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A Two-Minute Exam Can Save Your Life

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April is Oral Cancer Awareness Month, and today we talk about oral cancer, it's risk factors, diagnosis, and treatment.  We'll give you an oral cancer self-examination, and talk about the hot topic of vaping.  Finally, I had the privilege of sitting down with the President of the Olentangy Berlin High School Athletic Boosters to talk about their first year as a school.  Join us today!

Transcript

A smile says it all. If your teeth could talk, what would they say? Find out today on Talkin' Teeth with Doctor Kyle Bogan.

Hello, and welcome to April's episode of Talkin' Teeth. There are a couple of subjects today we're going to really dive and talk deep about. The first of which, April is Oral Cancer Awareness month, and so we're going to spend a good amount of time talking about what oral cancer is, how you can fight it, how you can detect it. What you should be seeing at your dentist's office to make sure they're helping, to make sure that you don't have oral cancer, and are keeping an eye on things.

Along with oral cancer, we're going to talk about vaping. It's a hot topic these days. Lots of new information and research coming out. Lots of stuff in the news lately about vaping. So, we're going to touch on that. We're going to tell you how to do an oral cancer self-examination. And, then we're also going to talk about our new office, it's getting ready to open on May 6th, we'll be in there. Give you an update on that. As well, I got a chance to sit down with April from the Olentangy Berlin High School Athletic Boosters, and we're just going to talk, and all things Berlin High School Athletics and what's going on this summer.

But first, let's go ahead and get to the topic of the day, and that's oral cancer. So, oral and oropharyngeal cancer, which just means cancer of the mouth and the upper throat, collectively kills 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 of us who do survive suffer long-term problems like facial disfigurement, difficulties eating and speaking, just because the main reason that the death rate associated with oral and oropharyngeal cancers remains particularly high, is because these cancers are not routinely discovered early in their development.

The biggest thing to help us combat cancer if finding it early. The earlier we find it, the higher the success rate of treatment. The problem with oral cancer is a lot of the time it's not discovered until very, very late in its development. Like I said, the good news is when it is detected early on, mortality and treatment related health problems are reduced, and a lot of the issues seen with treatments are reduced.

What we want to talk about is, being mindful of symptoms of oral cancer. I'm going to go through a list of things here. But, the main thing to remember, if you take nothing else away from the talk today, is if you have an ulceration or a sore in your mouth that doesn't heal within two weeks, you need to see your dentist to have it looked at. It doesn't mean it's cancer, but basically precancerous things and oral cancer will look like a sore and it just never heals.

Most things in our mouth, canker sores, cuts, those sorts of things should heal within about two weeks, or at least be on their way to healing. So, if you've got something that's hanging around, then just make sure you give your dentist a call.

As far as symptoms go, your mouth is one of the body's most important early warning systems. In between dental visits make sure that you're aware of these symptoms. Like I said, it's a sore or a soreness, or irritation that doesn't go away. Red or white patches, or pain, or numbness in the mouth or lips. Basically, any numbness ever, outside of having a procedure done, definitely, definitely see your dentist. Lumps, thickening tissues, rough spots, crusty or eroded areas. If you're having trouble chewing all of a sudden, or swallowing, or speaking, or moving your jaw or tongue, something that's newly happened, or if you have a change in the way your teeth fit together when you close your mouth. That's when you bite together if it feels different.

Again, this doesn't mean you have oral cancer. It just means you need to have it taken a closer look at. With these symptoms, again, two to three week time period, if it doesn't heal call your dentist. I don't think I can say that enough.

In its early stages, oral cancer can be treated in up to 90 plus percent of cases, but if it goes untreated or undetected like we talked about earlier, those success rates start to fall. There are risk factors that are associated with your risk of developing oral cancer. Historically those that are especially at high risk of oral cancer have been heavy drinkers, and heavy smokers older than age 50. Basically, or approximately 75% of all oral cavity and oropharyngeal cancers, meaning mouth, tongue, lips, throat, parts of the nose and the larynx are attributed to the use of smoke, and smokeless tobacco according to the CDC.

