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 Oral Mouth Cancer Screening Exam 
Charlotte Dentist NC North Carolina

 Dentist Charlotte NC North Carolina Holistic Biological Biocompatible 


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The oral cancer exam for my Charlotte NC area patients includes: 

- A History
- Exam
- Adjunctive Diagnostic Tools 
- Oral Brush Biopsy (OralCDx) 

The info below is from: 

Inside Dentistry
March 2010, Volume 6, Issue 3
Published by AEGIS Communications (http://www.dentalaegis.com/id/2010/03/oral-cancer-screening) 

Oral Cancer Screening 

Lynn W. Solomon, DDS, MS
Associate Professor
Department of Oral Pathology
Tufts University School of Dental Medicine
Boston, Massachusetts 

Charlotte dentist 

History:

History-taking is an important first step in every patient assessment, including oral cancer screening. Chronic exposure to tobacco, alcohol, and ultraviolet light are the major risk factors for oral SCC; however, about 25% of oral SCC cases arise in people who are considered “low-risk.”13 Oral SCC can, and does, occur in “low-risk” populations, such as children, adolescents, and young adults, presenting an extra challenge to the clinician.14,15 Demographics are relevant; male gender, African-American ethnicity, and increasing age are all factors that increase the risk of oral SCC. The mean age at diagnosis is 63 years and 96% of cases occur in people older than age 40.4 Other risk factors include: betel (areca nut) use, reduced host defenses, and nutritional and genetic factors.16 Certain oral clinical conditions are considered premalignant, eg, actinic cheilosis, smokeless tobacco keratosis, oral submucous fibrosis, proliferative verrucous leukoplakia, and oral erosive lichen planus, although it should be noted that the malignant transformation potential of oral erosive lichen planus is controversial.17 Patients with these conditions, immunosuppression, or a history of epithelial dysplasia or oral SCC should have more frequent screening examinations on a sliding scale of frequency depending on the progression, or lack thereof, of clinical lesions. Generally, it is prudent to examine most patients within 1 month of the initial evaluation, then at 3, 6, and 12 months for the first year after the initial evaluation. If the clinical and radiographic findings remain unchanged, then the period between recall appointments can be lengthened to 6 months, then 12 months.18 A history of previous oral SCC is significant because of evidence that carcinogenic substances affect all of the mucosal lining of the upper aerodigestive tract, not just the area that first became malignant, in a process known as “field cancerization.”19,20 Some evidence to support this theory is the fact that 35% of oral SCC survivors develop at least one second primary tumor during the 5-year follow-up after treatment.21 

Palpation and visual exam: 

submental nodes (L),submandibular nodes (center)preauricular nodes (R) 


post auriclular nodes(L), occipital nodes(center), right side anterior and posterior cervical nodes (along sternocleido-mastoid muscle)(R) 


left side anterior and posterior cervical nodes (along sternocleido-mastoid muscle) (L), supraclavicular nodes (center), thyroid gland (patient swallows) (L) 


Thyroid gland (L), parotid gland (patient clenches) (center), lips (R)


inside of lips (palpate) (L), inside of lip (visual) (center),

floor of mouth (R) 


Under upper lip (L), under lower lip (center), inside of right cheek (right) 


Inside of left cheek (L), top of tongue (center),
lateral border of tongue (R) 


bottom of tongue (L), floor of mouth (center), hard palate (R) 


soft palate and oropharynx