Journal of Advanced Clinical & Research Insights (2014), 1, 1–2

S H O R T C O M M U N I C AT I O N

Early detection of oral cancer: Duties of a dental surgeon

Nidhi Tripathi1, Sanyog Pathak2
1
Dental Surgeon, Reva Dental Clinic & Facial Surgery Centre, Jabalpur, Madhya Pradesh, India, 2Department of Oral & Maxillofacial Surgery, Hitkarini Dental
College & Hospital, Jabalpur, Madhya Pradesh, India

Keywords
Dental surgeon, early diagnosis, oral cancer
Correspondence:
Dr. Sanyog Pathak, Department of Oral &
Maxillofacial Surgery, Hitkarini Dental
College & Hospital, Jabalpur - 482 001,
Madhya Pradesh, India.
Email: pathak_sanyog@yahoo.com
Received 02 July 2014;
Accepted 28 September 2014
Abstract
Dental surgeons are the people who examine the oral cavity most frequently.
Unfortunately, due to lack of knowledge and training, structures other than teeth are
missed for proper examination. A large chunk of patients is still diagnosed in late stage of
cancer when prognosis is poor. For provisional diagnosis and referral, visual examination
by an expert dentist is sufficient. We, being stomatologists, can make a difference if little
bit time is spent and responsibility is shown from our side. As we all know, expertise is
acquired through imparting knowledge to budding dental graduates and training them
to spot even the slightest changes in the epithelium. In this article, we would like to
emphasize on the same.

doi: ***

Introduction
More deadly than breast, cervical, and prostate cancer, it has
been estimated that oral cancer kills one person every hour, every
day.[1,2] Studies suggest that head and neck cancer and tongue
cancer in particular is increasing in young adults both nationally
and internationally.[3] Most important step in reducing the death
rate from oral cancer is early diagnosis. Oral examination by a
health care professional is the most effective way to identify
suspicious lesions in their early stage. No group of medical
professionals has a better opportunity to have a positive impact
on early detection than dental surgeons. The overall 5 year
survival rate is 75% for those with localized diseases at diagnosis
but only 16% for patients with late stages because in the majority
of cases the cancer is diagnosed at Stage 3 or 4 with lymph node
metastasis.[4,5] Only about 1/3rd of all oral cancers are detected
in Stage 1.
Why we, the dentists?
As dentists are the ones, most frequently checking oral and peri-
oral region in each and every patient, we have an important role
in detecting and referring patients for treatment and follow-up
of oral mucosal lesions. Dentists should realize that a visit to
the dentist is no longer only about filling cavities, crowns, or
a postponable cleaning of teeth but actually a matter of health
and quality-of-life. Dental examination, when properly done
including a thorough screening for oral cancer will save millions
of lives, as Stage 1 disease is typically observed by a general
dentist during routine oral examination or screening. Although
likelihood for suspicious lesions is less for patients without any
tobacco related habit, proper screening is mandatory as it can be
a question of life and death.
Early detection is important: Give it more than a minute
Early diagnosis is a significantly relevant factor in the prognosis
of oral cavity carcinomas. Knowledge of clinical signs and oral
manifestations of precancerous lesions in general dentistry is of
paramount importance. Although basic oral cancer examination
for provisional identification requires only a 90 s visual and
tactile examination, too few dentists are spending their time for
the same.[6] Clinicians can increase survival rates if a precursor
lesion is discovered and treated prior to malignant progression.[7]
Diagnostic tools: Just keep your eyes open
Visual examination continues to be the gold standard for
identifying the early epithelial changes. Criteria for inspection of
the oral leukoplakia or squamous cell carcinoma includes changes
[Figure 1] in surface texture, loss of surface integrity, color,
size, contour deviations or mobility of intraoral or extra-oral
structures.[8] Various diagnostic tools are available for diagnosis
of oral cancer, but the gold standard remains tissue biopsy
with histopathologic assessment. It needs a trained healthcare

Journal of Advanced Clinical & Research Insights ● Vol. 1:4 ● Jan-Feb 2015 1
Early detection of oral cancer
Figure 1: Growth change in surface texture and color of mucosa
provider and is invasive, expensive, time taking. Other alternatives
are toluidine blue dye, chemiluminescence (ViziLiteR),
cytology (Brush biopsy), assessment devices (VELscopeR and
multispectral optical imaging system), and salivary diagnostics.
Except for incisional biopsy, none has shown the equivalency or
been confirmed to be superior to clinical examination.[9,10]
Performing duty the best way possible
The lack of prevention and early detection of oral cancer by
health care provider is a worldwide problem. Most dentists
claim to perform a thorough examination for oral cancer on
their patients, but several studies indicate that dentists lack
knowledge in relation to etiology and diagnosis.[7] The dentist
should perform an oral cancer screening examination on every
new patient at first visit and on every returning patient on an
annual basis unless specific risk factors are identified that require
more frequent screening. Smokers and alcohol users who are
considered high risk should be examined every year regardless
of their age.[11] If such measures are taken well within the time,
2 Journal of Advanced Clinical & Research Insights ● Vol. 1:4 ● Jan-Feb 2015
Tripathi and Pathak
probably, we can provide a better outcome of the treatment for
those suffering with this most feared disease.
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How to cite this article: Tripathi N, Pathak S. Early detection
of oral cancer: Duties of a dental surgeon. J Adv Clin Res Insights
2014;1:1-2.