A New Screening Tool for Oral Cancer

Oral cancer will strike an estimated 30,000 people this year in this country. Dr. Emily Senay offers some advice about a new screening test that could save lives.

Oral cancer is cancer of the lining of the mouth, the tongue, or other structures around the mouth. It kills more people than either cervical cancer or melanoma--skin cancer. Like many cancers, if you catch it early, there is great success in getting rid of it. But if you don't get it early, it can be deadly. The first line of defense against this kind of cancer is your dentist, who is trained to look for and recognize early signs of oral cancer.

If your dentist does find something suspicious, now there is a new test that uses a brush to take a cell sample from the questionable area. The brush is able to scrape down beneath a few cell layers to get a good sample. It's then sent to the lab for testing, and takes about 48 hours to get the results.

Nine times out of ten the result is benign, but the new test replaces the need for a biopsy using a scalpel if the test comes out negative. If the results are not normal, another biopsy is done and the dentist would then refer you to a cancer doctor.

Why does a dentist screen you for oral cancer rather than a cancer doctor?

Many oral cancers are discovered in the dentist's office during routine exams. Dentists are trained to do a visual inspection of your mouth for signs of cancer as part of your check-up because your dentist is usually the physician most familiar with your mouth and any changes that happen with sores or suspicious bumps. Dentists are trained in medical school to recognize the signs of cancer.

What kinds of suspicious signs would the dentist be looking for?

In general, they would be looking for a sore or an ulcer that doesn't go away after about a week. Or small white bumps in the mouth that can be an indication of precancerous cells. The reason a test like this is so useful is that many of these warning signs are actually benign, but you can't tell until you do the test. An oral cancer can look like a cheek bite or another noncancerous wound or sore in its early stages.

What causes oral cancer?

The biggest risk factors for oral cancer are smoking or chewing tobacco and alcohol use as well as any constant irritation to the mouth from dental implants, dentures, or chipped teeth. But it's important to note that at least a quarter of all cases are in people who have no known risk factors.

How often should you get screened for oral cancer?

If you visit your dentist's office regularly, you're probably getting enough attention, but you should always be on the lookout for sores or problems that don't go away after a few days. You can talk to your doctor or dentist about whether your particular situation requires more frequent screening.

Is the test covered by insurance?

Yes, by private insurancand Medicaid.

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