Those who chose to use cigarettes, cigars, pipes chewing tobacco, basically any type of tobacco product place themselves at a much higher risk for developing oral cancer, and other diseases like heart disease, COPD, emphysema, chronic bronchitis, lung cancer, that sort of stuff. Researchers believe that chronic alcohol abuse, or use combined with the use of tobacco multiplies the risk. 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.

According to the Center for Disease Control, oral cancer occurs twice as often in men than in females. This is considerably different from the five to one male to female ratio reported about 40 years ago. Its changed over the years, but still occurs more often in men than 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 is also a factor. 90% of oral cancer occurs in people over the age of 40, with 60 being the actual age. But, I will say that we are starting to see that change a little bit too. Where we're seeing oral cancer see a little younger sometimes as well. Today, cancer is also occurring more frequently in younger non-smoking people. Again, like I said, the age thing is changing just a little bit.

Early detection is the key. So, we're going to talk here in minute about a self-examination. And then, if you've never had an oral cancer evaluation, there's no better time to it that this month, April, being Oral Cancer Awareness Month. Your dentist ... This is something in my office that I do every six months when people come in for their routine checkup. There's no additional fee for it, or anything like that. The first thing, it's a visual exam. Every six months I'm taking a look. All the soft tissues, all the parts of the oral cavity. We're examining the tongue, the cheek, the lips, all of that just visually looking for changes.

We also have something called OralID. What it is, is an optically based technology called fluorescence technology. Honestly, it looks like a flashlight, so it's not a scary test. But, we shine this fluorescent light in the mouth. What it does is it shows areas of pre-cancer and cancer. So, they actually change color under the light. There's no better examination than visual examination, that's the standard.

We like to add this kind of adjunctive light to it just to help and make sure that we're being extremely thorough every six months, and making 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 weeks. Again, that two week rule. If it's still there after a couple weeks, there's various ways to examine it. The best way to examine it to be sure is under a microscope. Whether that means we take a brush and use brush cytology it's called, and look at the cells under a microscope. Sometimes that means a little incision or biopsy, where we take a little piece of that tissue and send that off to be looked at under a microscope.

Either way, if we have any concerns, there's multiple ways to find out, is it healthy tissue? Is it an ulceration? Or is it precancerous, or cancerous? Definitely something that your dentist should be doing. It's something that I do routinely, like I said, every six months just because it's definitely something, if it's found we want to find it early.

As far as an oral cancer self-examination, it's something you can do in between your visits. The main way to do this at home is to look at and feel several different areas. First off is your head and neck. You want to look at your face, and you want to look at your neck in a mirror. Normally, the left and right sides of the face have the same shape, and are symmetrical. You want to look for anything that looks like a lump, a bump, or swellings that are on only one side of your face. when you're looking in the mirror, any sign of asymmetry is something that you have examined.

Your face, you want to examine the skin on your face for changes in color, or size, sores, moles or growths. Anything different or out of the ordinary. On your neck, you want to press along the sides and front of the neck and look for tenderness or lumps. For the lips, you want to pull your lower lip down and look for sores or color changes, and then use your thumb and forefinger to feel the lip for lumps, bumps, or changes in texture. You do that for the lower lip, and for the upper lip.

On your cheeks, you want to look on the inside of your cheek for red, white, or dark patches. A lot of us have a line, it's called linea alba. That's right, where our teeth meet, and that's normal. It's just from our cheek sneaking in there when our teeth bite together. But, anything else out of the ordinary. You want to put your index finger on the inside of your cheek, and your thumb on the outside. Again, then squeeze and roll the sides of your cheeks between your fingers to look for lumps or bumps, or areas of soreness.

On the roof of your mouth, you're going to tilt your head back and open your mouth as wide as you can. Look for any lumps, and see if the color is different from that normal pink color, and, you want to touch and feel the roof of your mouth for bumps.

The floor of the mouth and tongue, you want to stick your tongue out, and look at the top surface for color and texture. You want to pull your tongue forward, and look at the sides, and look for swellings or color changes, or any ulcerations. That's another thing you want to look for.

