November is Mouth Cancer Action Month in the UK and the Faculty of General Dental Practice (UK) is supporting this initiative by promoting the role played by the whole dental team in preventing and diagnosing mouth cancer.
The British Dental Health Foundation (BDHF) estimates that this year 6,000 people will be diagnosed with mouth cancer and, without early detection, around half of these people will die. Awareness of mouth cancer has significantly increased over recent years, nevertheless early diagnosis and prevention is still crucial to survival.
As the academic home for general dental practitioners and dental care professionals(DCPs), the FGDP(UK) recognises the importance of dental professionals in the screening of patients for signs of mouth cancer. The early detection and referral of patients with suspicious oral lesions, coupled with the education of patients as to lifestyle choices, can significantly reduce the debilitating effects of this condition, with the Foundation stating figures showing that early detection can transform survival chances to more than 90%.
DCPs can play a key role in the detection of oral cancer. For instance, a dental technician may note an unfamiliar area on a plaster model, a dental nurse may see a new and unfamiliar raised area on a lip, or a hygienist may have concern regarding an abnormal area on the internal mouth tissues. The FGDP(UK) is aware of many cases where DCPs have gone on to refer suspect cases, thereby contributing towards early detection and a better outcome for the patient.
Tony Griffin, Chair of the DCP Committee at the FGDP(UK), says “Such awareness raising by DCPs enhances patient care and plays a crucial role in helping to ensure that potential cases of oral cancer are referred on early.”
The examples below highlight how the whole dental team can contribute to the detection and treatment of mouth cancer and also show the importance of early diagnosis in the fight against this disease.
“Two years ago, a patient came through to my surgery for a routine scale and polish having just had an examination with the dentist. I noticed a small white lesion on her tongue which all I can say is it did not look right. I was a little hesitant to call the dentist having just examined the patient but I decided I had to act on the side of caution. The patient was referred and diagnosed with squamous cell carcinoma. The patient was operated on and had a portion of her tongue removed. She has since been on four monthly reviews, now on the six monthly and I am please to hear that at present all is well.” Hilary
“I was able to spot an oral lesion in a patient and referred them to the dentist who referred them to a specialist. A biopsy had revealed a carcinoma and the patient had to undergo surgical intervention and chemotherapy.” Zahir
“I saw a patient who hadn’t been to the dentist in 15 years. The patient wanted some new dentures and her bottom denture didn’t feel right. Upon examining the patient I spotted on the lower jaw a lesion, more like a lump which initially I thought it was caused by her denture rubbing on. However, when I palpated under the jaw and inside, I noticed a large lump which was not on the other side. I didn’t feel this was right so I referred her to the dentist who I work with in dental surgery. The patient was seen by me on Saturday and her appointment was on the following Monday. The periapical X-ray showed up an abnormality so we discussed this and decided it would be best to refer the patient to the dental hospital. At the hospital she had a biopsy and it then proved to be rare ameloblastoma. The patient underwent two surgeries and she’s now under review every 4 months. She’s doing well despite all.” Carl
“Last year a DCP in the year above us (studying at Cardiff university) identified a legion while doing a STE at the beginning of a hygiene appointment, this was shown to the tutors and referred to Oral Med to be biopsied and was indeed a cancer.” Roxanne