Approximately 4,300 people were diagnosed last year with oral cancer. The Canadian Cancer Society estimates that of those who are diagnosed upwards of 1,200 people will die as a result. In fact, there are more cases of oral cancer diagnosed in a year than there are for cervical or ovarian cancer, and there are more deaths from oral cancer than from melanoma.
Early detection is critical. According to an article in the Journal of the Canadian Dental Association, “Oral Cancer: Just the Facts,” survival is much better when a tumour is diagnosed at an early stage. Unfortunately, more than 40 per cent of oral cancers are usually diagnosed at a late stage.
As an oral health professional, your dentist routinely checks for early signs and symptoms of cancer as part of the dental exam, says Dr. Ben Davis, district chief of the department of oral and maxillofacial surgery at Capital Health in Halifax.
“Dentistry isn’t just about the teeth,” he notes. “A proper head and neck exam should be done annually or semi-annually.”
As part of the examination, your dentist will conduct a medical history review and ask about your current health, as well as check for any abnormalities or changes in your mouth that might be indications of health problems, such as oral cancer. This may include feeling or palpating your neck; checking your face for discolouration; and examining your lips, the floor of your mouth, your tongue and your teeth.
It’s a thorough review, but not a time-consuming one. “It doesn’t take more than five minutes,” says Dr. Davis.
Your dentist may use photographs of your mouth and accompanying notes as a benchmark against which to assess and measure changes. “You put a ruler next to [the image]. You know exactly what was the size, the colour, and the feel,” says Dr. Davis, who is also the chair of the department of oral and maxillofacial sciences at Dalhousie University’s faculty of dentistry.
Oral cancer has a wide reach. It can affect the lips, tongue, gums, and even the lining inside the lips and cheeks as well as the floor and roof of the mouth and the area behind the wisdom teeth. Most oral cancers, however, are located on the sides of the tongue, the floor of the mouth, and the lips.
“Your dentist can identify pre-cancerous lesions,” stresses Dr. Davis.
There are numerous risk factors for oral cancer. Men are almost twice as likely as women to get the disease, and people over the age of 40 have a higher likelihood of developing oral cancer. The two most modifiable risk factors for oral cancer are tobacco and alcohol use. Up to 75 per cent of oral cancers may be attributed to their use.
Recently, research has identified a link between oral cancer and the human papillomavirus (HPV), a group of more than 100 different types of viruses but perhaps best known as the primary cause of cervical cancer in women. According to the Canadian Cancer Society, HPV may account for as much as 35 per cent of all oral cavity, head and neck cancers. Testing for an HPV infection can be done on a sample of cells and many provinces provide HPV testing for women, although none do for men at this time. An HPV vaccine for men and women is also available.