Checking for Cancer in the Mouth

Screening for oral cancer is not something most people think about. Interestingly, recent statistics show oral cancer screening is something that should be done routinely. Here's why.

In Australia, it is now well known cumulative sun damage is a critical risk factor for developing skin cancers (including those of the scalp, face, ears, nose, lips and neck). A history of heavy smoking, alcohol consumption and older age are commonly understood to be the main risk factors for some types of oral cavity cancer.

However, it is no longer only older people who are at risk of developing head and neck cancers. The latest research has identified an association between the Human Papilloma Virus (HPV) and oro-pharyngeal cancers (base of tongue, back of throat, soft palate and tonsils), affecting a wider range of age groups.

HPV And Oral Cancer In Younger Age Groups

Currently, the fastest growing segment of the oral cancer population, are young, non-smoking individuals who come to get oro-pharyngeal cancers from the HPV 16 virus (or HPV 18 Virus), which also cause cervical cancers. HPV infection in the mouth can be contracted from french kissing and from the genital area by oral sex.

Risks For Oral HPV Infection 

Risks of HPV infection increase with the number of sexual partners. The greater your number of sexual partners, the greater your chance of contracting HPV from oral sex. Having a partner who has had multiple sexual partners also increases your risk. People who have a weakened immune system are at a greater risk of HPV infection.

Symptoms Of Oral HPV Infection

Many people don’t have symptoms and are unaware they have HPV. The virus may be inactive for weeks, months or even years after infection. Most of the time, HPV is cleared by the body. It goes away within about 2 years, but not in all cases. For a small number of people, the immune system allows the virus to remain in the body for a long time, prosper, and cause oral cancer.

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Diagnosis Of Oral Cancer - Early Detection Is Key

Oral cancers are difficult to diagnose because of their location. Signs and symptoms may become obvious only at more advanced stages. However, early detection is paramount for good outcomes. Early detection can save lives.

As a patient, attend your dental check ups regularly, but present for additional review if you notice any red or white spot, ulcer, sore or lump in the mouth or neck that looks unusual or doesn’t heal; or if you have numbness, pain or tenderness in your mouth, difficulty swallowing, a hoarse throat or ear pain for more than 2 weeks.

A Dental Check Up Should Include Oral Cancer Screening

Every dental check up should include an oral cancer screening. Studies show the most effective oral cancer screening is a visual and tactile intra-oral and extra-oral examination. This must also include palpation of the neck and assessing the appearance of the tonsils and back of the throat for symmetry. At Melbourne Dentistry, we routinely perform a stepwise visual and tactile oral cancer screening on each patient, at every dental check up appointment.

Screening devices should only be considered an adjunct to a thorough visual and manual patient examination. Screening devices do not provide definitive answers.

The gold standard for diagnosis is a biopsy, ideally evaluated by an Oral Pathologist. If a patient were to have a suspicious finding at our practice, referral to an Oral Medicine Specialist or Oral and Maxillofacial Surgeon would be undertaken for the patient to have further evaluation, a definitive diagnosis (biopsy tissue evaluated by an oral pathologist) and prompt management.

Prevention Of Oral Cancers

Be mindful about the state of your mouth.  When you clean your teeth, follow what you are doing in front of the bathroom mirror. Not only will you become more familiar with what your mouth’s ‘normal’ looks like, you will also be more likely to identify anything that looks different.  If any changes do occur, discussing these with your dentist may bring about an early diagnosis.

Prevention of oral cancers should include maintaining regular dental visits for routine oral screenings - to detect any sign of cancers early, and at a curable stage.

Maintaining good oral hygiene is paramount in the prevention of oral cancers. To support a healthy immune system and maintain whole body wellness, a balanced diet, rich in fruits and vegetables that are high in antioxidants is believed to be beneficial.

Whether male or female, it may be of value to discuss with your general medical practitioner the merits of receiving either the Gardasil® or Cervarix® vaccines as a potential preventive measure against HPV infection and HPV related oral cancer.

For the long term, and to prevent non-HPV related oral cancers, deciding to quit cigarette smoking and ceasing the habit as soon as possible is highly recommended. Reducing alcohol consumption and the use of alcohol based daily mouth rinses should also be considered.

Wearing a hat and daily application and reapplication of sunscreens for the face, and lip balm for the lips, with a SPF of 15 plus, can help reduce your risk of sun exposure related cancers (such as SCC and Melanoma) of face and lip areas.