When caught early, oral cancers are highly treatable and often have a better prognosis. Oral health experts believe April’s designation as Oral Cancer Awareness Month is a useful time to raise patient and provider awareness about the disease.
The National Cancer Institute estimates there were 42,440 new cases of oral cancer — and pharynx cancer — in 2014, and 8,390 deaths. Death rates among white males have not changed significantly between 2007 and 2011, according to NCI.
Still, most oral cancer diagnoses are “caught late,” said Dr. John Hellstein, president of the American Academy of Oral and Maxillofacial Pathology, professor of oral and maxillofacial pathology at the University of Iowa and former chair of the ADA Council on Scientific Affairs. “That’s why we want dentists at every appointment to look for any kind of abnormality.”
Dentists should look for signs of oral cancer during any routine visit, according to Dr. Hellstein. “Attentiveness is the key,” he said.
The ADA encourages its members to promote early oral cancer detection through periodic extraoral and intraoral examinations and, with constituent societies, it promotes prevention and early detection of oral cancer through public education activities. The ADA Council on Scientific Affairs encourages clinicians to provide adult patients with thorough hard-tissue and soft-tissue exams, including lymph node examination, following completion of the patient’s health history and risk assessment.
Dr. Hellstein emphasizes the need for dental care providers to be fully aware of precancerous lesions and the possible signs of oral cancer. The signs and symptoms may include a sore on the lip or in the mouth; a white or red patch on the gums, tongue, tonsils or lining of the mouth; or a lump or thickening on the lips or gums or in the mouth that does not go away or heal.
Dentists and the dental team can also talk with patients about risk factors associated with oral cancers. Research has identified smoking, excessive alcohol consumption and especially smoking and drinking combined as factors that contribute to the development of oral cancers.
Human papillomavirus, particularly high-risk subtypes, has been associated with cancers of the tonsillar/pharyngeal regions. HPV-positive oropharyngeal cancers have been associated with sexual activity and may account for the increasing incidence of throat cancers in nonsmoking adults.