At the forefront of campaigning to help raise awareness of the risks and symptoms of mouth cancer, The British Dental Health Foundation estimates that over the next decade around 60,000 people in the UK will be diagnosed with the disease. Without early detection, an estimated 30,000 people will die. Worldwide, over 460,000 are expected to die from mouth cancer each year by 2030. It is one of the few flourishing cancer variations in the UK, with cases increasing by almost 50% in the last decade and claiming more lives than cervical and testicular cancer combined. Anyone can be affected by mouth cancer, whether they have their own teeth or not. Although more common in people over 40, particularly men, research shows that mouth cancer is becoming more common in younger patients and in women. The survival rate for people with mouth cancer is lower than those who have cervical cancer or melanoma skin cancer. [1]
Mouth cancer (or oral cancer) occurs where an abnormal group of cells develops anywhere in the mouth, on the surface of the tongue, lips or gingiva. These are called squamous cell cancers. Less commonly it can occur in the salivary glands, tonsils or pharynx or can appear as melanoma, which starts in skin pigment cells around the mouth or lips.
Mouth cancer arises when something goes wrong with the normal cell lifecycle, causing them to grow and reproduce irrepressibly. The two most common symptoms of mouth cancer are an ulcer that does not heal and constant discomfort or pain in the mouth. Other symptoms can include red or white patches in the mouth, inexplicable loose teeth and a lump or thickening on the lip, tongue or neck. Similarly bad breath, unexplained bleeding or numbness in the mouth and difficulty or pain with chewing, swallowing or speaking can indicate the presence of mouth cancer. All of these symptoms can be due to other conditions, so tests are needed to confirm the diagnosis. Mouth cancer can of course be treated more successfully when it is diagnosed early and it is thus important for dentists to emphasise the urgency of self-awareness to patients. The changes to the GDC’s recommended CPD topics highlight this, as professionals are urged to include five hours of study on the topic within their five-yearly CPD cycle.
Mouth cancer is not hereditary and most causes are linked to alcohol and tobacco. Chewing tobacco is particularly dangerous and the risk of mouth cancer is increased if tobacco and alcohol are consumed together. A diet containing large quantities of red meat and fried food can also be a contributory factor. As highlighted in media coverage of Michael Douglas and his 3-year battle with this disease, recent research has linked mouth cancer to the human papillomavirus (HPV).[2]
What can dental professionals do to help?
It is important for all members of the dental team to raise patient awareness of the simple lifestyle changes that can help prevent the development of mouth cancer (or prevent it reoccurring after successful treatment). These are not smoking, keeping to the recommended weekly limits for alcohol consumption (21 units for men and 14 units for women) and eating a healthy, balanced diet, low in fat and high in anti-oxidants, full of fresh vegetables, citrus fruits, olive oil and fish.[3] Reminding patients to wear sun block on their lips, staying out of the sun between 11am and 3 pm and wearing a wide-brimmed hat to protect their face will not only help prevent melanoma but also other types of skin cancer.
It is the dental professional’s responsibility to perform checks that include feeling the neck and face to check for swellings, as mouth cancer can often be discovered in its early stages. Regular dental appointments are thus imperative in the prevention and early detection of mouth cancer. Patients with particularly busy lives need simple and convenient methods for booking regular dental visits. As the dental industry heralds the power of the internet, it is becoming easier for patients to book their appointments online.
Working in collaboration with NHS Choices, Zesty is an online booking service, committed to providing quick and easy access to dental appointments. This is done by providing dental practices with a profile on the Zesty website, where any free appointments, including cancellations, can be advertised and filled as quickly as possible. A constant stream of patients is thus guaranteed, keeping the practice as busy as possible, and ensuring patients with any immediate concerns can book an appointment quickly.
A prime advantage of being able to book an appointment online is that the service is available both day and night. Rather than wait in physical or emotional discomfort until Monday morning, a patient in agony or concerned about mouth cancer at 3am can simply log on to their computer and instantly book an appointment. This ensures peace of mind and maybe a better night’s sleep, which in turn improves the quality of customer service.
Dental professionals need to continue raising the profile of mouth cancer, to assist in early diagnosis and help fight against the horrors of this potentially fatal disease.
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[1] All facts from Mouth Cancer Action Month 1-30 November 2013, British Dental Health Foundation Online
<http://www.mouthcancer.org/> [accessed 25th October 2013]
[2] Catherine Shoard, ‘Michael Douglas: oral sex caused my cancer’, The Guardian Online
http://www.theguardian.com/film/2013/jun/02 [accessed 25th October 2013]
[3] Mouth Cancer Foundation Online
<http://www.mouthcancerfoundation.org/home/get info/learn about > [Accessed 28th October 2013]