You want to 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, and feel for any lumps or bumps. Very similar to the exam that I do in the chair, but, anything that you feel is out of the ordinary never hurts to give the dentist a call, give our office a call, and we're more than happy to take a look and make sure it's nothing abnormal.

One other thing that I wanted to dive into today along the same lines as oral cancer and being a cause is vaping. Vaping is a big deal these days. I've never heard more about it than I have recently in the news. Basically, there are these instruments, vaping, they used to be called E-cigarettes, and there's a juice, or a liquid that goes into them. It can be nicotine containing, or non-nicotine containing. Basically, we're finding that, the advertisements for these vaping instruments talk about it as smoking cessation, getting you to quit smoking agent.

It talks you about it being healthier than smoking. What we're finding is that just really isn't true. Johns Hopkins actually posted an article titled, The Five Truths You Need To Know About Vaping. We'll march to them real quickly here. First, truth number one is, it says that vaping is less harmful than traditional smoking. While on the surface that appears to be true, some of the newer research coming out that I've been reading actually is saying that we don't know. And even John Hopkins' article says that while we don't know exactly are in E-cigarettes or vaping liquid, they think that there are less than that are in cigarettes because cigarettes contains 7,000 different chemicals.

When you look at the vaping liquid bottle, it has maybe four ingredients. But the newer research is showing that when those ingredients are heated, they quite probably break down into other more toxic chemicals. Instead of having four or five, there could be hundreds of different chemicals. I had heard recently that they're over 10,700 different registered vaping liquid flavors on the market today and that's ever increasing.

So, knowing exactly what's in those and what those agents that are in there break down into is very difficult. The common knowledge so far has been that vaping must be more healthy than smoking, whatever that means. But I do believe that the emerging research is going to show that that may not be true. Johns Hopkins article also listed truth number two, saying that vaping is still bad for your health. Nicotine is the primary agent in both regular cigarettes and E-cigarettes and vaping liquid, and it's highly addictive. So, nicotine is nicotine is nicotine. Whether it comes from a cigarette or it comes from vaping liquid, it's still tobacco.

It causes you to crave smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine is also toxic. It raises your blood pressure, spikes your adrenaline, which increases your heart rate and the likelihood of having a heart attack.

There are many unknowns about vaping including what chemicals make up the vapor and how they affect physical health over the long term. One of the quotes in the Johns Hopkins article says people need to understand that E-cigarettes are potentially dangerous to your health, and that you're exposing yourself to all kinds of chemicals that we don't yet understand and are probably not safe. That's the big thing, we just don't know what's in there, and that's a big question mark.

Truth number three, electronic cigarettes are just as addictive as traditional ones. Again, both E-cigarettes and regular cigarettes contain nicotine, which actually some research suggests maybe as addictive as heroin and cocaine. What's worse, many E-cigarettes users get even more nicotine than they would from a tobacco product. I'm going to go through an article in a minute that talks about that. Because you can buy extra strength cartridges which have higher concentration of nicotine, or you can increase the E-cigarette's voltage to get a greater hit of the nicotine. Potentially, nicotine overdose is a potential.

Truth number four, Johns Hopkins says electronic cigarettes aren't the best smoking cessation tool. Like I said, a lot of times E-cigarettes or vaping is considered or touted as a way to quit smoking because there's a certain amount of nicotine in the liquid. That's a heavy marketing thing. But E-cigarettes have not received the Food and Drug Administration's approval as a smoking cessation device. A recent study found that most people who intend to use E-cigarettes to kick the nicotine habit ended up continuing to smoke both traditional and E-cigarettes.

Finally, truth number five, and one of the most unfortunate things is that a new generation is getting hooked on nicotine. Among youth, E-cigarettes are more popular than any traditional tobacco product. In 2015, the U.S Surgeon General reported that E-cigarette use, or vaping use among high school students had increased by 900% and 40% of young E-cigarette users had never smoked regular tobacco.

