April is Oral Cancer month, so it seems like the perfect time to write about oral cancer.  According to the American Cancer Society, oral cancer and oropharyngeal cancer will affect 1 in 60 men and 1 in 140 women. On average in America, there are 54,000 new cases diagnosed per year, and sadly 11,230 people die in America every year from oral cancer. The number of cases of oral cancer have been on the rise over the past 20 years, which is believed to be due to the Human Papilloma virus. The most common sites for oral/oropharyngeal cancer to be formed are the tongue, tonsils/oropharynx, gums, and floor of the mouth, but it also occurs in lower numbers on the lips, in the salivary glands, and other oral sites.

teeth x-ray, oral cancer screening

One depressing fact is that the ability to diagnose oral cancer early hasn’t increased at a similar rate like most other cancers.

tongue cancer screening

If your MD isn’t pulling your tongue out, then you are only being screened for oropharyngeal cancer since most tongue cancer is on the side or underbelly of tongue.

Oral cancer can affect anyone, but like most cancers, there are certain risk factors that increase your risk.  The biggest risk factor for oral cancer is tobacco use (smoking and chewing tobacco). Alcohol use is the second risk factor with research showing the more someone drinks the higher the risk of developing oral cancer.  If someone smokes and drinks, research shows the risk is multiplied and that the risk is 30 times greater than someone who doesn’t drink or smoke. HPV or Human Papilloma Virus has also been found to increase the risk of developing oral cancer.  Men develop oral cancer at two times a greater rate than women do. Being overweight has also been shown to increase risk of oral cancer.  The age risk is changing with the new link with HPV.  Patients 55 or older still have a higher risk than younger patients, but HPV associated cancer tends to be diagnosed at much higher risk with patients under 50. Oral cancer especially of the lip are often found in patients with very high UV exposure.

Like most cancers, the key to successful treatment is screening and diagnosis.  One depressing fact is that the ability to diagnose oral cancer early hasn’t increased at a similar rate like most other cancers.  Sadly, we often catch oral cancer too late, resulting in more deaths than if we could diagnose earlier. The key to early diagnosis is regular oral cancer screening.  I’m sure many reading this are thinking “Where do I get this oral cancer screening?” or “What is an oral cancer screening?”.  Many patients don’t even notice that we do an oral screening at every hygiene appointment.  A hygiene visit consists of multiple parts: scaling and polishing, radiographs (recommended yearly), probing and periodontal evaluation (done at least yearly), oral cancer exam by both hygienist and dentist, and exam by dentist. Every hygiene visit, both your hygienist and Dr. Holtzclaw do a visual oral screening where we evaluate the tongue, all oral tissue, and all other oral/facial areas visually. We also check lymph nodes of the neck and face with palpation because many tumors aren’t visible.  Regular radiographs are also crucial because many tumors and cysts are able to be identified radiographically before they are large enough to be visible in the mouth.  At our office, we also yearly use a piece of technology called the Identifi to allow us to see possible cancers or abnormalities that aren’t visible to the naked eye yet.

I’m not going to go a ton into treatment because it varies greatly based off how early we diagnose.  Like most cancers, if caught very early then all that might be needed is a biopsy.  At it progresses, the surgery becomes more invasive, and chemotherapy and radiation are often needed.  As it progresses, the risk of metastasis also increases which decreases prognosis of successful treatment. The earlier the diagnosis, the better the survival and less invasive the treatment.

treatment plan oral cancer

“With more regular screening as a country, I’m confident we can start having more early oral cancer diagnosis and less and less people dying of oral cancer.”

Dr. Gary Holtzclaw | Simpsonville Family Dentistry

My hope with this blog is to educate you and not scare you to death.  With more regular screening as a country, I’m confident we can start having more early oral cancer diagnosis and less and less people dying of oral cancer. My hope is that everyone reading this now makes a point to make sure they are at least being screened yearly for oral cancer. These screenings are still largely the job of the dental profession.  If your MD isn’t pulling your tongue out, then you are only being screened for oropharyngeal cancer since most tongue cancer is on the side or underbelly of tongue.  I also hope now knowing the risk factors that you do what is in your power to try to get your rate as low as possible.  If you have any questions, feel free to reach to us at (864) 963-3481 or email. I also want to thank and give credit to the American Cancer Society for the data and the best collection I’ve found for information on oral cancer or cancer in general.  You can check their oral cancer information out here.

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