There are over 38,000 new cases of oral cancer diagnosed each year. Oral cancer kills approx. 9,000 people each year in the U.S. It has a low survival rate. Lives can and must be saved by performing this simple exam.
5-15% of all dental patients have oral abnormalities. The vast majority of these are truly benign. Detecting those that are precancerous is the key to improving survival of oral cancer patients.
Screen each patient at every appointment to detect lesions that may be pathologic. Identify suspect lesions that require additional testing and referral. Prevent advanced or irreversible disease by recognition.
The complete examination should include both inspection and digital palpation of extra and intra oral structures. Oral tissues are an indicator of your patients overall health Abnormal conditions can be recognized if the appearance of normal oral structures is known. The color and size of structures may vary with genetic patterns and age.
Lips Lateral surface of tongue Retromolar pads Buccal mucosa Floor of mouth Hard & soft palate Gingiva
White areas: Vary from filmy, barely visible change in the mucosa to a heavy, thick, heaped up area of dry white keratinized tissue. Leukoplakia: White patch that can not be scraped off. Found on lips, tongue, and lining of the mouth. Red areas: Lesions of red, velvety consistency, sometimes with small ulcers.
Erthtoplakia: Used to designate lesions that appear as red patches that can’t be characterized as any specific disease. Ulcers: They may have flat or raised margins. Palpation may reveal induration. Masses: elevations above the surrounding tissues, or below mucosa found by palpation. Pigmentation: black or brown pigmented areas maybe located on mucosa where pigmentation doesn’t normally occur.
Localized: lesion is limited to a small focal area. Generalized: involves most of an area of section of the mouth. Single: one lesion of a particular type with a distinct margin. Multiple lesions: more than one lesion of a particular type. › Separate- discrete, not running together. › Coalescing- close to each other with margins that merge.
A- anatomic location (i.e. left buccal mucosa adjacent to #14) B- boarder (i.e. well demarcated) C- color & configuration (i.e. red, linear) D- diameter & dimensions (i.e. 4mm x 2mm x 1mm in height) T- type (i.e. macule)
Explain procedure to patient( what youre doing and why) Remove all removable prostheses. Use visual inspection and palpation technique with optimal lighting Use mirror and retractors when necessary.
Visually inspect the entire oral cavity and oropharynx. Use the dental light and mirror to look for any conditions (i.e. herpetic lesion)
Examine the patient at each appointment. Ensure a thorough health history. Educate on behaviors that increase risk of oral cancer. Identify and document suspicious lesions. Refer to obtain a definitive diagnosis. Follow up to make sure diagnosis was made.
Bifid uvula Fordyce granules Ankyloglossia Fissured tongue Geographic tongue Mandibular torus Buccal exostoses Palatinus torus Linea alba