How is screening for oral cancer done?

Watch as dentist and prosthodontist Dr. Jonathan Levine describes how various screening tests for oral cancer are performed.

Oral Cancer screening is taught at every dental school and is a recommended part of every new patient and periodic exams. The dentist usually will start by looking at the lips, outside and inside then looking at the inside of the cheeks, floor of the mouth, hard and soft palate, the tongue on top and under. They would look for anything out of the ordinary including white spots, red spots, open sores, lumps etc. Many dentists will also use some diagnostic aids, like the Velscope, ViziLite or Trimira to further evaluate areas of interest. A diagnosis for oral cancer can only be confirmed with a microscopic evaluation of a biopsied area.

When there is a suspect area, your dentist may do a brush biopsy (similar to Pap smear in gynecology) or may perform or an excisional (full removal) or incisional (part removal) biopsy. Should the lab result confirm a cancerous lesion, you would then be referred to an oncologist.

I consider an oral cancer screening the most important part of the dental exam. According to the American Cancer Society, in 2011, almost 40,000 Americans were diagnosed with oral cancer and sadly 7,900 died. However, the good news is with regular oral cancer screenings at your cleaning and checkup appointments, oral cancer can be caught early and treated in its most curable state. At my office, an oral cancer screening consists of a careful review of any risk factors (smoking and alcohol use), palpation of the cheek, tongue, lips and floor of the mouth, and an enhanced visual exam using blue light fluoroscopy called Sapphire Plus Lesion Detection system. If anything unusual is noted during the exam, a possible referral will be made to an oral surgeon for further evaluation and treatment.