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Family Health Magazine - DENTAL HEALTH

Screending for Oral Cancer
How to protect yourself

As with any cancer, oral cancer is easier to fight if it is found early. However, in the early stages these cancers of the mouth, tongue or throat are often painless. Many people are unaware of any change. Oral cancer can affect anyone, although people over the age of 45 are more likely to get it. Visiting your dentist and dental hygienists regularly and watching for signs can help find and treat it.

The numbers

  • Over the last decade, 17,383 cases of oral cancer were diagnosed in Canada.

  • The five year survival rate for oral cancer has increased to 63 per cent.

  • Smoking and drinking habits, location of the cancer and stage of disease all influence the chance of surviving it.

Oral cancer screening takes only a short time and can be done during a regular dental visit. Dentists and dental hygienists are trained to detect oral and other head and neck cancers such as thyroid, esophageal, nasopharyngeal and pharynx cancers.

If unusual changes in the head and neck area are found during your exam, the dental hygienist or dentist will immediately refer you to a dental specialist (pathologist) for diagnosis. If necessary, a piece of tissue can be removed and sent to a medical lab for analysis. If it is cancer, you will be referred to a cancer clinic for further diagnosis and treatment. Successfully treating oral cancer depends on the type and location of the cancer and how early it is found.

Many people, particularly those with full dentures, do not visit their dental office for routine preventive care. They are at risk of missing the early signs of cancer. Both professional and self-examinations are very important. Your dental hygienist can teach you how to look for the signs of oral cancer. Doing an oral cancer self-exam at least once a month is recommended, particularly if you smoke or drink alcohol daily.

If you find a lump or a change in the tissue of your mouth that does not go away within two weeks, visit your dental office for a professional screening. Most changes found in tissue are not cancerous. However, it is best to be safe and to put your mind at ease with a proper diagnosis.

Reducing your risk

  • Stop or limit use of tobacco products, including cigarettes, pipes, cigars, and chewing tobacco.
  • If you drink alcohol, do so in moderation.
  • Protect your lips from excessive exposure to sunlight by using a sunscreen with a sun protection factor of 15 (SPF 15) or higher.
  • Make sure your dentures fit properly and do not irritate the gums or cheeks.
  • Examine your mouth monthly for signs of cancer.
  • Visit your dental hygienist or dentist regularly. Ask that a complete cancer examination of your head and neck be done as part of the exam.

Early warning signs of oral cancer

  • Any lump or thickening in tissues of the face, neck or mouth that does not heal within two weeks – often these lesions are not painful.
  • Swellings, lumps or bumps on the lips, gums, or other areas inside the mouth.
  • White patches, red patches, red and white patches, or dark patches on the tissue of the cheeks, tongue, floor or roof of the mouth.
  • Repeated bleeding in the oral tissues.
  • Difficulty chewing, swallowing, or moving the jaw or tongue.
  • Soreness or a feeling that something is caught in the throat, ear pain.
  • Numbness, loss of feeling or pain in any area of the tongue, face, mouth or neck.

Report any of the following head and neck abnormalities that last longer than one month to your dentist, doctor or dental hygienist:

  • unusual colour changes (red and/or white patches)
  • tenderness in the mouth and/or throat
  • dentures that don’t fit and cause soreness
  • difficulty chewing or swallowing
  • hoarseness or slurring of words
  • pain in jaw, ear or face
  • spitting up blood or bloody discharge from ears, nose and or mouth
  • stuffy nose
  • reduced tongue movements
  • altered sensation or numbness in the face
  • double vision.

How to Do A Complete Head and Neck Self-Examination

Face symmetry
Look carefully at both side of your face in the mirror. Although normally both sides are not exactly the same, note any unusual bumps, lumps, swellings, moles, color changes or sores on the skin. If you find a lump or a lesion that does not go away in two weeks, see your dentist or doctor for proper diagnosis. Chances are that it is not cancer. However, it is better to have a proper diagnosis made early.

Masseter muscle
Using your fingertips, massage along the large cheek muscle on both sides of your face. This is called the masseter muscle and is mainly used for chewing. While applying a gentle pressure, clench your teeth together several times. You will feel the muscle contract. If you feel too much pain in this muscle, it is best to consult your dentist. This could be due to a habit such as clenching and grinding your teeth. Any unusual or prolonged pain should be properly diagnosed.