There are a few reasons why. They suggest that E-cigarettes are particularly enticing to young people. First, teens believe that vaping is less harmful than smoking. Second, E-cigarettes have a lower per use cost than traditional cigarettes and vaping cartridges are also formulated with flavorings like apple pie and watermelon to appear to appeal to younger users. There are also some places out there where you can make custom liquids where they can mix flavors and create their own mix and flavor.

They also say that with no smell, E-cigarettes reduce the stigma of smoking. Let's go back, I want to grab this article here. It's the one I talked about earlier, is that school districts are really trying to, with the young people really taken after vaping, school districts are finding different ways to let kids know about the dangers.

One recent issue and I believe this was a 10TV article if I remember right. One recent issue included a Lincoln Heights middle schooler caught with a vaping device on a bus that made other students ill. Upper Arlington has a parent volunteer group called The [inaudible 00:17:12] Project, which is trying to get the message to parents and using teens to talk to kids about it. High schoolers are going to the middle schools telling kids not to vape. There are videos featuring police, doctors and school leaders who are out there on social media, trying to get the message across that these aren't super safe devices.

After reports, one of the things we talked about earlier was nicotine and the concentration and possible nicotine overdose. There were reports of seizures after vaping. After these reports, US Food and Drug Administration is trying to alert the public to a potential new risk and calling for people to come forth with cases that the agency might not know about.

The FDA has identified 35 cases of seizures, mostly among younger users between 2010 and 2019. That's also seen a slight increase in the reports of seizure since June. Seizures are known to be a possible side effect of nicotine poisoning, the FDA said. They know that nicotine isn't a harmless substance, especially in the developing brains of kids. But the unfortunate thing is there's no clear pattern to the seizures. Some of them who had seizures were vaping for the first time, and some had been using the products for a long time. The time and the seizures also ranged from after a few puffs on the E-cigarette, to a whole day later.

Several people had previously received seizure diagnoses, which just means they've had seizures in the past and they may have instituted a new seizure. A few had other issues prior to the seizures. The big takeaway, I think, from E-cigarettes and vaping is that we just don't know. But what we do know is probably that it's not safe, and especially for our youth.

One local story that was in this week's news recently, is that here in the Olentangy local school district, leaders are taking a closer look at ways to combat vaping. The district hosted an event on February 6th, so a few months ago to discuss the dangers of vaping. At the event, students from a group called Clearing The Fog shared information that they gathered that highlights the rampant use of vaping in Olentangy schools and in every school.

Again, that goes along with all the things that we're seeing out of the FDA. Just with April being Oral Cancer Awareness Month, I really wanted to highlight that one issue, just because it seems to be more prevalent among our youth and just becoming more prevalent overall. Just, there's so many unknowns. Current research being done will hopefully clarify some of those unknowns, and just wanted to kind of get the word out there.

That is all about oral cancer. Take aways from oral cancer, this topic. Number one, see your dentist regularly. Make sure that part of that examination, that 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 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.

Check this out.

All right, now we're going to move on to our next topic. One of my favorite parts of doing this podcast is getting to sit down with people in our community just to talk about what amazing things are happening. This is no different this time around. I got a pleasure to sit down with April from the Olentangy Berlin High School Athletic Boosters. Just to talk about Olentangy Berlin Athletics in their first year. Getting ready to come to the end of that first year. How it went, some of the lessons learned, what they're doing over there. We are privileged enough to be able to sponsor the athletic department. It's just amazing what they've done this year at Olentangy Berlin High School. I want to go ahead and play that interview for you because they are doing some amazing things this year at Olentangy Berlin High School.

All right, we're here with April from the Berlin High School Athletic Boosters. We're just talking about, they just finished their first year as a school and having to get a new athletic department up and running. We're honored to be a sponsor of that. I want to bring April along just to recap the year a little bit and talk about the school and what's been happening. So, hey April. Thanks for coming on.

Hey Dr. Bogan, thanks for having me.

Yeah. I know that was probably a huge undertaking, bringing up that whole athletic department. Can you tell me what it was like being a part of that process and getting the athletic programs up and running?

