Health Sense : Teeth and oral cancer: How to detect and treat it?
While most people are familiar with high blood pressure and diabetes, not many have heard about oral cancer and its devastating effects.
About 640,000 cases are diagnosed every year worldwide and only about 50 percent of these patients will still be alive five years’ later. These grim statistics are testament to the fact that the disease is often discovered too late.
The five-year survival rate for early-stage oral cancer is more promising, however, at 80 to 90 percent. But, in the case of late-stage cancer, these rates go down to 20 to 30 percent. Unfortunately, most cases of oral cancer may start as a small red or white patch in the mouth, which patients do not notice. It can take only two or three months for early-stage oral cancer to progress to a late stage, when it invades the tissues and becomes an ulcer or swelling, sometimes spreading to the neck.
Heavy smoking and alcohol consumption are the main risk factors in the West, though in this part of the world, habits such as chewing betel nut, which contains nicotine, are also a major cause of the
There are many oral screening methods, one of which is the Velscope, which was used for a mouth-cancer awareness campaign in Singapore. Velscope uses a special filter to detect alterations in the fluorescence of oral mucosal tissues and has been reported to be a useful way to detect early carcinogenic changes.
This is principally due to ignorance, and a study in India has validated that early detection could reduce late-stage oral cancer and directly improve survival rates. With some modifications to the study, we devised a system of oral self-examination so that patients could examine their own mouths more adequately and on a regular basis, and then report to a doctor or dentist if there was a suspicion of something wrong. This method consists of ten quick steps that a patient can easily use on a daily basis to look carefully into the mouth to detect early oral cancer; it functions in the same way as women conducting self-examination of their breasts for the early detection of breast cancer.
Another condition, though not deadly, and one that is common among young people is the problem of wisdom teeth. These teeth typically appear in people aged between 18 to 21 years old and being the last to erupt, there is often a lack of space, which results in them growing abnormally.
The gums overlying these partially buried teeth can become infected, and cause a painful condition called pericoronitis. This is when most patients will present themselves to the clinic.
Most impacted wisdom teeth can be removed surgically in ten minutes by an experienced oral and maxillofacial surgeon.
For the fearful and anxious patient, the use of intravenous sedation can alleviate the problem. “Horror stories” of the dentist taking an hour or more to yank out a wisdom tooth are usually due to an incorrect assessment of the case by an inexperienced surgeon. Difficult cases are best managed under general anesthesia and at our clinic, where a cone-beam CT scan is used to aid the planning of the surgery, especially in those cases where the inferior dental nerve is near the apices of the wisdom teeth.
More serious complications, such as numbness of the lips and tongue, can occur if the surgeon is inexperienced and damages these nerves. Cone-beam CT scans constitute the latest technology, and are very useful for planning implant surgery as well as other surgical procedures, as it allows the surgeon to visualize the precise anatomy of the problem.
Dr. Victor Fan is a Senior Consultant Oral & Maxillofacial Surgeon at the Medical-Dental Oral and
Maxillofacial Surgery Gleneagles Medical Centre, Singapore
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