The Role of Oral Surgeons in Oral Cancer Screenings


Oral cancers account for about 3 percent of all cancers diagnosed annually in the United States with 54,000 new cases each year and more than 11,000 deaths. Like most cancers, early detection is key to successful treatment options.

“Positive identification of oral cancers at the earliest stages, results in the best prognosis for cure and long-term survivability,” says the Oral Cancer Foundation. “The most important step in reducing the death rate from oral cancer is early discovery. No group has a better opportunity to have a positive impact on this than members of the dental community.”

While dentists and dental hygienists are naturally the first lines of defense in early detection by performing “opportunistic” oral cancer screenings during routine patient cleanings and checkups, oral surgeons also play a vital role, especially as they are specialists in biopsies that can confirm the presence of cancerous cells.

Causes and Symptoms of Oral Cancer

The National Institute of Dental and Craniofacial Research says that oral cancers can develop on the tongue, the tissue lining the mouth and gums, under the tongue, at the base of the tongue, and the area of the throat at the back of the mouth.

Twice as many men as women develop oral cancer, typically after the age of 40.

Causes of oral cancer include:

  • Tobacco and Alcohol Use: Tobacco use of any kind, including cigarette smoking, puts you at risk for developing oral cancers. Heavy alcohol use also increases the risk. Using both tobacco and alcohol increases the risk even further.
  • HPV: Infection with the sexually transmitted human papillomavirus (specifically the HPV 16 type) has been linked to oral cancers.
  • Age: Risk increases with age. Oral cancers most often occur in people over the age of 40.
  • Sun Exposure: Cancer of the lip can be caused by sun exposure.

If you have any of the following symptoms, you should consult a dentist, oral surgeon or doctor:

  • A sore, irritation, lump, or thick patch in your mouth, lip, or throat.
  • A white or red patch in your mouth.
  • A sore throat or a feeling that something is caught in your throat.
  • Difficulty chewing, swallowing, or speaking.
  • Difficulty moving your jaw or tongue.
  • Swelling of your jaw that causes dentures to fit poorly or become uncomfortable.
  • Numbness in your tongue or other areas of your mouth.
  • Ear pain.

Early Detection of Oral Cancer is Crucial

The Moffitt Cancer Center says that adults over the age of 20 should have an oral cancer screening every three years while those over the age of 40 should have annual oral cancer screenings.

“People with risk factors - such as adults who use tobacco, are heavy alcohol drinkers, have human papillomavirus (HPV) and/or have a family history of cancer - should request an annual oral cancer screening,” says the Moffitt Cancer Center.

The Oral Cancer Foundation says a “wait and see” approach regarding any abnormalities that dentists or patients find can prove to be dangerous as it will allow possible cancer to spread.

“Any sore, discoloration, induration, prominent (exophytic) tissue, irritation, hoarseness, complaints of difficulty in swallowing, unilateral earaches, which does not resolve within a two week period on its own, with or without treatment, should be considered suspect and worthy of further examination or referral,” says the Oral Cancer Foundation.

What Happens During a Routine Oral Cancer Screening

Oral cancer screenings always begin with a clinical examination of a patient’s mouth and throat.

A light, mirror, and tongue depressor will be used to look for any abnormalities such as:

  • Bumps
  • Patches of Color
  • Ulcerations
  • Swelling

“All areas of the mouth will be examined, including the roof of the mouth, tonsils, inner cheeks, gums, and tongue. The dentist will also palpate the jaw, the neck, under the chin, and the outside cheeks to feel for any unusual masses or firm nodules,” says the Moffitt Cancer Center.

If abnormalities are detected, a more detailed screening may take place, according to Moffitt Cancer Center, including:

  • Using a laser light that reflects abnormal tissue differently than it does normal tissue
  • Spreading toluidine blue dye over the suspected abnormal area, which will turn blue if irregular tissue is found
  • Rinsing the mouth with a solution of acetic acid and then using a special light to examine the abnormal area

Oral Surgeons Can Confirm Cancer with Biopsies

John Hopkins Medicine says that when your dentist finds any signs of oral cancer when doing a routine screening, they will likely refer you to an oral surgeon for a biopsy.

“The biopsy will give your doctors more information about whether the lesion is cancer and what type of cancer,” says John Hopkins.

The Oral Cancer Foundation says that oral surgeons can add a second informed opinion in a multi-step system of determining patient risk.

“Referral to a specialist, such as an oral surgeon, adds another informed opinion to the process, and involves now a professional that routinely does conventional biopsy,” says the Oral Cancer Foundation.

If a biopsy does not find cancer, but benign abnormalities, your oral surgeon may want to reexamine the area periodically to make sure no new activity has taken place.

Contact Northwest Oral & Maxillofacial Surgery today to find out how our board-certified oral surgeons can help with your oral cancer screenings, including performing biopsies in our offices under IV anesthesia if needed.

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