The Importance of Adding Oral Cancer Screenings to Dental Routines
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Misty Mattingly, RDH, BSDH
Many people are often surprised to learn that oral health issues can be an indicator of an individual's overall health and that problems in the mouth can affect other parts of the body. Dental and medical professionals throughout the country often emphasize to their patients the importance of making oral cancer screenings part of one's dental exam routine every April, which is Oral Cancer Awareness Month, but vigilance all year long is important. In fact, it can be lifesaving.
The prevalence of oral cancer underscores the importance of regular screenings, as research from the Oral Cancer Foundation indicates that oral cancer cases in the United States have increased over the past 10 years.1 In the U.S., there were more than 54,000 cases of oral cancer diagnosed in 2021, which was roughly four times greater than the number of cervical cancer cases diagnosed that year.2
Conditions within the oral cavity that require medical attention include:
• Red, white, or dark discoloration of soft tissue.
• Ulcerations or sores that do not heal.
• Any abnormality that easily bleeds when touched.
• Difficulty speaking, chewing, or swallowing.
• Swelling of the jaw.
• Difficulty moving the jaw.
• Tongue numbness.
• Difficulty moving the tongue.
• Ear pain.
Despite the alarming oral cancer statistics, the news isn't all bad. Patients diagnosed with oral cancers have an overall 5-year relative survival rate of 66%, but survival rate increases to 85% when the disease is found in the early stages and is still localized to the organ of origin.1 This is why it is crucial for dental and medical professionals to encourage patients to regularly check for signs and symptoms and to contact their dentist or primary care physician if an oral abnormality persists for two weeks or longer.
For Amber Young, chief brand officer at Oral Cancer Cause, the day she elected to have an oral cancer screening on the advice of her dentist was a moment that changed her life. The results of the screening detected what was later determined to be Stage 4 cancer that, if left undetected, would have been fatal.
"I wouldn't be here if my dentist and her team didn't care so much about their patients," Young says. "I'm so thankful for my dentist. I love my dentist. She saved my life, and I advocate for her and her team."
One of the leading causes of oral cancer is the human papilloma virus (HPV), as more than 70% of oral cancers are associated with HPV-16 and HPV-18 subtypes.3 In the oral cavity, these subtypes of HPV manifest primarily in the back of the throat, the base of the tongue, the tonsils, or the soft palate. There are approximately 130 versions of HPV, and HPV-16 is currently the leading cause of oral cancer.
Due to the potential transmission of the virus to the oral cavity, it is highly recommended that individuals who have tested positive for HPV should have regular screenings for oral cancer. Other key factors that can increase the risk of oral cancer include tobacco use of any kind, heavy alcohol consumption, excessive sun exposure to the lips, and a weakened immune system. Additionally, individuals who are overweight and those aged 40 years and older are at higher risk of oral cancer.
It is also important to note that other illnesses, such as diabetes, HIV, osteoporosis, and Alzheimer's disease, can cause oral conditions that include tooth decay and periodontal disease.
Dental professionals who are trained in the latest screening technologies can perform noninvasive tests to detect abnormalities in the mouth. Among the technologies used to detect oral cancer is a handheld scope that uses blue light to illuminate the natural fluorescence of oral tissue. This technology enables clinicians to identify abnormalities that may not have been apparent or even visible to the naked eye.
To increase early detection and treatment, private dental practices and dental service organizations (DSOs) that train their staffs on available and emerging technologies to diagnose oral cancer will play a critical role in improving patient outcomes.
The fight to raise awareness of oral cancer, increase early detection, and reduce mortality rates will require the efforts of everyone in the equation—dental professionals, medical staff, and patients. With the goal of ensuring early detection through patient education and routine screenings, clinicians and advocates will continue to highlight the importance of oral care awareness, not just in April but all through the year.
Misty Mattingly, RDH, BSDH, is senior vice president and chief dental hygiene officer at Sage Dental.