Presented by Dr. David Clark, Bsc., MSc (Oral Pathology), FAAOP, FRCDC.
Oral cancer is a disease with a mulitifactorial etiology. While the disease may occur with no prior history, traditional risk factors have included smoking and alcohol consumption in a population made up predominantly of males in thte 5th to 7th decade of life and involving high risk intraoral sites such as the floor of the mouth, lower lip, and ventral/lateral surafaces of the tongue. Sadly, the average 5 year survival rate has essentially remained unchanged over the past 50 years- approximatly 50-52%. This poor prognosis is particularly high due to this disease being routinely discovered far too late in its development, i.e. at stage 3 or 4.
Increasing evidence now links a viral etiology to oral cancer, in particular, the role of the human papilloma virus (HPV) in the pathogenisis of this disease. HPV is now considrered to be a risk factor for a subset of oral cancer- oropharyngeal carcinoma. This subset is defined by a younger demographic often favouring different intraoral high-risk sites that include the base of the tongue, soft palate, and the tonsillar tissues.
The presentation will highlight
a) steps involved in performing a thorough extra-oral/intra-oral soft tissue examination.
b) HPV- it’s prevalence, risk factors, symptoms (“ASK/LOOK/FEEL”), modes of transmission.
c) identify the various tools/steps used in arriving at a definitive diagnosis.
d) current treatment modalities (including pre-treatment dental management initiatives).
e) treatment complications/ side effects.
f) future research/treatment initiatives in oral cancer- where are we heading?
g) communication with patients about oral cancer – the role of the dental hygienist.
Dentistry has always been about prevention and the dental hygienist is in a strategic position amongst oral health care professionals to play a key role in this facet of oral care. On-going efforts at early detection and diagnosis of all forms of head and neck squamous cell carcinoma remain crucial to improving the current 5-year survival rate for this disease.