Call to action for detection of oral cancers

Squamous cell carcinoma of the oral cavity and pharynx accounts for over 48,250 cases per year in the United States with approximately 9,575 deaths per year.1 The Oral Cancer Foundation notes, “A thorough, systematic examination of the mouth and neck need only take a few minutes and can detect these cancers at an early and curable, stage. Our goal is to discover oral, head and neck cancers early, before patients present complaining of pain, a mass, bleeding, otalgia, or dysphagia.” The traditional method for screening for oral cancers include: notation of any facial asymmetry, masses, skin lesions, facial paralysis, swelling or temporal wasting. In addition, inspection of the lips, both moving and at rest, can also be performed. Importantly, the improvement in patient outcome can only be achieved if the disease is detected and treated at an early stage. New techniques have been implemented or adapted in dental settings that offer scientists highly sought-after methods for the early detection of oral cancer.2

Autofluorescence is a thoroughly investigated optical technique that is a simple, user-friendly, and cost effective way to provide real-time detection and characterization of oral lesions. While this method has been reported to be exceedingly accurate in distinguishing diseased oral mucosa from healthy oral mucosa, there is not enough evidence to show its ability to accurately discriminate between lesion types. Trimodal spectroscopy (fluorescence spectroscopy, elastic scattering spectroscopy and Raman spectroscopy) has shown higher sensitivity and specificity toward diagnosis.2

The Velscope® Vx Enhanced Oral Assessment System when used together with and as a supplement to the traditional intra and extraoral head and neck exam can provide timely information to dentists and hygienists to enable enhanced visualization of abnormal tissues. The device emits a harmless, bright blue light which is used to inspect the mouth and tongue. The device is sensitive to abnormal tissue changes, and the distinctive blue-spectrum light causes the soft tissue (oral mucosa) of the mouth to naturally fluoresce. Healthy tissues fluoresce in distinct patterns that may be visibly disrupted when tissue undergoes an abnormal change (which can occur in the oral mucosa for a multitude of reasons) such as when associated with dysplasia or oral cancer.3

In addition to tobacco use, frequent and/or excessive alcohol consumption, a compromised immune system, Human Papilloma Virus (HPV16), and past history of cancer could increase the possibilities for development of oral cancer. Because these habits or health issues are prevalent in our society, dental professionals are presented with an urgent call to action for oral cancer awareness and education of patients regarding regular screenings.

  1. The Oral Cancer Foundation. Cancer screening protocols.https://oralcancerfoundation.org/discovery-diagnosis/cancer-screening-protocols/. Accessed April 20, 2018.
  2. Awan KH. Oral Cancer: Early Detection is Crucial. J Int Oral Health. 2014;Sep-Oct 6(5): i-ii.
  3. Velscope® VX Enhanced Oral Assessment. Velscope® Technology.http://www.velscope.com/velscope-technology/overview/. Accessed April 20, 2018.