One of the most important evaluations a dentist can perform is the oral cancer screening. When performing this check, “most patients are unaware of what is being done,” says dentist, Scott D. Benjamin. The key is
communication!
When this exam is being performed, most patients believe that a check for decay and cavities is the only thing being looked at. For others, if they hear oral cancer screening, they become nervous and worry that there is a problem. Dr. Benjamin’s suggestion, change the name; instead of “oral cancer exam,” try “enhanced oral exam.”
With today’s technology there are many options of how to perform an oral cancer exam. There are several salivary diagnostic tests. The most basic test is having patients rinse with a special solution and expectorating in to a tube that is
analyzed by a lab. OralDNA Labs has helped in the development in many tests to predict risk of diseases in the future. MyPerioID PST is a test to see if a patient is susceptible to periodontal disease by genetics. MyPerioPath is also
used. This test concentrates on the 13 pathogenic bacteria that are known to cause periodontal disease. OraRisk HPV is another test created by the lab to predict if a patient could develop HPV.
There are also various visual enhancements with different lightings and cameras to help see a concerned area more clearly. For example, fluorescence technology can help in seeing directly by the eye or indirectly by a monitor and can assist in evaluating hard and soft- tissue structures. A VELscope Vx can then be used to take pictures of these areas detected. In addition, DentLight TM Oral Exam Kit is used as a light source to stimulate a fluorescent response projected
from the tissue. The areas of concern can be seen with the light through different filters that are attached to loupes. This area can then be photographed with a camera with the supplied filter. Identafi TM uses a multi-spectral fluorescent and reflectance to enhance mucosal abnormalities. This device uses a three- wave length optical illumination and visualization system and in addition includes a disposable mirror. ViziLite Plus with TBlue is a disposable tool that gives a diffused light. The patient rinses with an acetic acid solution, the tissue is dried and re-examined with a chemiluminescent light. If an area of concern is seen, the TBlue swab is used to visualize the area in depth.
Microscopic evaluations and Cytology (or surgical biopsies) are the most popular options for examining oral cancer. A Brush Cytology is the gathering of disaggregated epithelial cells by strongly brushing with a sterile nylon bristle brush. This
cytology is commonly used to check for leukoplakia or erythroplakia of the mouth. OralCDx Brush test is the most effective test to rule out the presence of abnormal cells. This test uses the brush to wipe the cells to placing them on a glass slide. The newest technology is the liquid-bases cytology of the oral cavity. The exam includes the brushing of the tissue where the cells are transported from the brush to a liquid preserve bottled solution by spinning the brush in the solution to remove the gathered epithelial cells from the brush.
There are many tests to indicate whether your patient has or is susceptible to getting periodontal disease or a type of oral cancer. With a new phrase and new technology, there are many ways of preventing and treating these infections,
while keeping your patient comfortable.
Dr. Farber, his associates and team at the Farber Center have advanced training in diagnosing oral pathology. Many biopsy procedures are performed at their offices. Please feel free to consult with us on any of your oral cancer concerns.
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