Temporomandibular joint
On both sides of your face locate the joint that connects the lower jaw (mandible) to the bone of your skull (temporal bone). This joint is called the temporomandibular joint. Place the fingertips of your index and middle fingers on the cartilage just in front of your ear opening. Apply gentle firm pressure, and open and close your mouth slowly. If you feel any pain or hear any popping, clicking or grinding, see your dentist. This may be a sign of a poor bite or an injury to the joint.

Pre-auricular Lymph nodes
The pre-auricular lymph nodes are located just in front of the cartilage part of the ear opening. Place your index and middle finger over this area and massage gently and firmly. If you feel any hard, round lumps in this area that do not go away within two weeks, get professional advice.

Post-auricular lymph nodes (behind your ear)
Place your fingertips directly behind your ear lobes. Using gentle pressure and a circular movement, feel for any lumps or bumps in the tissue. The lymph nodes located in this area are called the auricular lymph nodes because of their location next to the ear. Feeling nothing here is normal. If on the other hand, you feel a solid fixed lump or a tenderness that does not go away in two weeks, see your dentist or doctor.

Mandible (submental gland and submandibular gland)
Start by cupping the lower jaw (mandible) with your thumb and fingers beginning at your chin. Continue to press along the jaw line with your fingers, moving back toward the angle of the jaw just below the ear. Any unusual bumps and lumps should be noted and reported to your dental office.

Thyroid gland and larynx
Place your fingers on each side of the trachea (windpipe) in the middle of your neck just below your chin. The trachea is largely made up of cartilage tissue and is about 11 centimetres long. The front surface of this tube is covered by the thyroid gland. Gently push back and forth on this area to feel the thyroid gland. Then swallow, observing the up and down motion of the gland. If you experience any difficulty in swallowing or detect any lumps in this area seek proper diagnosis.

Cervical lymph nodes
The cervical lymph nodes run in a chain along both sides of your neck. By turning your head toward your shoulder and tipping your chin down, you will be able to feel the length of strong muscle that runs from behind your ear to your collarbone. Gently but firmly pushing down on the tissue running along this muscle, move from the upper to lower region of this muscle. Repeat this procedure on the opposite side of your neck. Report any unusual lumps or pain sensations to your doctor, dentist or dental hygienist within two weeks.

Occipital lymph nodes
The occipital lymph nodes are located on each side of your spine at the back of your head just below the skull. To locate the area tilt your head towards your chest and with the fingertips of both your hands, press and massage along the base of your skull. Then move down slightly to the soft tissue. Get professional assessment if you note any lumps, bumps or signs of tenderness.

Pull the lower lips down and out from the teeth. While looking in a mirror, look for any sores or obvious color changes to the tissue. White patches or velvety red patches should be reported to your dentist. Use your thumb and forefingers to feel for any lumps, bumps, or changes in texture. Repeat this procedure for the upper lip as well.

Maxillary palate (roof of the mouth)
Tilt your head back and open your mouth wide so that you can see the back of the roof of your mouth in the mirror. Look for color changes such as white patches, and red and white velvety areas. Also note any bright red areas. These areas can be very small and sometimes difficult to see. Report any unusual findings within two weeks to a doctor, dentist or dental hygienist.

Oropharynx (back of throat, tonsil area)
Look at the back of your throat by looking in a mirror in a well-lit room. Say “ah.” Note any color change that is different than normal. The back of your throat often appears a little red in color. However, if you see definite changes that are white, red and white, or obvious growths, report them immediately.

Buccal mucosa (inside of the cheeks)
Place one hand flat against the outside of your cheek. Open your mouth, and with one or two fingers of the opposite hand, gently but firmly press the tissue. If you feel any lumps or bumps, or observe any color changes, report to your dentist or dental hygienist for a further assessment.

Stick out your tongue and in a mirror inspect the top surface for color and texture. To get a good look, grasp the end of your tongue with a gauze pad between your index finger and thumb. Pull your tongue gently outward, to the left and to the right while looking for changes in color, texture and shape.

Floor of the mouth
Place the tip of your tongue to the roof of your mouth while staying relaxed. Inspect the floor of your mouth and the underside of your tongue in a mirror for any color and changes in shape. It is normal for the underside of your tongue to look as though veins are visible. With your finger, press along the underside of your tongue to detect any lumps or unusual swelling. If color changes are very obvious or you see a lump, talk to your dentist or dental hygienist about it.

FAMILY HEALTH is written with the assistance of:
College of Family Physicans of Canada
Alberta College of Family Physicians
FAMILY HEALTH is written with the assistance of:
College of Family Physicans of Canada
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2019, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1    [DH_FHd09]
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