ORAL CANCER

The oral cavity includes your lips, cheek lining, gums, front part of your tongue, floor of the mouth beneath the tongue and the hard palate that makes up the roof of your mouth. The throat (pharynx) starts at the soft part of the roof of your mouth and continues back into your throat. It includes the back section of your tongue as well as the base where the tongue attaches to the floor of your mouth.

During your visit ,we can talk to you about your health history and examine these areas for signs of mouth and/or throat cancer. The screening will consist of a visual inspection of the mouth and palpation of the jaw and neck. Regular visits to your dentist can improve the chances that any suspicious changes in your oral health will be caught early, at a time when cancer can be treated more easily. In between visits, it's important to be aware of the following signs and symptoms and to see your dentist if they do not disappear after two weeks.

Frequent Signs and Symptoms of Oral Cancer

Early

Persistent red and/or white patch Non-healing ulcer
Progressive swelling or enlargement Unusual surface changes
Sudden tooth mobility without apparent cause
Unusual oral bleeding or epistaxis Prolongedhoarseness

Late

Indurated area
Paresthesia(numbness), dysesthesia (abnormal sensation) of the tongueor lips
Airway obstruction
Trismus Dysphagia
Cervical lymphadenopathy Persistent pain or referred pain Altered vision

DIAGNOSIS OF ORAL CANCERS AND PRE CANCEROUS LESIONS

Currently, the most effective way to control oral cancer is to combine early diagnosis and timely and appropriate treatment. Because more than 90% of all oral cancers are squamous cell carcinomas, the vast majority of oral cancers will be diagnosed from lesions on the mucosal surfaces.

The challenge is to differentiate cancerous lesions from a multitude of other red, white, or ulcerated lesions that also occur in the oral cavity. Most oral lesions are benign, but many have an appearance that may be confused with a malignant lesion, and some previously considered benign are now classified premalignant because they have been statistically correlated with subsequent cancerous changes. Conversely, some malignant lesions seen in an early stage may be mistaken for a benign change.

Any oral lesion that does not regress spontaneously or respond to the usual therapeutic measures should be considered potentially malignant until histologically shown to be benign. A period of 2-3 weeks is considered an appropriate period of time to evaluate the response of a lesion to therapy before obtaining a definitive diagnosis.

A definitive diagnosis requires a biopsy of the tissue. Biopsies may be obtained using surgical scalpels or biopsy punches and typically can be performed under local anesthesia. Useful adjuncts include vital staining, exfoliative cytology, fine needle aspiration biopsy, routine dental radiographs and other plain films, and imaging with magnetic resonance imaging (MRI) or computed tomography (CT) and also latest advances like Cone Beam Computed Tomography (CBCT), PET scan etc.

Imaging the Oral Cavity and Associated structures

A diagnostic imaging evaluation consisting of either Intra Oral Periapical radiograph (IOPA), panoramic radiographs (OPG), Cone Beam Computed tomography (CBCT),computer tomography (CT) scanning or magnetic resonance imaging (MRI) is also used to assess the extent of local and regional tumor spread, the depth of invasion, and the extent of lymphadenopathy. CT is superior in detecting early bone invasion and lymph node metastasis, but MRI is preferred for assessing the extent of soft tissue involvement and for providing a three-dimensional display of the tumor. MRI is also the preferred technique for imaging carcinoma of the nasopharynx or lesions involving paranasal sinuses or the skull base.