April is Oral Cancer Awareness month, so we’ll be talking about all things oral cancer. We’ll cover how you can fight it, how you can detect it,what your dentist office should be doing to check for oral cancer, and how you can perform a self-examination.
Oral and oropharyngeal cancer, meaning cancer of the mouth and the upper throat (including the tongue, lips, throat, parts of the nose and the larynx), collectively kill one person every hour of every day of the year. Of the people that are newly diagnosed with these cancers, 40% will not survive longer than five years. Many who do survive suffer long-term problems like facial disfigurement and difficulties eating and speaking. The main reason that the death rate associated with oral and oropharyngeal cancers remains particularly high is that these cancers are not routinely discovered early in their development.
Early Detection is Key
The best way to combat cancer is finding it early by being mindful of symptoms of oral cancer. The earlier we find it, the higher the success rate of treatment. The problem with oral cancer is that often it isn’t discovered until very, very late in its development. In its early stages, oral cancer can be treated in up to 90 plus percent of cases, but if it goes untreated or undetected, those success rates start to fall.
If you take nothing else away from this article, make sure to see you dentist if you have an ulceration or a sore in your mouth that doesn't heal within two weeks. This doesn't mean it’s cancer, but precancerous spots and oral cancer will look like a sore that never heals.
Most issues in our mouth such as canker sores, cuts, etc. should heal within that two-week time frame, or at least be on their way to healing. If you have something that's hanging around, it never hurts to give your dentist a call. In fact, it could save your life!
Signs & Symptoms
Your mouth is one of the body's most important early warning systems. Between dental visits, make sure that you're aware of these symptoms. Like we said, oral cancer can appear as a sore, soreness, or irritation that doesn't go away. Here are some symptoms that warrant a trip to the dentist:
- Red or white patches, pain, or numbness in the mouth or lips
- Lumps, thickening tissues, rough spots, crusty or eroded areas
- Trouble chewing, swallowing, speaking, moving your jaw or tongue, or if you have a change in the way your teeth fit together when you close your mouth
Again, these symptoms don't necessarily mean that you have oral cancer, but you should probably see your dentist, especially if they don’t go away within that two to three-week time period.
Know the Risks
There are several risk factors that are associated with an increased likelihood of developing oral cancer.
Heavy Smoking & Drinking: Historically, heavy drinkers and heavy smokers older than age 50 are at the highest risk. Approximately 75% of all oral cavity and oropharyngeal cancers are attributed to the use of smoked and smokeless tobacco according to the Center for Disease Control and Prevention.
Using cigarettes, cigars, pipes chewing tobacco (basically any type of tobacco product) puts you at a much higher risk for developing oral cancer, as well as heart disease, COPD, emphysema, chronic bronchitis, lung cancer,etc. Suffice it to say, tobacco is bad. Researchers believe that chronic alcohol abuse, or use combined with the use of tobacco multiplies the risk.
Sun Exposure: When you're talking about the lips and the mouth,exposure to sun is another variable or risk factor for developing cancer around the lips.
Male vs. Female: According to the Center for Disease Control, oral cancer occurs twice as often in males as in females. This is considerably different from the five-to-one male-to-female ratio reported about 40 years ago. It's changed over the years, but still occurs more often in men than in women. Increased tobacco use among women is the main reason for the changes in the cancer rates compared with those that came out of the 1950s.
Age: Historically, 90% of oral cancer occurs in people over the age of 40, with an average age being 60. However, we are starting to see a change in this trend where we're seeing oral cancer a little younger sometimes as well. Today, cancer is also occurring more frequently in younger non-smoking people.
If you haven’t had an oral cancer evaluation, there's no better time to do it than Oral Cancer Awareness Month. We provide an oral cancer evaluation at our office with every routine checkup for no additional fee. This is a visual exam that we perform every six months. We take a look at the soft tissues and all of the parts of the oral cavity, examining the tongue, cheek, lips, etc. visually looking for changes. There's no better examination than a visual examination.
In addition, we perform an OralID examination. This is an optically-based technology called fluorescence technology. It isn’t an invasive test, and the equipment is similar to a flashlight. When we shine the fluorescent light in the mouth, areas of pre-cancer and cancer will actually change color under the light. We add this adjunctive light out of an overabundance of caution and to make sure there aren't any changes.
If we see something that looks a little suspicious, we generally keep an eye on it for a couple of weeks. If it's still there, there are various ways to examine it. The best way is under a microscope. We take a brush and use a method known as brush cytology and look at the cells under a microscope. Sometimes we will make a small incision or biopsy, taking a little piece of that tissue and sending it off to be looked at under a microscope. Either way, if we have any concerns, there are multiple ways to find out if it’s healthy tissue, an ulceration, precancerous, or cancerous. This is definitely something that your dentist should be doing. Like we mentioned, we do this routinely, about every six months, because that early detection is so important.
An oral cancer self-examination is something you can do in between your visits to the dentist.
Your Head and Neck: Look at your face and neck in a mirror. Normally, the left and right sides of the face are roughly symmetrical. Check for anything that looks like a lump, a bump, or swelling on only one side of your face. When you're looking in the mirror, examine anything that appears to be asymmetrical.
Your Face: Examine the skin on your face for changes in color or size, sores, moles, growths, or anything out of the ordinary. Press along the sides and front of the neck and look for tenderness or lumps. Pull your lower lip down and look for sores or color changes, then use your thumb and forefinger to feel the lip for lumps, bumps, or changes in texture. Do this for both the lower and upper lip.
Your Cheeks: Look on the inside of your cheek for red, white, or dark patches. Put your index finger on the inside of your cheek, and your thumb on the outside. Squeeze and roll the sides of your cheeks between your fingers to look for lumps or bumps, or areas of soreness. Many of us have a line called the linea alba right where our teeth meet, and that's normal. It's just from our cheek sneaking in there when our teeth bite together. Don’t confuse this with other issues.
The Roof of Your Mouth: Tilt your head back and open your mouth as wide as you can. Look for lumps, see if the color is different from that normal pink color, and touch and feel the roof of your mouth for bumps.
The Floor of the Mouth and Tongue: Stick your tongue out and look at the top surface for color and texture. Pull your tongue forward and look at the sides, checking for swellings, color changes, or any ulcerations. Look under your tongue by putting the tip of your tongue on the roof of your mouth, and look at the floor of the mouth and the underside of the tongue for any color changes. Again, you can take your fingers and roll around your tongue, feeling for any lumps or bumps. This is very similar to the exam that we do in the chair. It never hurts to give your dentist or our office a call if you feel anything out of the ordinary. We're more than happy to take a look and make sure it's nothing abnormal.
The Main Takeaways
This is a lot of information and you may be feeling overwhelmed. To simplify things here’s a quick summary:
- See your dentist regularly. Make sure that part of your routine examination is an oral cancer screening.
- In between dentist visits, make sure you're doing a self-assessment at home every now and then. You don't have to do it every day. You don't have to do it every week. Once a month, just take a look, or if you feel something weird, just make sure you're doing that self-exam at home.
- If you have something in your mouth, a sore that lasts more than two to three weeks, call your dentist and have it looked at professionally.
And remember, you can always schedule an appointment at our office by calling 740-548-1800!