How Your Dentist Could Save Your Life From HPV-Related Oral Cancer
A tiny white spot on the side of the tongue, a rough spot on the roof of the mouth — these changes in the mouth are often easy to overlook. But for two of my recent patients, they were signs of oral cancer.
These women were younger than 40, neither smoked, and they socially drank alcohol. Both are alive, I believe, because they consistently have regular dental exams, during which I performed what a general dentist always should: a full check for head and neck cancer, including looking closely in the mouth, feeling for lumps and bumps in the neck, and asking patients if they’ve noticed any changes.
When you think of the things that can save your life, your twice-yearly dental visit may not come to mind. But it should. Your dentist is your first line of defense against oral cancer, which kills nearly 9,000 people per year — nearly one person per hour. That’s more than cervical, skin, or testicular cancer. More than 70 percent of oral cancers are caused by human papillomavirus (HPV), which also causes cervical cancer. Early detection is key: When oral cancer is found quickly, the five-year survival rate is 80 to 90 percent, but it’s only 20 to 50 percent if the disease is advanced.
Think about it: Your dentist has the expertise to do a thorough oral exam and is familiar with your mouth, so he or she can detect even slight changes early. Your physician may not do a thorough oral exam. Plus, you see your dentist twice a year, while you may only see your physician once a year.
During each visit, I look closely in the patient’s mouth, move the tongue around, check the roof of the mouth, run my fingers along the gums, look down the throat, feel under the jaw and the back of the neck, and ask pointed questions about any changes my patients have noticed, no matter how tiny. Patients often notice new spots or bumps, and thankfully, the majority of them amount to nothing. If the patient thinks the spot or bump might have been from a bite, burn, or aggressive toothbrushing, I schedule an appointment for two weeks later. If at that point the bump or spot is still there, I use a special scope that safely uses infrared light to peer into oral tissue and identify whether there may be a bigger problem — such as early cancer, an infection, or inflammation. If I note something unusual with the scope, I refer patients to a specialist such as an oral surgeon or periodontist (a dentist who specializes in gum disease) who may test a small piece of tissue (biopsy) to determine if cancer is the cause. If cancer is detected, the patient can start treatment right away.
Once a year, I offer all of my patients an additional exam with that special scope to identify areas where something concerning might be going on, even if they haven’t noticed anything. This can help identify early signs of cancer before anything is visible on the surface.
Oral cancer can be prevented. Because tobacco and heavy alcohol use are risk factors for oral cancer, it’s important to quit smoking and chewing tobacco, as well as to reduce alcohol consumption. Increasingly, oral cancer is caused by HPV, which is sexually transmitted. The HPV infection is the most common sexually transmitted disease in the world, affecting 20 million Americans ages 15 to 49. HPV-caused oral cancer is on the rise, showing up in younger people who don’t smoke, chew tobacco, or drink excessively. Because the HPV vaccine can prevent cancer caused by the virus (including oral and cervical cancer and other cancers), I highly recommend that my patients have their children vaccinated before they become sexually active. (The recommended age is 11 or 12.) In fact, both my son and daughter have received the HPV vaccine.
Because most of us were not vaccinated, the oral cancer exam at your twice-yearly dental checkup is vital. We need your help, too. Be sure to tell your dentist about your health, particularly if you’ve noticed any changes in your mouth or throat. Let your dentist know if you’ve had any of the following symptoms, which can be a sign for oral cancer:
- Red, white, or discolored spots or bumps
- Sores that bleed or last longer than two weeks
- Patches or lumps in the mouth, especially those that are thick or hard to the touch
- Persistent sore throat, or a feeling that something is caught in the throat
- Difficulty chewing, swallowing, or moving the jaw or tongue
- Ear pain
- Tongue numbness
- Pain when swallowing
- Changes in the way your teeth fit together
All general dentists should do an oral cancer check at every exam, so be sure to ask your dentist about it. For more information, visit Knowyourteeth.com to find a dentist in your area.