Approximately 35,000 new cases of oral cancer are diagnosed each year in the United States. According to the American Cancer Society, around 25 percent of those people will die of the disease. Although the use of tobacco and alcohol are risk factors in developing oral cancer, approximately 25% of oral cancer patients have no known risk factors. Therefore, it is imperative that everyone receive regular examinations of the oral and facial tissues. These examinations are typically done by a dentist as part of a regular dental visit.
Many types of abnormal cells can develop in the oral cavity, often in the form of red or white spots. Some are harmless and benign, some are cancerous, and others are pre-cancerous, meaning they can develop into cancer if not detected early and removed. Most oral cancers arise on the lips, tongue or on the floor of the mouth. They also may occur inside your cheeks, on your gums, or on the roof of your mouth. Oral cancer typically begins as a painless lesion. Left untreated it may or may not become painful. Often patients never know there is a lesion.
The stage at which oral cancer is diagnosed is critical to the course of the disease. When detected at its earliest stage, oral cancer is more easily treated and cured. When detected late, the overall five-year survival rate, as reported by the National Institutes of Health, is about 50 percent. When oral cancer spreads (metastasizes), it usually travels through the lymphatic system and often appears first in nearby lymph nodes. It can then spread to other tissues and organs.
Treatment for cancers that have metastasized is more complicated than that of localized lesions. For smaller lesions, treatment can be as minimal as surgical removal of a small area of tissue. If the cancer cells have spread to surrounding tissues, radiation, chemotherapy, and/or removal of a large section of tissue, which may include bone, muscle, and teeth, could be necessary.
When your dentist performs an oral cancer exam, he or she will inspect your face, neck, lips, and mouth as well as feel and look at the insides of your lips and cheeks. The dentist will pull your tongue to one side and then the other and also check underneath. He or she will look in the roof and floor of your mouth as well as back of your throat. There are also new devices that have been developed in the past few years to aid dentists in early detection of oral cancers. Dr. Cheek uses the VELscope oral cancer detection device in our practice as an adjunct to the visual oral cancer check she does at every examination. These devices use a special light to observe the fluorescence of the tissue to detect abnormalities that may not yet be visible to the naked eye.
Although anyone can develop oral cancer, you can reduce your risk by avoiding tobacco and alcohol use and by using sunscreen on your lips, as frequent sun exposure can make you prone to developing lip cancer. Irritation from ill-fitting dentures and partials can also create areas of dysplasia which are prone to becoming cancerous. Certainly if you notice a sore or nodule that doesn’t seem to be healing, notify your dentist immediately.