By Angela C. Canfield DDS
Every sixty minutes, a person dies from oral cancer. The disease is typically associated with long-term tobacco use, but it is becoming more frequent in young adults who have never smoked.
Besides tobacco use, the risk factors that could lead to oral cancer include DNA abnormalities or family history. But the main cause of oral cancers, especially in young adults who don’t smoke, is the human papillomavirus (HPV), which may be spread by sexually active people through intimate or even close contact. HPV is the leading cause of cervical cancer, which used to be the leading cause of cancer deaths for women in the United States. Now that more and more women routinely get PAP tests that provide early detection of conditions that could lead to cervical cancer, those cancer rates are on the decline. In fact, these days, a person is three times more likely to die from oral cancer than cervical cancer.
According to the National Cancer Institute, forty percent of those diagnosed with oral cancers will die within five years. While the disease has few, if any, early symptoms, early detection can make a dramatic difference, increasing survival rates to as much as ninety percent. And now, a routine test that takes only thirty seconds is available to provide that early detection and even offer prevention from the disease itself.
The test is basically a minty mouthwash or saline solution administered by a dentist or other oral health care provider. You swish and gargle and spit it back into the test cup. It’s that simple.
While easily administered, this genetic test has a complex function, looking for oral cancer risk on a molecular level in three ways:
• Cell abnormalities. Changes to your cells could mean a precancerous condition or infection exists.
• HPV. This virus can lead to some cases of oral cancer, or clear up on its own. In either case, I monitor and test my patients more frequently, especially if an infection tends to linger.
• DNA damage. People with certain DNA damage seem to be at a higher risk for oral cancer. These abnormalities don’t mean you have oral cancer or that you are destined to get it, but more frequent monitoring is usually necessary, just to be safe.
While not always present, possible signs of oral cancer could include a mouth sore that bleeds easily and does not heal within two weeks, a lump or thickening in the oral soft tissues, soreness or a feeling that something is caught in the throat, difficulty chewing or swallowing, ear pain, difficulty moving the jaw or tongue, hoarseness, or numbness of the tongue. Some signs of oral cancer might also easily be mistaken for a toothache or a cold.
I recommend to my patients aged 18 and older that they be tested annually for oral cancer. Results can vary from negative to being “high risk” or positive. For patients who test positive for precancerous cells, I usually suggest a follow up visit with an ear nose and throat (ENT) specialist, depending on the levels found. I will continue to monitor high-risk patients and administer follow-up tests as needed.
Can you afford not to be tested? Please talk with your oral health care provider about your risk factors and the advantages of oral cancer screening.
Angela Canfield, DDS, is licensed by the Georgia Board of Dentistry and the National Board of Dentists. She owns and practices at two dental offices: Premier Dental Designs in Rincon, Ga., and Sandfly Family Dental in Savannah, Ga. Contact Dr. Canfield at molar799@yahoo.com or 912-826-4037.