Core Concepts in Oral Cancer Education:
What Every Oral Health Professional Should Know
Compiled by Hillel Ephros, DMD, MD
Diplomate, American Board of Oral and Maxillofacial Surgery
Academic Fellow, American Academy of Oral Medicine
Objectives
Dentists should be able to:
- perform a competent oral cancer examination;
- describe oral lesions of local and systemic etiology;
- identify oral lesions that should raise the suspicion of malignancy;
- appropriately select and consider using diagnostic adjuncts to assist in oral cancer early detection;
- describe an approach to managing questionable and suspicious oral lesions;
- develop and implement an office protocol for oral cancer screening;
- discuss the role of the dentist in the comprehensive management of oral/head & neck cancer patients;
- articulate the ethical and medical/legal responsibility of dentists to screen for oral cancer, especially in high risk populations.
1. The stakes: dentists should be able to articulate the differences between the survival and quality of life for the typical stage III or IV patient and for an individual whose oral cancer is detected in its earliest stages. 2. The risk factors: dentists should be able to list the major risk factors for oral squamous cell carcinoma (SCCA). 3. The high risk sites: dentists should be able to describe the high risk sites for oral SCCA in the USA. 4. The earliest appearance: dentists should be able to identify suspicious lesions. 5. Diagnosis: dentists should be able to discuss diagnostic techniques. 6. Responsibility: dentists should be able to identify who is responsible for diagnosing early squamous cell carcinoma (SCCA) 7. Treatment: dentists should be able to describe how oral cancer patients are treated 8. Complications: dentists should be able to discuss complications of the disease and its treatment 9. Behavior: dentists should be able to discuss methods for influencing the behavior of their patients 10. Demographics and racial disparities: dentists should be able to describe the subpopulations at elevated risk and the huge disparities between the races regarding oral cancer
Articles
Importance of Radiation Oncologist Experience Among Patients With Head-and-Neck Cancer Treated With Intensity-Modulated Radiation Therapy (IMRT)
American Society of Clinical Oncology, 2016
Epidemiology of Human Papillomavirus–Positive Head and Neck Squamous Cell Carcinoma
Journal of Clinical Oncology, September 8, 2015
Rising Population of Survivors of Oral Squamous Cell Cancer in the United States
Cancer, May 1, 2016
HPV Infection in the Head and Neck Region and Its Stem Cells
Journal of Dental Research, 2015
Oral Cancer Care Struggles with Three Misconceptions
by Jo-Anne Jones, RDH, MS
Dentistry Today, April 2016
Cancer Prevention and Treatment: The Dental Hygienists Role
by Cathy Draper, RDH, MS
Access Magazine, Nov 2010
HPV Vaccine Provides Protection at Multiple Sites, Even Among Some Previously Exposed
American Association for Cancer Research, April 2015
My Journey with Cancer: A Dental Hygienist’s Perspective
by Jennifer Cicci, RDH
CDHA Oral Health Canada Magazine, Spring 2015
Researchers Discover Genetic Fingerprint of HPV Virus in some Head and Neck Cancers
Oral Cancer Foundation, January 2015
Failure to Diagnose and Delayed Diagnosis of Cancer: Medicolegal Issues, The Journal of the American Dental Association, December 2009
Oropharyngeal Cancer Epidemic and Human Papillomavirus, Emerging Infectious Diseases
Centers for Disease Control and Prevention, November 2010
Can Saliva-Based HPV Tests Establish Cancer Risk and Guide Patient Management? Mark W. Lingen, DDS, PhD Section Editor, Oral and Maxillofacial Pathology, September 2010
Human Papillomavirus and Survival of Patients with Oropharyngeal Cancer The New England Journal of Medicine, July 2010
Oral Cancer Screenings A Must, Say Malpractice Attorneys
Oral Cancer Foundation, March 2011
Other Resources
AAOM Clinician’s Guide by A. Ross Kerr, David Lederman, Hillel Ephros. A concise education on early detection of oral cancer. Includes detailed photographs. Downloadable version of the AAOM Clinician’s Guide.
Issue of the OMS Clinics of North America, guest edited by Hillel Ephros, DMD, MD. Contributions from a wide variety of clinicians on psychological issues in dentistry and oral and maxillofacial surgery. Includes a chapter by Albert Wu and his Johns Hopkins’ associates about how to talk with patients and families when adverse outcomes occur. Another chapter deals with end of life issues and focuses on ethical questions related to advanced oral cancer.
For more information visit the Oral Cancer Foundation.