Sure, yeah. It was a huge undertaking. Its been a crazy, amazing ride. I've been thrilled to be part of the process and continue to learn something new every day. I have a significant amount of respect for our athletes, coaches, teachers and administration. Together, we're all building a very strong positive environment that is welcoming to everyone.

I'll tell you, I got to go to a couple of football games and a basketball game and the environment, you can tell it's a brand new school. It was like it had been a tried and true program. So, kudos for that because it was really awesome, I thought.

That's great feedback. Thank you.

How did you get involved with the Athletic Boosters and that whole process?

I have two boys. One's a freshman athlete at the high school, and I have a seventh grader at Hyatts Middle School. He'll be there in a couple years. We really just wanted to make sure that we started the Boosters off properly. I hope people think we've done that. Change of any sort can be really, really difficult. Of course, we've had some resistance from people, but I think we're getting there. We're just doing things the Berlin way.

That's right.

We molded together what other schools have done and took the best pieces of that and thought, well, we're going to try this. If we're going to make some changes along the way, we will. I guess mostly important, anybody who wants to get involved with Boosters, we do a monthly meeting, the first Monday of every month at seven o'clock at the school. We're always looking for people to donate their time and talents. We'd love to everybody join us.

Yeah, absolutely. Put on the double blue and come out and volunteer.

Sure, that's right.

Absolutely. What's your specific role as president? What was your role in this whole thing besides probably leading the charge I would imagine?

It is. I oversee basically all the operations of the Booster Club. But I definitely have a great team of people who back me up. I'm blessed to be able to work with all the sponsors and spearhead some of our fundraising efforts. I'm very involved with the community and I've gotten involved between the middle schools and the elementary schools as well who will feed to Berlin.

To me, it's just imperative that those families in those schools know that we're here, know that we want them to be involved. They are the future success of our program. We want them to be involved as well. Some people think it's scary almost, to transition from elementary school into middle school, and then middle school into high school again. But I hope we can pave that way and take off some of those stressors that come into high school and just be a welcoming environment for people.

So, it's like an uncharted territory and the fear of the unknown, right?

Yeah, definitely. I remember both moves from with my children. Once you've done it once, it's not so scary. It's definitely a big change.

I know probably working with the kids and coaches is probably ... That would be my answer. But what is the most rewarding aspect of your role that you probably ... I can't speak for you but for me, I can't imagine being a part of seeing these kids have this new program.

No, it's amazing. You hit the nail right on the head. To be able to deal with the volunteers and administration and coaches, they're setting the most positive environment there for these kiddos. We are just truly blessed to be able to be surrounded by all these incredible people in our lives there.

I know you guys had a great amount of sponsorships. If anybody out there is looking to sponsor, I'm sure they would happily talk to you about that. We had a great experience sponsoring this year. What does that funding go toward? My guess is operations, right?

Yeah, absolutely. We provide lots of things for the athletic department and for all 28 sports teams. Thank goodness to some of our fundraising-

28, wow that's a lot of them. I didn't really think about the number.

Yeah, it seems like an immense overwhelming thought to begin with. No, we try to help out, support all of them. We're extremely fortunate this year to have brand new facilities. I think some of the biggest difficulties we've had to overcome this year, it's just the expectation that people have the same things that they had at their prior schools.

We have everything we need for our kids to compete and compete at an extremely high level. Some of our kids have done amazing, amazing things this year, and some of our programs are still evolving, which we expected. But some of those things they thought they needed to have there, they found out weren't needs necessarily. They were wants. We'll get there. It's just going to take some time. Those other programs took a long time to build up and we will as well.

Yeah, for sure. I know you've got two athletes in your family. I guess you can answer this first both from a booster and as a parent, what do you think it is about athletics and just school programs that it's really important for kids to participate in?

Well, I think they go unsaid. I think they are a great social outlet for any high school students and their families, and even elementary schools and your middle schools. I think it's imperative that those kids have something in their lives.

