Oral Cancer Screening

Routine dental exams are a crucial part of maintaining the health of your mouth. With exams, we can detect the presence of some different oral health issues in their earliest stages, before you ever notice anything is wrong. By detecting issues early, we can provide much more conservative treatments to restore your oral health and protect your mouth, and your whole-body health, from potentially serious consequences. A major part of your dental exams is a visual inspection of your mouth. Your teeth and gums are checked for signs of cavities, damage, and gum disease. There is also another component to your routine dental exams. At Sunnyside Dentistry, we also check your mouth for signs of oral cancer with routine oral cancer screenings.

What is Oral Cancer?

Oral cancer is the largest group of head and neck cancer. It begins in your mouth and can start just about anywhere, including your lips, tongue, cheeks, gums, and palate. It can also start at the back of your mouth near the entrance to your throat. The early stages of cancer can be difficult to detect. Without diagnosis and treatment early, oral cancer can quickly spread, making it more difficult to treat. It can also be fatal if not addressed in the early stages. Oral cancer affects over 40,000 Americans every year, and just over half of those diagnosed survive past five years.

Types of Oral Cancer

There are several different types of oral cancers. These include:

•	Squamous cell carcinoma. Squamous cell carcinoma makes up about 90% of all oral cancers. The mouth and throat are lined with squamous cells. With this type of oral cancer, some of these squamous cells are abnormal.
•	Verrucous carcinoma. This is a slow growing type of cancer made up of squamous cells. It rarely spreads to other areas and makes up about 5% of oral cancers.
•	Minor salivary gland carcinomas. This is a group of cancers that refers to several types of oral cancers that affect the minor salivary glands.
•	Lymphomas. These are cancers that develop in the lymph tissue, which is a part of your immune system.
•	Benign tumors. In some cases, non-cancerous tumors, or tumor-like conditions, can develop. There are some cases in which these non-cancerous tumors can become cancerous, so treatment is recommended.
•	Leukoplakia and erythroplakia. Both leukoplakia and erythroplakia are non-cancerous, but still, cause abnormalities. With leukoplakia, white patches can be seen, whereas erythroplakia is characterized by red patches. These conditions can be pre-cancerous, so a biopsy is often performed.

What are the Risk Factors for Oral Cancer?

Oral cancer can affect just about anyone. However, there are certain risk factors that can increase your likelihood of developing the condition. Some of these factors are controllable, while others cannot be. Common risk factors for oral cancer include:

•	Lifestyle factors. There are several lifestyle factors that can significantly increase your risk of developing oral cancer. Some of the biggest contributors are tobacco use and alcohol consumption. Approximately 80% to 90% of oral cancer patients use tobacco products, including cigarettes, chewing tobacco, and snuff. Your risk is dependent upon the duration as well as the frequency of your tobacco use. About 70% of oral cancer patients consume a significant amount of alcohol. If you smoke and drink, your risk becomes incredibly high.
•	Genetics. If you have a direct blood relative, such as a parent, who has suffered oral cancer, your risk is increased. Additionally, there are some genetic conditions that can lead to a higher risk. Fanconi anemia is a blood condition caused by inherited gene abnormalities. Those with this condition are 500 times more likely to develop oral cancer than the rest of the general population. Another genetic condition with a high risk is dyskeratosis congenital.
•	Your age. Although oral cancer can strike at any age, it generally tends to affect the older population more. On average, people are diagnosed in their early 60s, with most people receiving diagnosis over the age of 55.
•	Your sex. Oral cancer is twice as likely to affect men as it is women.
•	Exposure to UV light. Oral cancer that begins in the lips occurs more frequently in those who have seen heavy sun exposure, such as those who work outside, without proper protection.
•	Human papilloma virus, or HPV. HPV includes approximately 100 related viruses. A handful of these viruses have been linked to oral cancer, with HPV16 having the strongest connection.

There are also a few unproven risk factors. They are not backed by scientific studies and are controversial, yet there is still some concern. These factors include:

•	Mouthwash, particularly those with alcohol.
•	Irritation from dentures that do not fit properly. Ill-fitting dentures that cause long-term irritation to your gums have raised concerns about oral cancer risk. This link has not been confirmed, but loose dentures have been known to trap cancer-causing substances such as tobacco.

Symptoms of Oral Cancer

There are many symptoms that can point to oral cancer. When oral cancer first develops, symptoms can often be mistaken for other issues, and therefore go unchecked. Some of the most common symptoms that can point to oral cancer include:

•	Sores in your mouth that just will not heal. This is the most common symptom.
•	Chronic pain in your mouth.
•	Red or white patches on your intraoral tissues, including your gums, tongue, or cheeks.
•	A lump that develops in your cheek.
•	Finding it difficult to chew and swallow your food. You may also find it difficult to move your jaw or your tongue.
•	Swelling in your jaw.
•	A numb sensation in your chin or your tongue.
•	A persistent sore throat. You may also feel as though you have something stuck in your throat and no matter what you do, you cannot clear it out.
•	Your teeth become loose. This can cause your teeth to shift out of alignment, which then alters your bite.
•	A change in your voice. You might notice that your voice becomes hoarser.

