Malignant tumours in the oral cavity. If undetected and untreated, they can invade and destroy nearby lymph nodes and adjacent structures. They can form secondary tumours by metastasis. Almost all mouth cancers are squamous cell carcinomas.

In the UK there are nearly 3800 new mouth cancer cases and over 1700 deaths reported yearly. This includes 217 deaths in Scotland and 51 in N> Ireland. Experts say these figures grossly underestimate the true incidence and mortality.

On average, the 5 year survival rate for persons with mouth cancer in England and Wales is only approximately 50%. Mouth cancers are often only being detected during the later symptomatic stages of the disease, when successful treatment is far less likely.

The incidence of mouth cancer is about twice as high in men as in women, and is most frequent in those over 40. At high risk are smokers and other tobacco users, heavy consumers of alcohol, those who have had mouth, lung or throat cancer before and those who are immuno-compromised.

It is dentists’ or doctors’ responsibility to detect suspicious lesions which may be early signs of the disease. Patients with such lesions must be referred to hospital specialists for diagnosis. Doctors and dentists are NOT responsible for diagnosis.

While dentists are trained to thoroughly examine the oral cavity for signs of suspicious lesions, few patients report having had a mouth cancer examination. Most cases are diagnosed only after the appearance of symptomatic growths, discolouration, pain or numbness – all indicators of later-stage cancer. In its very early stages, mouth cancer can be almost invisible or it can appear to be an innocuous mouth ulcer, often painless, making it extremely difficult to detect.

Late detection results in death or significant deterioration of patient quality of life. A positive biopsy is often followed by large surgical resections, radiation and chemotherapy, with accompanying loss or diminution of speech, chewing, swallowing and breathing. Disfigurement of the face, head and neck is not uncommon.

When mouth cancer is detected early, while still localised, the five-year survival rate is anticipated to be 90%. There is clear evidence from a large collaborative European study that maximum survival benefit is obtained by treating small, early lesions.

Thorough extra and intraoral visual examination should be supplemented by palpation of any suspicious area and the submandibular and cervical lymph nodes.

Tolonium Chloride ( Ora Test ) is designed for use after a full head, neck and soft tissue examination. It stains early asymptomatic and invisible lesions a distinct dark blue, highlighting the smallest potential malignancy and alerting the dentist to the need for further examination, although to-date we have found that the statistical evidence for its reliability non too encouraging, A simple biopsy examined under a microscope remains the only guaranteed way of determining diagnosis.

Routine examination of at-risk patients for early detection of suspicious lesions. Screening is not diagnostic. If an abnormality is detected, referral for definitive diagnosis and necessary treatment is essential.

Many dental authorities including the British and American Dental Associations recommend yearly screening or at the start of a new course of treatment.

Mouth cancer affects nearly 3,800 people in the UK per year, with 1,700 per year dying from the disease. The quality of life of the survivors is severely compromised. Smokers and drinkers over the age of 40 and ethnic groups who use chewing tobacco and betel nut are particularly at risk. The disease is also increasing among younger people, yet there is no routine screening programme.

Patients with white patches, persistent ulcers or soreness of the mouth should visit a dentist.

There is a higher proportion of deaths per number of cases from mouth cancer than either breast cancer, cervical cancer or skin melanoma, although the public are more aware of the risks from these three diseases.

The Denplan Excel Accreditation programme is presently the ONLY dental care scheme where mouth cancer screening is an essential part of the consultation. It is a requirement in the contract between the dentist and Denplan that this screening is carried out if the dentist is to remain Denplan Excel Accredited. At this practice, the ONLY Denplan Excel Accredited dental practice in Chorley, we have been routinely screening for mouth cancer for several years. As our Denplan Excel patients will be aware, we routinely discuss the results of their thorough consultation following the determination of their Oral Health Score.

Further information at    http://www.rdoc.org.uk