Dental checkups: looking beyond a toothache

We all know a dentist can find potential holes in our teeth and let us know if we’re failing flossing duties, but you may not realise they can also screen for oral cancer.

It’s been drummed into us from a very early age that we need to visit the dentist every six months to check on our teeth and gums. 

But according to Bupa dentist Dr Mark Psillakis, your dentist can also screen for oral cancer.

Why oral cancer screens are important?

While some people experience signs and symptoms including a lump or ulcer that’s not going away, Dr Psillakis says others might not see any signs until the cancer has metastasised (spread to other parts of the body). 

The five year survival rate of oral cancer if it is picked up in the early stages is 65-85 per cent, however if it’s not discovered until the later stages it drops to between 9-41 per cent.

“This is why early detection is the most critical factor,” says Dr Psillakis. “The secret when it comes to looking out for things that can potentially change into something more sinister is if it has been there for more than 10 days.” 
close up of mouth with dentist examining

Oral cancer checks

Dr Psillakis says an oral cancer screen should really be part of the normal examination process. 

“A visual examination is something we’ve been doing for quite some time,” Dr Psillakis. “Looking for any red and white patches, lumps, persistent ulcerations, rolled borders and feeling the lymph nodes.”

If there is an abnormality, the dentist may perform a biopsy, which means taking a sample from the area and sending it to a laboratory for testing. In other cases the dentist may refer a person to a specialist for further investigation. 

“The key diagnostic aid is biopsy, but the problem is there are some malignancies that by the time it becomes clinically evident to justify a biopsy it may have already progressed to the point it’s metastatic,” says Dr Psillakis.

There are aids which can help with early diagnosis, but they’re not fool proof yet, so there is always the possibility of a false positive or negative result.

“We’re always looking for easier ways to diagnose oral cancer,” Dr Psillakis. “We have brush biopsies where you can run it over the affected area to obtain cell samples for microscopic examination rather than excising a sample.”

“There are mouthwashes and dyes that stain fast proliferating nuclear material and that’s what a malignancy is; basically the cell is multiplying so fast that some of the genetic information doesn’t get copied across as it should.”

Dr Psillakis says he’s also trialing a torch which causes healthy tissue to glow, and malignant cells to appear as a dark spot.

“The thing about this particular light is clinically the tissues could look perfectly normal, you hit it with this light and you see these black spots,” says Dr Psillakis. 

When to have an oral cancer check

Dr Psillakis says it’s important not to ignore any lumps or lesions in your mouth.

“If you have any lumps or ulcers that persist for longer than 10 days, it’s important to get it checked out,” he says.

This is particularly important for men over 40, or those with risk factors including a family history, smokers and other tobacco users and heavy drinkers.

Bupa Dental

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