To me, there's nothing better than driving through the high school after the school day and listen to the kids practicing and hearing them competing, and the laughter and the friendships that they're building. I swear, our stadium lights just be like a beacon in the night. When you see all the lights that we have coming from there, it just cries out for people to come join us.

It's awesome.

I hope people just feel that and embrace that. I think there's something for everyone. Whether you're an athlete or not at Berlin High School, I think it's such a great environment for people to spread their wings and find some new adventures for themselves.

It's funny, I've never been a part of a launching a new school. My kids, where they go, they'll end up at Berlin. It was neat for me to be able to see the community that evolved around the new school and how tight knit community is already around that, the school and it's just a really neat thing.

Absolutely.

I know we talked about before we started about, what's going on right now with the Boosters. I know summer's coming up. Probably not a whole lot. But what kind of plans are made over the summer for Berlin athletics, and are there any events that happen over the summer like camps, that sort of stuff?

Yeah, we have lots of summer camps coming up. In fact, you can follow them on our Facebook page if you want, which is Olentangy Berlin Athletic Boosters. They're also on the athletic website through the school page, olentangyberlinathletics.com. We really encourage our youth in our community to experience what it's like to try a new sport or build upon one that they really love. Come out and join us this summer. We've got a lot going on over there. I think just about all of our coaches have put together summer camps and there's more to come yet, I believe.

That's awesome. So yeah, please get involved in Berlin High School athletics. Again, great job this year. I can't even imagine the number of man hours that went into putting all that together. So, congratulations to you for helping orchestrate all that with the Boosters and the school. I'm looking forward to next year.

Thank you. We look forward to having you back next year.

Yeah. Thanks for coming on.

Thanks for having me.

All right. Finally today, I want to give you a quick update on North Orange Family Dentistry's new campus, which is a stone's throw from our current office. We are going to be open in the new location on May 6th. Super excited about that. We are currently wrapping up interior finishes. Flooring is going down and paint, final touches everywhere. Getting all the latest and greatest dental technology installed and ready to go for the patients.

The completion dates like I said, we'll be in there May 6th. After May 6th, we still have a little bit of moving to do. We're going to be closed at our current office on May 2nd and May 3rd. It's a Thursday and Friday. Those are the two days we're actually going to be moving from our current office into the new space. We will still have someone available via phone for any potential issues or emergencies.

And then we will have a grand opening celebration on June 1st, that's a Saturday, from 1:00 to 5:00. We're having a carnival theme, we will have inflatables, games, candy, treats. Guided tours to the new office. We'll have a food truck on site. Really, we're just hoping the community will come and share in our new office. I think it's going to be a great addition to the Lewis Center community, the Delaware community. Really, we've just designed the office to be the dental home for the community.

The location, the address is 7325 Gooding Boulevard. It is just down the street right across from the Olentangy trail from our current office. That's it. It has been a 24 month process of planning and designing and building and just really creating the most technologically advanced dental office in the area to provide the highest quality care for the community that I live in and care about. I'm super excited to share that with you. I hope you all come out to the grand opening on June 1st.

Well, that does it for our show today. If you have any questions, if you have any concerns. If you want more information about oral cancer, please reach out to my office more than happy to invite you into the office for questions. You can email the office at info I-N-F-O @northorangefamilydentistry.com. You can call us at 740-548-1800. If you don't have a dental home, we would love to welcome you to the North Orange Family Dentistry family. Or if you just have a question about something you heard on the podcast today, we're happy to answer that as well.

Thanks for listening, and we will see you in May.

Thanks for listening to Talkin' Teeth with Dr. Kyle Bogan. Be sure to visit northorangefamilydentistry.com to join the conversation, access the show notes and discover our fantastic bonus content. Please remember this podcast is for educational purposes only. It is not intended or implied to be professional, medical or dental advice or a substitute for professional care by a dentist or other qualified medical professional.

Guests to speak in this podcast express their own opinions, experience and conclusions, and North Orange Family Dentistry and Dr. Kyle Bogan, do not endorse or oppose any particular treatment option.

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