Examination for Early Detection of Oral Cancer

Many of our patients who have received comprehensive periodontal care (gum treatment) usually return every six months or less for routine follow-up checks. The visit comprises scaling of tartar by the dental hygienist and an examination by the specialist. This time-tested protocol is based on long-term scientific studies, and it continues to prove to be the key to preserving treatment results. After the dental cleaning, the dentist examines the state of health of the gums and identifies new sources of infection.

60 seconds on oral cancer

The regular appointments involving dentist, hygienist and patient create a unique intimacy and we are on the frontline for early detection of pathologic developments in the oral cavities of our patients. The hygienists and dentists also have the responsibility and the capability of detecting unforeseen pathologic developments other than those of a periodontal nature: for example pre-cancerous lesions and suspicious ulcerations of various types.

Considering that oral carcinoma is one of the most severe forms of cancer, and that the staff members of the clinic are familiar with the oral cavities of our patients, we regard the early detection of oral cancer as a mission of the highest order of importance.

Following the treatment by the hygienist, the specialist performs a clinical examination of the oral soft tissues comprising the following: the internal mucosa of the upper and lower lips, cheek, soft and hard palate, pharynx (throat), base of the tongue and floor of the mouth.

This examination is non-invasive and is conducted annually. It is simple and short, carries no additional charge, and is performed within the framework of the regularly scheduled treatment.

The extremely positive patient response to this examination has encouraged us to persevere and stay on this course. In the event of suspicious findings, the patient is referred immediately to the appropriate specialists for more in-depth examination.

Needless to say, early detection and appropriate treatment of developing lesions may save lives!

A Few Facts About Oral Cancer:

A - Oral cancer is a particularly severe disease

Oral cancer is one of the more severe forms of malignancy in the human body. It is relatively common, being the sixth most prevalent type of malignancy. It is a severe form of disease from a number of viewpoints:

  1. Morbidity of up to 50% within 5 years (greater than that of skin cancer or cervical cancer).
  2. The general awareness of the disease is relatively low, not only among the public, but also within the medical system.
  3. It can cause facial disfigurement that may restrict eating, speech and swallowing. Emotional distress, lowered self-image and social problems are other by-products.     
  4. Its detection is made complicated by the absence of pain in the early stages of development.                                                                           
  5. In many cases its first manifestation appears in less visible locations (floor of the mouth, lateral border of the tongue, soft and hard palate).   


B - The Importance of Early Detection:

Because the first stages of the disease are free of symptoms, early detection of the focal point improves the chances of surviving and maintaining one’s quality of life. Both dentist and hygienist have an important role to play in this detection. An examination scanning the oral mucosa of all tissues of the oral cavity is recommended once every year.

An ulcer or lesion that fails to heal within 10 days should be regarded as suspect

Any such occurrence requires consultation with either an oral pathologist, an oral surgeon or a periodontist. It may be deemed advisable to take a biopsy (the taking of a sample which includes both healthy and abnormal tissue).                                                                                                                                                                              

C - Risk Factors

The principal cause is tobacco and smoking. Alcohol consumption is in second place and when the two factors are present in combination the incidence of the disease is tripled.

D - Oral Cancer in Relation to Age

In general oral cancer is a disease that occurs in middle aged adults (95% of those affected are over the age of 40) and the average age of incidence is 60. Males are affected three times as much as females. 

E - The Warning Signs

  • An ulceration which fails to heal spontaneously after 10 days
  • Enlargement with or without ulceration
  • An abnormal white lesion
  • An abnormal erythematous lesion or an abnormal combination of the two.
  • A brown, grey to black lesion
  • A bleeding lesion
  • The most common form of oral cancer is Squamous Cell Carcinoma (90%)


F - The Progress of Oral Cancer

As with all cancers it can metastasize to the lungs, liver, bones and lymph nodes in the neck if treatment is not promptly commenced. In addition the oral lesions can represent metastases of tumors in distant locations (e.g. breast, liver, lungs and prostate gland) 

G - The Treatment

The treatment aim is two-fold: complete reversal of the malignant process along with restoration of facial form and oral function.

The prognosis will be favorable if the condition has been categorized as localized, that is to say without invasion of the adjacent tissues and without metastasis. In such cases the treatment will be restricted to localized surgery for the removal of the tissue pathology.

If, however, the disease is in an advanced stage and has penetrated the adjacent tissues and shows signs of metastasis to the lymph nodes, then radiation therapy will be necessary in addition to surgery. The prognosis for such cases falls to less than 50%.

The comprehensive multi-disciplinary treatment will integrate specialists in various fields: oral surgeons, ENT specialists, prosthodontists, oncologists, psychologists, social workers and plastic surgeons. The most common treatment regimen is surgery, radiation and major reconstructive surgery for the provision of reasonable function and esthetics.

Vascular microsurgery and plastic surgery currently play a central role in the treatment of oral cancer. 

F - Conclusion

As with other malignant diseases the watchwords with respect to oral cancer are early detection and the raising of public awareness.