You probably know that proper oral hygiene is important in keeping your gums healthy and your chompers white. But have you ever wondered what the dentist is doing when she grabs your tongue, pulls it out of your mouth, and peers inside? Amanda Venk, DDS, a dentist at Norman Family Dentistry, explained that dentists “first check for swollen lymph nodes under the jawline. Then we check the soft tissues around and inside the mouth including the lips, cheeks, gums, tongue, floor of the mouth, hard and soft palate, tonsils, and throat. We’re looking for asymmetrical changes in color and shape, and we’ll also examine the radiographs for any abnormalities.” Oral Cancer Awareness
One of the things dentists are looking for with this exam is any sign of oral cancer, which is the sixth most common cancer worldwide. Over 58,000 Americans are diagnosed with oral cavity or oropharyngeal cancers annually, and April is Oral Cancer Awareness Month.
The salivary glands as well as everything Venk listed above can be at risk for cancer. There are multiple risk factors associated with oral cancers, with the highest being any kind of tobacco use. Alcohol use, excess body weight, ultraviolet light and poor nutrition all have links to oral cancers. Men are twice as likely to be diagnosed as women. The average age of diagnosis is 64, but about 20% of cases occur in people younger than 55 years old. Oral Cancer Awareness
In the last 20 years, the prevalence of oral cancer has steadily increased because of the link with the human papillomavirus (HPV) infection. Most HPV infections do not cause cancer, however, a few strains are directly linked to cancer of the oropharynx, especially those in the tonsil and base of the tongue. Because of this, oral cancers are becoming more common in younger adults who have no history of tobacco use.
Venk noted that you should let your dentist know if you experience any “swelling or sores that won’t heal, unexplained bleeding or numbness and color changes” anywhere in your mouth. Symptoms of oral cancer may include “difficult or painful swallowing, changes in speech, weight loss or mouth sores that won’t heal.” If something appears suspicious, either your dentist or an oral and maxillofacial surgeon (OMFS) can perform a biopsy. Oral Cancer Awareness
Much like other cancers, there are multiple treatment options and most physicians make decisions on a case-by-case basis. Your dentist will point you in the right direction to find the right provider, which may be an OMFS, a radiation oncologist or a medical oncologist. Surgery, radiation, chemotherapy and immunotherapy are all viable treatment options and a combination of these may be used.
But not every bump in your mouth means cancer: Venk said that “canker sores, tonsil stones, benign protrusions of extra bone, localized gum infections or vascular malformations” can all mimic cancer. So, if you notice something new when you are brushing your teeth, go to the dentist to get it evaluated.
Dental Detective Work
You may not have guessed this, but your dentist can probably tell whether you have trouble sleeping. Dr. Venk explained, “If a patient has a retroclined lower jaw or if we can’t see anything beyond the hard palate when they stick out their tongue during the oral cancer screening, I’ll ask screening questions for Obstructive Sleep Apnea. These patients are physically set up for their airway to close off during sleep, putting them at greater risk of OSA.” Just another reason to keep that routine cleaning appointment!
