Oral cancer is the 13th most common cancer (of the 23 that are reported) in Canada. Each and every year, 1,000 or more Canadians die from oral cancer. It seems to affect males more often than females. In 2013, 2% of the 39,400 males who died from cancer were as a result of oral cancer, whereas 1% of the 36,100 females who died from cancer were due to oral cancer.

As with all cancers, oral cancer can occur without much cause, although there are risk factors. One such risk factor is tobacco use, especially of chewing tobacco. Another is abuse of alcohol. It is estimated that tobacco and alcohol usage accounts for 75% of all oral cancer cases. We offer comprehensive oral cancer screening in Edmonton and urge everyone to undergo this test atleast once a year.

Other potential causes of oral cancer are human papillomavirus (HPV); prolonged and repeated exposure of the lips to the sun; a poor diet (especially one lacking in fruits and vegetables); genetics (especially if one or both of your parents had cancer); and age. Oral cancer often affects people over the age of 45, and people over the age 60 have the highest incidence of oral cancer.

The Screening

Especially if you are in a high-risk category for oral cancer, ask your dentist about having an oral exam. This includes the first, and sometimes all three steps.

Physical examination

oral cancer physical exam

Using gloved hands, your dentist will engage in a multitude of inspections, including
1) Asking you to remove your dentures or partials, if you have them.
2) Inspecting your face, neck, mouth and lips
3) Feeling for lumps under your jaw and at the sides of your neck
4) Looking for red and/or white patches inside your lips and cheeks
5) Ask you to stick out your tongue, to be checked for abnormal color or texture and for swelling
6) Checking the base and the underside of the tongue for possible symptoms
7) Looking at the roof as well as the floor of your mouth, and the back of your throat
8) Placing a finger on the floor of your mouth as well as a hand under your chin and then gently pressing down in order to check for lumps or sensitivity.

Even if you do not ask for it, most dentists follow this procedure during routine checkups. It should be noted that the mouth is a hotbed of bacteria, which often results in small lumps and sores located there, most of which are non-cancerous.For any that your dentist suspects may be a symptom of oral cancer, you may be given diagnostic tests or referred to an oral surgeon.

Toluidine blue stain screen

oral cancer screening with toluidine blue stain

Another screening process for oral cancer is to rinse your mouth with a blue dye. The blue dye is likely to attach itself to abnormal cells in your mouth, indicating a higher probability of cancer.

This test can give ‘false positives’ with inflammations and surface trauma and hence is used in conjunction with other methods of screening and not as a sole determining factor. In high risk groups, a positive toluidine test should be reason enough to get a biopsy done.

The blue-stain test is widely used in monitoring recurrence of the disease in post-therapy oral cancer patients who are in remission.

Fluorescent light test

oral cancer screening with fluorescent light testA special light using devices like ViziLite or VELscope is shone into the mouth after the patient is asked to gargle with a solution which makes cancer-suspect tissues look dark and healthy tissues look lighter. This test is done to complement the physical exam and both together form part of the standard oral exam. These screening procedures may not be covered by insurance.

This test also can offer false positives, but we ask the patients to get a biopsy done even with the slightest indication. With oral cancer, it is better to err on the side of caution and avoid a potentially fatal disease.

The screening tests serve as indicators to enable early detection of oral cancer but are not definitive. If the dentist does see signs of oral cancer then he or she will refer you to an oral surgeon right away and the ultimate determination of whether or not an abnormal, unusual or suspected source of cancer is indeed cancerous is through a biopsy.

Biopsy is a procedure in which abnormal cells are removed and individually tested for cancer. If this procedure or test is positive then oral medications, surgery, radiation therapy and chemotherapy are the common treatments for it.

Common symptoms

Excluding those mentioned in the physical examination section include
1) bleeding or numbness in the mouth
2) sores that do not heal after two weeks
3) difficulty in swallowing
4) changes in taste or in sensation of the tongue
5) persistent hoarseness or a change in the voice
6) problems in moving the tongue.