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A dentist’s role in oral cancer treatment

Photo: US Army Africa, CC, https://flic.kr/p/9Ghxuk

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Each trip to the dentist helps spot and treat cavities, clean teeth, provide preventative treatments like sealants, and seek out signs of gum disease. But many don’t realize it is a cancer screening, too.

“A routine dental exam is vital for maintaining good oral health, and it’s also the best method for detecting oral cancer in its early stages,” says Mark Roettger, D.D.S., Clinic Director of the University of Minnesota Dental Clinic. “Dentists have the primary role in oral cancer detection because we work most closely with the mouth, and inspect it most thoroughly.”

Oral cancer affects more than 30,000 people each year, and like most cancers, can be difficult to treat once it has advanced. The five-year survival rate is just 50 percent.

Treatment may result in permanent damage to the mouth and oral functions. Patients may need an oxygen tank after treatment or lose the ability to speak. Some lose parts of the tongue or jawbone. It can be particularly disfiguring.

Dentists provide support to reduce those complications. Early detection through oral cancer screenings significantly reduces the breadth of treatment needed, and can salvage many, if not all, of the mouth functions. But chemotherapy and radiation treatment can also cause many oral complications. Dentists help manage those complications.

“We help patients maintain their quality of life,” Roettger said. “Sometimes, radiation will cause debilitating mouth sores forcing patients to use feeding tubes. Others might experience dry mouth and lose salivary function. We help prepare for this and cope with these situations when they occur.”

It’s important to visit the dentist before oral cancer treatment. Many patients will experience a reduction in blood vessels or blood supply to the bones of the mouth. The diminished blood flow prevents any pre-existing tooth damage from healing, which provides an entry portal for infection. If those infections enter the bloodstream, they can be fatal, especially with an immune system weakened from chemotherapy. Dentists repair or extract teeth before treatment to reduce that infection risk and reduce the complication of osteoradionecrosis, a fancy term for destruction of local bone after a tooth extraction.

“As dentists, we have the opportunity and the obligation to do as much as we can to help people with oral, head and neck cancers live a comfortable life during and after treatment,” Roettger said.

Roettger said it’s also critical to educate patients about risk factors like tobacco use, alcohol consumption and HPV infection. Eliminating or reducing those risk factors can help prevent oral cancer, and routine dental exams will help dentists identify oral cancer in the earliest stages for the best treatment outcomes.

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