Detecting Oral Cancer
A Guide for Health Care Professionals
New Cases30,000
Deaths8,000
Oral & Pharyngeal Cancer
5 Year Survival Rate = 50%
Early Detection
Saves Lives
Leukoplakia
Erythroplakia
Lump or thickening of
oral soft tissue
Soreness or “lump” in
throat
Difficulty chewing or swallowing
Ear painDifficulty
moving jaw or tongue
Hoarseness
Numbness of tongue or
mouth
Swelling of the jaw
Warning Signs
Risk Factors
Overview•Head & neck exam should be routine•Review history of alcohol and tobacco use•Follow-up on suspicious signs
Armamentarium
•Proper lighting•Dental mouth mirror•Gauze squares•Disposable gloves•5 minutes of time
Examination Preparation
Extraoral Examination
Examine
Face, head and neck – note asymmetry or changes
Lymph nodes – palpated bilaterally
Perioral & Intraoral Soft Tissue Exam
Lips
Labial Mucosa
Perioral & Intraoral Soft Tissue Exam
Labial Mucosa
Buccal Mucosa
Perioral & Intraoral Soft Tissue Exam
Buccal Mucosa
Gingiva
Perioral & Intraoral Soft Tissue Exam
Dorsum of Tongue
Left Margin of Tongue
Perioral & Intraoral Soft Tissue Exam
Right Margin of Tongue
Ventral Surface of Tongue
Perioral & Intraoral Soft Tissue Exam
Floor of Mouth
Hard Palate
Perioral & Intraoral Soft Tissue Exam
Oropharynx
Floor of Mouth - Bimanual
Suspicious Oral Lesions
Homogenous Leukoplakia
Leukoplakia with Early Squamous Cell Carcinoma
Suspicious Oral Lesions
Nodular Leukoplakia with Severe Epithelial Dysplasia
Erythroleukoplakia with Candida Infection
Points To Remember When Screening for Oral Cancer
Most oral cancers are located on the lateral borders of the tongue, floor of the mouth and lips – special attention should be focused in these areas.
Tell your patient what you are doing with each procedure and why.
Always note any changes in color and texture of all soft tissues or any swelling. If you detect an abnormality, determine the history of the lesion; if the abnormality has been of more than 2 weeks’ duration, take appropriate action to obtain a biopsy.
Points To Remember When Screening for Oral Cancer
Follow up to ensure a definitive diagnosis of an abnormality.
Teach your patients about the signs and symptoms of oral cancer.
If a patient uses tobacco products, provide appropriate counseling or refer patient for counseling.
Remove all removable prostheses before starting the examination.
Photographs for this program were provided by:
Joseph Konzelman, DDS
Jens Jorgen Pindborg, DrOdont
Slide series revised by Visual Dynamicswww.visualdynamics.us
For more information: National Institute of Dental and Craniofacial Research (NIDCR)National Oral Health Information Clearinghouse1 NOHIC WayBethesda MD [email protected]