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Are we doing enough to prevent oral cancer?

May 1, 2008
Dental problems have long been regarded as non-life-threatening. Daily, this concept is being proven as untrue and simplistic.

For more on this topic, go to www.dentaleconomics.com and search using the following key words: oral cancer, cancer, oral cancer prevention, chronic periodontal disease.

Dental problems have long been regarded as non-life-threatening. Daily, this concept is being proven as untrue and simplistic. Nearly every week there is another article recognizing the mouth as the gateway to the body. Recent research found people with chronic periodontal disease are at greater risk for oral cancer. With this growing body of evidence, it is time to reevaluate oral cancer prevention procedures. And it's what our patients want and will be asking for more and more.

ADA oral cancer awareness campaign

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Preventing cancer from occurring and detecting it early, when it may be curable, is at the center of our nation's research and public health agendas. The National Cancer Institute's Challenge Goal 2015 is to "substantially reduce the incidence of cancer and integrate early detection with markers of prognosis, through the development and effective delivery of medical approaches to prevention and early detection and the promotion of effective, evidence-based public health interventions and policies."

Because early detection is the key to prevention, the value of identifying suspicious spots early is paramount. We know Pap smear screening makes a difference. In 2005, the American Cancer Society reported that from 1955 to 1992 when routine Pap smear screening became instituted on a routine basis, there was a 74 percent drop in cervical cancer death rates. There are about 55 million Pap smears performed annually. Of those, 6 percent identify cancer of some kind, including 3 percent that identify cervical cancer. Cervical cancer kills half as many people annually as oral cancer, yet what are you doing routinely in your office? The answer is not enough. And the public wants more.

A 2005 ADA survey showed that virtually all dental practitioners claim to conduct regular oral cancer screenings, yet only 15 percent of patients report receiving an oral cancer examination. Late in 2007, the Crown Council (www.CrownCouncil.com), along with OraPharma, 1-800-Dentist, and Oral Health America, commissioned and funded a scientific, national public opinion survey to identify the public's perceptions of dental health and the role dentists play in providing dental health services. The results showed 85 percent of survey respondents indicated that it was important to them that their dental professionals check for oral cancer. Yet only 51 percent of survey respondents indicated that the professionals they were seeing actually did so. That means that one-third of those surveyed were expecting something that they were not getting.

It is hard to know how much of the general public really knows about oral cancer, but interest will only increase.

The ADA announced a nationwide awareness campaign urging people to see their dentists regularly for oral cancer examinations. This three-year nationwide public service campaign was kicked off in November 2007 by ADA (www.ada.org) in collaboration with OralCDx Laboratories (www.oralcdx.com). The campaign includes magazine and other national print advertising, outdoor advertising, and national distribution of patient and dentist educational materials. (See photo above.)

The goal is to boost public awareness of oral cancer and spotlight dental professionals' roles in helping to stop this disease, years before it can even start.* New York City's Third Annual Oral Cancer Walk was held April 19, with participation of students from New York University College of Dentistry and others. April 21 through 27 was the Yul Brynner Head and Neck Foundation's (www.headandneck.org) Oral, Head and Neck Cancer Awareness Week. The Oral Cancer Foundation (www.oralcancerfoundation.org) receives 15 million hits each month and has 20,000 medical and dental Web sites linked to its content. Our patients will be asking and expecting more; are you ready?

Clearly defining/redefining and codeveloping your oral cancer prevention/detection protocols with every person who works in your practice is the first step. Protocols should include the use of adjunctive technologies. (See table below.) Practicing and calibrating both the techniques and communication will be a key to successful implementation. Every person plays a key role in communicating the importance of oral cancer prevention to your patients. This can only be based on the belief that oral cancer prevention is a high priority. It is what your patients want.

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* The ADA does not endorse any specific product in connection with this awareness campaign and has no financial interest in the products.

Patti DiGangi, RDH, BS, is a speaker, author, practicing dental hygiene clinician, and American Red Cross authorized provider of CPR and first aid training. She can be contacted through her Web site at www.pdigangi.com.

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