Spotting Oral Cancer

Soft Tissue Examination
oral cancer
All of us have to worry about tooth decay, but after the age of 40, the risk for an even more serious condition increases dramatically: oral cancer!

Ten thousand people die from oral cancer each year, with 95% of them over the age of 40.

Cancer can strike any part of the mouth, including the lips and tongue. If the cancer is not detected early, tumors can grow deep into local tissues and spread to lymph glands in the neck. The risk for oral cancer increases with age and alcohol and tobacco use.

By having regular visits, your dentist can detect oral cancer at a stage when it can be more successfully treated.

You can help, too. When brushing and flossing, check for red or white patches in your mouth. Look for tender or numb areas, sores that don't heal, and lumps or rough spots.

If you detect any of these signs or symptoms, call your dentist at once.

Oral cancer represents approximately 3% of all cancers. This, however, translates to 30,000 new cases every year in the United States. The single greatest risk factor is tobacco. While cases of oral cancers are seen in patients who do not use tobacco, these constitute a very small percentage of all oral cancers. All forms of tobacco have been implicated as causative agents including cigarette, cigar, and pipe tobacco as well as chewing tobacco. In India and Sri Lanka, where chewing tobacco is used with betel nuts and reverse smoking (placing the lit end in the mouth) is practiced, there is a striking incidence of oral cancer- these cases account for as many as 50% of all cancers!

Heavy alcohol usage is an additional causative factor. Lip cancer, while included in statistics for oral cancer, is
more similar to skin cancers. Sun exposure is the primary cause of these, while pipe smoking is also a factor.

Cancers of the mouth present in various forms. Any persistent white patch must be regarded as being suspicious. Additionally, velvety red patches- particularly those with white speckles- should be areas of concern. Finally, any non-healing ulcer (erosion) merits evaluation. More often than not, these areas are painless.

The tongue is the most common site of oral cancer. Typically, the side of the tongue (farthest back in the mouth) is involved. The floor of the mouth (that area beneath the tongue) is next in order of frequency followed by the insides of the cheeks with involvement of other areas showing a lesser incidence.

While self-examination is advised, some areas cannot be adequately viewed and, of course, there is no substitute for examination by a professional. The best method for detection is to be sure to have semi-annual check-ups by your dentist. Should an area of concern appear in between these appointments, arrangements should be made forexamination. If your dentist has any concern or question, he or she will refer you to an oral and maxillofacial surgeon for evaluation and possible biopsy. Biopsy is a quick office procedure which allows the surgeon to take a sample of the tissue in the area of concern for examination under a microscope.

Certainly, it is best to err on the side of caution. However, one should not be unduly alarmed by every white area in the mouth nor by every ulcer since there can be a multitude of harmless causes.

As with any other cancer, treatment of oral cancer is best undertaken at the earliest stage. This maximizes chances of successful treatment. Smaller areas may be treated by radiation or surgery while larger areas will often necessitate combined therapy. Prevention, of course, is the best approach and can best be achieved by avoidingrisk factors- refraining from all tobacco products and consuming alcohol in moderation.

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Stuart A. Greene, DDS-FAGD
2009 Birdcreek Terrace Temple, TX 76502 254.773.9007 | Fax 254.773.8051
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