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Tuesday, January 31, 2023
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Oral cancer is a disease which impacts thousands of people in the United States, and which unfortunately has been growing in scale.  The Oral Cancer Foundation estimates that 42, 000 Americans will contract oral cancer this year, the fifth year in a row of growth in this disease.

What’s most unfortunate is that 75% of oral cancer cases can be traced back to behavioral issues like smoking, excessive alcohol consumption, poor dental hygiene, bad nutrition and other controllable activities.  The good news is that early detection can lead to control of the disease: this makes your dental professional your first line of defense against oral cancer.

Why is this? The reasons are simple: dental professionals can spot the early stages of the disease and deal with them before they seriously impact a patient’s health.  In addition, the simple act of having a professional hygienist clean your teeth leads not only to improved appearance and better overall oral health, but can also prevent mouth cancer.  These easy actions can yield significant results, which makes the rise in oral cancer rates since 2007 all the more unfortunate as so much hardship can be so easily prevented.

Oral cancer has many symptoms, most of them visible to patients.  Any problems with swallowing, or discomfort in the tongue are early signs.  Any sustained appearance of sores or lesions over a two-week period is also a signal.  An important thing to recognize is that the initial signs of oral cancer do not involve pain, but visual tells like sores and ulcers.  These may not be immediately apparent to non-professionals, which is all the more reason for regular visits with dental professionals, especially for higher risk groups like smokers.

Once an oral cancer event has been identified, how is it treated? As the Oral Cancer Foundation notes, treatment is a multidisciplinary effort involving surgeons, oncologists and dental professionals.  Before the cancer itself is dealt with, however, other oral problems may be

resolved as not dealing with simpler matters, such as decayed teeth, may make recovery more difficult.  As such, basic issues will be dealt with first in an effort to avoid more complicated surgeries down the line, especially radiation therapies.

Once basic maintenance on the mouth, including a thorough cleaning, has been completed, surgeonswill remove the diseased tissues.  It is possible, depending on the nature and severity of the cancer, that oncologists may elect to treat the disease with radiation or chemotherapy. In addition, as noted by the professional support organization Cancer Care, some newer drugs, different from traditional chemotherapies, appear to be promising.  These new drugs, known as Blocking Agents, inhibit the growth of cancer by blocking the receptors on a cancer cell, which is the mechanism through which cancer grows.

The exact treatment options will vary by patient, of course, but all of these options are available to the multidisciplinary team that will over see the treatment and recovery.

The postoperative process is also extremely important.  Depending on the processes chosen by the patient’s team, reconstructive dental surgeons may be brought in to rebuild the mouth and to restore the patient’s appearance.  Frequently, reconstructive surgeons may use what is called a “flap”, a piece of tissue taken from another part of the body, to restore the mouth and or the tongue.  In addition, reconstructive work can be done on the jaw, which is vital to rebuilding the patient’s mouth. Physical therapists may be brought in to help the patient regain basic motor skills.

Oral cancer is a tragic disease as it is one of the easiest things we can prevent.  Smoking, excess alcohol consumption and poor oral health are all controllable behaviors.  The fact that much has been made of the impact of smoking on the mouth makes the growth of oral cancer so unfortunate.  The good news is that with early detection, treatments can be comprehensive and life saving.  But with proper dental care, there is no reason to get to that point.  As noted at the beginning of this article, your dental professional is your first line of defense against this painful disease.  He or she can provide you with the basic care needed to ward off oral cancer.  At the same time, your dental professional can observe early signs of the disease that laypeople may not see.  Perhaps in no other medical space can such a small amount of prevention lead to so much of a cure.

Dr. Jeremy Peyser graduated in 1985 from the Univ. of Pennsylvania Dental School. He did a residency at Bird S. Coler Hospital. He has been practicing dentistry for 25 years and provides a full scope of general dentistry with special emphasis on preventative, cosmetic dentistry, and endodontics.

By Dr. Jeremy Peyser

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