The Importance of Prevention
A preventive program is a cooperative effort by the patient, dentist, and dental staff to preserve the natural dentition and supporting structures by preventing the onset, progress, and recurrence of dental diseases and conditions.
Preventing dental disease starts at home with good oral hygiene and a balanced diet. It is continued in the dental office by the efforts of your dentist and dental hygienist to promote, restore, and maintain your oral health.
Prevention also includes regular dental exams, cleanings, and x-rays. Sealants and fluoride are also great preventive treatments that help protect the teeth.
Prevention helps avoid serious and costly dental problems and is the key to having a healthy, confident, beautiful smile.
Professional Dental Cleaning
Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:
- Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
- Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
- Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
During the course of a regular check up, a comprehensive dental exam will be performed by your dentist during your regular check-ups. These visits will include:
- Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
- Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
- Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
- Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
- Examination of existing restorations: Check current fillings, crowns, etc.
Oral Cancer Exams
According to research conducted by the American Cancer society, more than 30,000 cases of oral cancer are diagnosed each year. More than 7,000 of these cases result in the death of the patient. The good news is that oral cancer can easily be diagnosed with an annual oral cancer exam, and effectively treated when caught in its earliest stages.
Oral cancer is a pathologic process which begins with an asymptomatic stage during which the usual cancer signs may not be readily noticeable. This makes the oral cancer examinations performed by the dentist critically important. Oral cancers can be of varied histologic types such as teratoma, adenocarcinoma and melanoma. The most common type of oral cancer is the malignant squamous cell carcinoma. This oral cancer type usually originates in lip and mouth tissues.
There are many different places in the oral cavity and maxillofacial region in which oral cancers commonly occur, including:
- Salivary Glands
- Oropharyngeal Region (throat)
Reasons For Oral Cancer Examinations
It is important to note that around 75 percent of oral cancers are linked with modifiable behaviors such as smoking, tobacco use and excessive alcohol consumption. Your dentist can provide literature and education on making lifestyle changes and smoking cessation.
When oral cancer is diagnosed in its earliest stages, treatment is generally very effective. Any noticeable abnormalities in the tongue, gums, mouth or surrounding area should be evaluated by a health professional as quickly as possible. During the oral cancer exam, the dentist and dental hygienist will be scrutinizing the maxillofacial and oral regions carefully for signs of pathologic changes.
The following signs will be investigated during a routine oral cancer exam:
- Red patches and sores – Red patches on the floor of the mouth, the front and sides of the tongue, white or pink patches which fail to heal and slow healing sores that bleed easily can be indicative of pathologic (cancerous) changes.
- Leukoplakia – This is a hardened white or gray, slightly raised lesion that can appear anywhere inside the mouth. Leukoplakia can be cancerous, or may become cancerous if treatment is not sought.
- Lumps – Soreness, lumps or the general thickening of tissue anywhere in the throat or mouth can signal pathological problems.
Oral Cancer Exam, Diagnosis and Treatment
The oral cancer examination is a completely painless process. During the visual part of the examination, the dentist will look for abnormality and feel the face, glands and neck for unusual bumps. Lasers which can highlight pathologic changes are also a wonderful tool for oral cancer checks. The laser can “look” below the surface for abnormal signs and lesions which would be invisible to the naked eye.
If abnormalities, lesions, leukoplakia or lumps are apparent, the dentist will implement a diagnostic impression and treatment plan. In the event that the initial treatment plan is ineffective, a biopsy of the area will be performed. The biopsy includes a clinical evaluation which will identify the precise stage and grade of the oral lesion.
Oral cancer is deemed to be present when the basement membrane of the epithelium has been broken. Malignant types of cancer can readily spread to other places in the oral and maxillofacial regions, posing additional secondary threats. Treatment methods vary according to the precise diagnosis, but may include excision, radiation therapy and chemotherapy.
During bi-annual check-ups, the dentist and hygienist will thoroughly look for changes and lesions in the mouth, but a dedicated comprehensive oral cancer screening should be performed at least once each year.
If you have any questions or concerns about oral cancer, please ask your dentist or dental hygienist.
Comprehensive Oral Pathology Exams
The soft tissue of the mouth is normally lined with mucosa, which is special type of skin that should appear smooth in texture and pink in color. Any alteration of the color or texture of the mucosa may signal the beginning of a pathologic process. These changes may occur on the face, neck, and areas of the mouth (e.g., gums, tongue, lips, etc.). The most serious of these pathologic changes (which may or may not be painful) is oral cancer, but there are also many other common pathologic problems, including:
- Geographic Tongue – Also known as Benign Migratory Glossitis or Erythema Migrans, is a condition where the tongue is missing papillae (small bumps) in different areas, and a map-like appearance can develop. This condition is usually seen as red well defined areas on or around the sides of the tongue. The red patches (which can look like an unsightly rash) may come and go from hours to months at a time and cause increased sensitivity to certain substances.
- Median Palatal Cyst – This cyst is of developmental origin and is essentially a fluid filled skin sac. It usually appears in the middle of the palate and may cause substantial discomfort.
- Hairy Tongue – An overgrowth of bacteria or a yeast infection in the mouth which can cause the tongue to appear hairy and black. This condition is usually a result of poor oral hygiene, chronic or extensive use of antibiotics, or radiation treatments to the head or neck. It is often also seen in HIV positive patients and those who are intravenous drug users. Hairy Tongue may or may not require treatment.
Treatment of Pathological Diseases
In the majority of cases, the pathological changes experienced in the oral region are uncomfortable and disfiguring, but not life threatening. However, oral cancer is on the rise (especially among men) and the chances of survival are around 80% if an immediate diagnosis is made.
Oral cancer is a general term used when referring to any type of cancer affecting the tongue, jaw, and lower cheek area. Since it is impossible for the dentist to decisively diagnose a pathological disease without taking a biopsy sample of the affected area, seeking immediate treatment when changes are first noticed might be a life and death decision. For less serious problems, there are several options available, such as:
- Antibiotics – In the case of a bacterial infection or persistent soreness, the dentist may prescribe a dose of antibiotics to return the mucosa to its natural state. This will alleviate soreness and discomfort.
- Diluted Hydrogen Peroxide – When poor oral hygiene is causing changes to the soft tissue, the dentist may prescribe a diluted hydrogen peroxide mouthwash. This will kill more bacteria than regular mouthwash and improve halitosis (bad breath).
- Oral Surgery – If the patient has cysts or abnormal non-cancerous growths, the dentist may decide to completely remove them. This can improve comfort levels, alleviate breathing problems, and make speech substantially easier depending on the location of the cyst.