Dentists ­ Caretakers of the Oral Cavity

 

The next time you visit your dentist, be sure he or she looks beyond your teeth and gums -- it could save your life!

 

"Dentists are our first line of defense in detecting oral cancer, and in some instances, head and neck cancers," says Dr. Bela B. Toth, professor of head and neck surgery at M. D. Anderson. "They are in a unique position to screen these areas, checking for abnormal nodes or lumps, and tissue and skin changes that may indicate cancer or an infection."

 

Since detecting cancer in its earliest stages affords the best chance for successful treatment and possible cure, he says, a thorough oral and head and neck screening should be part of a routine dental examination.

 

Screening should include:

 

· A general health risk assessment. If you smoke or chew tobacco, drink or have a job that exposes you to the sun, be sure to tell your dentist. These factors can greatly increase your risk for cancers of the mouth and skin.

 

· A head and neck exam. Before doing an oral exam, your dentist should check behind your ears and examine the hairline, face, nose and lips for skin cancer. If you wear glasses or makeup (particularly lipstick), your dentist should ask you to remove these because they may conceal suspicious moles or skin lesions.

 

Your dentist also should palpate the lymph nodes of the neck. If these glands are swollen or an unusual lump is found, it could indicate an infection in the mouth or possibly cancer.

 

· An oral exam. Once inside your mouth, your dentist should inspect the lining of the mouth, the tissues around the teeth and gums, cheeks, upper and lower lips, hard and soft palate and tonsilur pillars.

 

The sides of the tongue, floor of mouth and the small area behind the wisdom teeth should also be considered. "These three areas are the most likely places for cancer development and should be examined well," says Dr. Jack Martin, professor of head and neck surgery.

 

The most common cancer in the mouth, says Dr. Toth, is a squamous cell carcinoma. Pre-malignant lesions occurring in the lining of the mouth also are frequently seen. They include leukoplakia and erythroplasia. The former is characterized by white, thickened areas, while the later presents as a red patch.

 

There are other benign lesions and anatomic landmarks in the mouth that can mimic cancers, Dr. Martin adds. They, too, should be examined by your dentist.

 

Although panoramic X-rays are traditionally done to check teeth once a year, your dentist also may find them useful in spotting lesions of the maxilla and mandible, says Dr. Martin.

 

While yearly screenings are recommended, you can take charge of your own oral health between visits by doing monthly exams "and, of course being diligent about brushing and flossing," says Dr. Martin.

 

Here's what you can do:

 

Using a mirror, simply examine your lips, teeth, gums, tongue and cheeks. If you notice a sore on the lip or mouth that doesn't heal in a reasonable amount of time (in about two weeks); a lump in the mouth or elsewhere, including the face, jawbone and neck; a white or red patch on the gums, tongue or lining of the mouth; unusual bleeding; pain and/or have difficulty chewing and swallowing, contact your dentist or physician -- these may be indicators of cancer or some other underlying problem.

 

If your dental visit doesn't already include routine screening, be sure to request it, says Dr. Toth. "It's vitally important. Dentists are the oral caretakers of the mouth and they are responsible for maintaining not only the health of their patients' teeth, but also the health of the entire oral cavity."

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