The Importance of Oral Cancer Screenings

Routine dental exams are essential for detecting a variety of different oral health issues in their earliest stages. We check over your teeth and your gums, checking for chips, cracks, decay, cavities, and gum disease. We can detect these issues before you ever notice that anything is wrong. This allows you to get the treatment you need to restore your oral health and prevent more serious complications.

Another part of your routine dental exam is your oral cancer screening. The earliest warning signs can be difficult to detect, as they are often completely missed. If you do notice symptoms, they are often mistaken for other issues, and therefore go unaddressed. The reason having regular oral cancer screenings are so important is because the earlier oral cancer is caught, the easier it is to treat. Not only that, but the rate of success of that treatment is much higher.

We are highly experienced in detecting the earliest warning signs of oral cancer, often before you even notice that they are there. Oral cancer is dangerous cancer. The longer it goes undiagnosed and untreated, the more opportunity it has to worsen and spread. If oral cancer spreads, it becomes more difficult to treat, which also increases your risk of the condition becoming fatal.

Diagnosing Oral Cancer

Your oral cancer screening is just the first step in the diagnosis of oral cancer. We perform these screenings during your regular dental exams, although most people are completely unaware that these screenings are happening. After checking over your teeth for signs of damage and decay and your gums for signs of infection, we then look over all of your intraoral tissues. We are checking for anything unusual, such as odd growths, patches or red or white tissue, lumps, and other abnormalities. If we do detect something out of the ordinary, a closer examination is needed to accurately diagnose the condition. Your oral cancer screening is quick, simple, and completely painless.
There are several different ways in which oral cancer can be diagnosed. Common methods for diagnosis include :

•	A biopsy. A soft tissue biopsy is a procedure that involves removing a small portion of the abnormality in question so that the tissue can be examined more closely under a microscope. With this method of diagnosis, we can see cancerous and pre-cancerous cells.
•	Fine needle aspiration. If oral cancer spreads to your lymph nodes, swelling or masses can develop. A fine needle aspiration, or FNA, involves inserting a thin needle into the mass to remove some of the cells within, which are then examined under a microscope.
•	A CT scan. If you have been diagnosed with oral cancer, a CT scan may be recommended. With a CT scan, we can create 2-dimensional or 3-dimensional cross sections of your body. This is done with an X-ray and a computer. With a CT scan, we can determine if your oral cancer has spread to nearby lymph nodes or other areas in the body.
•	A PET/CT scan. This type of scan involves the use of both CT technology and PET imaging and can be used to help determine if oral cancer has spread to other regions of your body. To perform this type of imaging, a liquid is injected into your veins, which collects in cancerous cells, making them easy to see.
•	An MRI. An MRI involves the use of a magnetic field, which is then used to create images of your body. With this type of imaging, we can detect if oral cancer has spread to other soft tissues in your head and neck. This includes your brain.

Treating Oral Cancer

When oral cancer is diagnosed, it is important that you get treatment right away. The exact treatment you receive will depend significantly upon how advanced the cancer is, where it is located, and what type it is. Treatments for oral cancer include:

•	Surgery. In the earliest stages of oral cancer, all that is often needed is a small surgical procedure during which the abnormality in your mouth is removed. A portion of the tissue surrounding the tumor may also be removed to ensure that all cancerous tissue is removed. If the cancer has spread to the lymph nodes, then these are removed as well.
•	Radiation. Radiation is a treatment that involves directing radiation beams at the abnormality. This is generally done once or twice a day, up to 5 days a week for anywhere from 2 to 8 weeks. If your cancer is in more advanced stages, radiation may also be combined with chemotherapy.
•	Chemotherapy. Chemotherapy, also simply called chemo, is a treatment that involves the use of drugs to kill cancerous cells. These drugs can be taken orally, or they can be delivered directly into your bloodstream intravenously. Those undergoing chemo can have the treatments done as an outpatient procedure, although some patients are hospitalized for the course of their treatment.
•	Targeted therapy. This is a type of treatment that involves the use of drugs. These drugs bind with specific proteins in cancer cells, which inhibits their growth. This particular treatment can be used in the early stages of oral cancer. It can also be used in more advanced stages as well.

Taking care of yourself during treatment as well as during your recovery is essential. Good nutrition is critical. However, you may find that eating is more difficult or that you have developed a loss of appetite. Even so, getting essential nutrients, including vitamins and minerals, is critical for helping your body to heal. It is also imperative to keep your mouth clean and moist while you undergo treatment.

Recovery following oral cancer treatment will vary based on the type of treatment you receive. Following treatment for more advanced cancer, you may also require some type of reconstruction or rehabilitation to restore your abilities to eat and speak. The outlook for oral cancer patients depends upon the type and stage when you are diagnosed. For instance, treating stages 1 and two is often much easier, and the chances of success are much greater. Follow-ups following your oral cancer treatment will help to ensure that you are recovering properly and that your cancer has indeed been eradicated.

Early detection of oral cancer, followed quickly by treatment, is essential for stopping the spread of the disease, restoring your oral health and preventing more serious issues from arising. For more information about oral cancer screenings, and to schedule your next dental cleaning and exam, call Sunnyside Dentistry at (503) 451-5104 today.