright © 2004 by Larry Trivieri, Jr. All rights reserved.

Mama Gums