Oral Cancer Facts

Since this is Oral Cancer Awareness month, I wanted to start and end the month with some thoughts on this collection of cancers. I was recently asked to talk about oral cancer on one of our local television stations and so I contacted the Oral Cancer Foundation for some information. I talked with their Director who is an oral cancer survivor of 11 years. He was a pleasant person to speak with and had lots of valuable information to share. Among his statistics:

1. 110 people every day are diagnosed with an oral cancer
2. 1 person dies every hour of every day from oral cancer
3. Anecdotally, on the oral cancer foundation survivor list, about 1/3 are under 30 years of age
4. There seems to be a correlation with the HPV virus and oral cancers
5. In 2007 oral cancers rose 11%
6. Survival rate is good if found early, but overall about a 55% survival after 5 years

The signs of possible oral cancer lesions inside your mouth include both “raised” and “sunken” lesions, changes in coloration, hardening lesions and lesions that bleed easily. These changes should have been present at least 14 days before you start to worry, and your dentist is a great place to start for a diagnosis.

Always feel free to talk to your dentist about what to watch for and ways to prevent oral cancer.

Massachusetts has an oral health plan

The plan, presented at the Massachusetts State House by the Better Oral Health for Massachusetts Coalition on April 12, is the result of over a year and a half of work by a dental care providers, program sponsors, lawmakers, state officials, insurers, health advocates, policy leaders, and consumers, in communities from Cape Cod to the Berkshires.

The goal of the state Oral Health Plan is to improve the system of oral health services in the state through a strategy that includes increasing access to preventive services, broadening the public’s understanding of oral health, developing the oral health workforce, and strengthening disease surveillance. The plan emphasizes cost-effective strategies and public-private partnerships at the local, regional and statewide levels.

The Better Oral Health for Massachusetts Coalition was formed in 2008 in response to data provided in 2008 report by the Catalyst Institute’s report, The Oral Health of Massachusetts. This report found gaps in access to preventive oral health services across Massachusetts. For example, 48% of children under the age of 9 suffer from tooth decay and 1 in 10 children from low-income and minority families reported mouth pain while at school. Untreated tooth decay can inhibit a child’s ability to learn, speak, and eat, and result in lower educational attainment and poorer overall health.

I had the pleasure to serve as master of ceremonies at the launch of the plan. Speakers representing state government and the health care community spoke about the importance of oral health and its connection to overall health.

The DentaQuest Foundation has been the primary supporter of the Better Oral Health for Massachusetts Coalition through in-kind and financial contributions. View the plan at www.massoralhealth.org or, at www.dentaquestfoundation.org/resources/reports.php.

Guest post by Ralph Fuccillo, President, DentaQuest Foundation

Acid Reflux and Oral Cancer

The survival rate for people with oral cancer has not shown much improvement over the past several decades and we should discuss some reasons for that.

In general terms, mouth cancers have about a 50% survival rate after 5 years. Most physicians believe this is because the cancers of the mouth are diagnosed later than other cancers, mainly because the public ignores many early signs.

As a dentist, I am expected to perform a 90-second oral cancer screening for patients. In this screening, I look for color changes in the tissues or small ulcerations in the oral cavity. Many lesions are found at the base of the tongue and under the tongue – places most people never look at in their own mouths.

A dentist needs to take a piece of gauze and pull your tongue, twisting it from side-to-side to get a good look under and behind the tongue. There are other tools available to dentists today for biopsying these ulcerations to tell if they are cancerous. One popular tool uses a rinse and blue light to show ulcerations. This tool does not give a diagnosis of the tissue changes, but it makes them easier to find. For those with insurance, the visual oral cancer screening is included as part of the oral evaluation performed by dentists, and should not be charged separately.

The leading causes of oral cancer include the use of tobacco and alcohol, but certainly it can strike anyone. My mother died nearly 40 years ago from a form of oral cancer related to acid reflux and which is almost completely preventable today. Prior to her death, I was not aware that acid reflux can irritate the esophagus until it becomes malignant. Common associated diagnoses are GERD and Barrett’s esophagus. GERD is a term for acid reflux; Barrett’s esophagus is the pre-cancerous esophagus caused from acid reflux that then becomes irritated and later may become malignant. Your dentist may be able to recognize untreated Barrett’s from signs of erosion on the teeth from the acid and may alert you to have a conversation with your physician.

This month (April) is oral cancer awareness month. I wanted to remind you to make sure your dentist pulls and twists your tongue at your next visit.