Spokane Journal of Business

Dentists often are first line of detection of oral cancer

Cases attributed to STD said climbing as overall cancer deaths decrease

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When visiting the dentist, there is much more at stake than your pearly whites.

Primary care physicians are likely the first to come to mind when it comes to diagnosing illnesses and diseases, but there is an unexpected health care professional to consider as well: the dentist.

Dentists are in a unique position to serve as the unsung hero in early diagnosis. The mouth is the window to the body, and dentists increasingly are becoming the first line of detection for many systemic diseases including respiratory diseases, diabetes, oral cancers, and sexually transmitted diseases.

During routine dental checkups, dentists can uncover important clues about a patient's overall health.

Oral cancer today

Oral cancers, which include those of the mouth and tongue, are the sixth most common cancer, accounting for 34,000 newly diagnosed cancers every year. According to the Oral Cancer Foundation, 90 percent of cases can be cured if found in their earliest stages. Unfortunately, less than half of patients are cured due to the fact that they are diagnosed in later stages. Oral cancer can be relatively painless early on, and therefore hard to detect.

The American Cancer Society says symptoms of oral cancer can include sores on the inside of the mouth; pain, numbness or tenderness in the mouth or lips; a lump or small eroded area in the mouth; a prolonged sore throat; and difficulty chewing. This is where dentists come in, as they can see these warning signs and suggest follow-up consultations with your physician.

So what causes oral cancer?

Historically, smoking, tobacco, and heavy alcohol use have been major risk factors, and have been most common among men in their 60s, with a lifelong history of these habits. But according to the Oral Cancer Foundation, the same cannot be said today.

There are an increasing number of young, nonsmoking oral cancer patients. This news can be unsettling, and it's not entirely clear as to why this is so.

One strong risk factor that's relatively new to the mix is the human papillomavirus (HPV), the most common sexually transmitted disease in the U.S. In fact, recent studies have shown HPV to be the second leading cause of oral cancer.

While the number of cancer-related deaths has decreased, the number of HPV-associated cancers has gone up. Between 1988 and 2004, the percentage of HPV-related oropharynx cancers increased by 225 percent, according to a study published by the Journal of ClinicalOncology.

HPV-related cancers

Taking a look at the number of HPV infections nationwide is overwhelming.

At a glance, approximately 79 million Americans are infected with HPV. The virus, which has more than 120 variations that affect different parts of the body, is easily transmitted by contact of skin, with certain strands sexually transmitted. Many times, there are no noticeable symptoms, which leave a majority of cases undiagnosed.

Women often get diagnosed through their annual checkups and pap smears. Men, on the other hand, might not think to get screened and the virus might go undetected.

Because of this, HPV-related cancers are affecting men at a far greater rate than women, and the Center for Disease Control estimates nearly 11,100 men are diagnosed every year.

There are particular strands of HPV that have been associated with cancers: HPV 16, 18, 31, and 45.

Oral cancers have been linked particularly to HPV16, which often form in the back of the throat, inside the mouth, and on the tonsils. Tumors not associated with HPV tend to form on the anterior tongue, floor of the mouth, or on the inside of cheeks.

In 2013 there will be more than 41,000 new cases of cancers of the oral cavity and pharynx in the United States alone, resulting in nearly 8,000 deaths, the National Cancer Institute predicts.

As the number of infections climbs even higher, there is a growing need for additional prevention efforts for HPV-associated cancers, and a visit to the dentist is an important part of that equation.

Fortunately, oral cancer has received more attention in the media fairly recently.

Award-winning actress Gwyneth Paltrow and her family have created the Bruce Paltrow Oral Cancer Fund, in honor of her father who lost his fight to oral cancer in 2002. The fund helps those without insurance to get the resources they need to help with treatment.

And while I am encouraged because this kind of media attention creates more awareness to hopefully prevent loss of lives in the future, early detection is still the first step.

Early detection

Traditionally, individuals visit the dentist more frequently than they visit their doctor, and dental visits are an unrealized opportunity to find early warning signs for serious illnesses and diseases.

Most people receive oral cancer screenings during their regular checkup without knowing it, but just to be sure, ask your dentist about the screening on your next visit.

A visit to the dentist is more valuable than most realize. It's imperative to think of your dentist the same way you do your physician.

Be vocal with your dentist and disclose all health-related problems and hereditary concerns you have, even sexually transmitted diseases. Dental visits are an unrealized opportunity to find warning signs that can save your life.

Luckily, it can be as easy as saying 'ahhh.'

  • Dr. Ron Inge

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