Posts for: December, 2014
No one wants to hear the word “cancer.” But thanks to advances in detection and treatment, the disease increasingly can be stopped in its earliest stages when it's most treatable and outcomes are most favorable. Oral cancer accounts for a relatively small 3% of cancers in men and 2% in women, but early detection rates are lagging. Our office screens for oral cancer as part of your regular checkups. Knowing some of the signs and symptoms can help you monitor as well.
The main areas where oral carcinomas (cancers) occur are:
- the tongue (most common location, particularly the sides and on the floor of the mouth),
- the lip (especially the lower one),
- the oral cavity (the mouth), and
- the pharynx (back of mouth and throat).
Most oral cancers are preceded by surface changes (lesions) of the oral membranes. In the “precancerous” stage, white or red patches start forming and a non-healing ulcer may appear. The most common locations on the tongue for this to occur are on the sides and underneath on the floor of the mouth. Lip cancers typically develop on the lower lip, usually in people with a history of sun exposure. There has often been prior damage at the site such as scaling and crusting.
Be aware that oral cancers can be mistaken for cold and canker sores, ulcers, minor infections, and even irritations caused by biting or certain types of food. If lesions don't heal within two or three weeks, there's a higher likelihood that they are cancerous.
An in-office examination includes the following:
- visual inspection of face, lips, neck and mouth;
- inspection of sides and underneath of tongue and floor of mouth using gauze to gently manipulate the tongue;
- palpation of the floor of the mouth, sides of neck and glands to detect unusual lumps; and
- an “open wide and say ‘Aah’” examination of the back of your throat.
There are some risk factors for oral cancer that can't be controlled, such as a family history, age and race. But awareness, monitoring for potential signs and seeking prompt attention are always key ingredients in protecting your oral health!
If you would like more information about oral cancer detection, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Cancer.”
For years, even as tobacco use began to decline and disappear in most settings, professional baseball seemed one of the few exceptions. Now, the tide is finally turning. Recently, the legendary right-hand pitcher Curt Schilling revealed that he had been treated for oral cancer — and said that his chewing tobacco habit was to blame. “I’ll go to my grave believing that was why I got [cancer],” Schilling told the Boston Globe.
Schilling isn’t the only former player whose oral cancer is blamed on smokeless tobacco. Tony Gwynn, Hall of Famer and beloved coach, recently passed away from oral cancer at the age of 54. His death led to players pledging to give up the habit. But many still use “dip” or “snuff,” thinking perhaps it’s not so bad after all.
In fact, nothing could be further from the truth. With nicotine as its active ingredient, chewing tobacco can be just as addictive as cigarettes. Not only is nicotine addictive, it also increases heart rate and blood pressure, constricts the arteries, and affects the body in other ways. In addition to nicotine, chewing tobacco contains about 30 other chemicals known to cause cancer.
Tobacco use of any kind is a major risk factor for oral cancer. While it isn’t as well-known as some other types of cancer, oral cancer can be just as deadly. About 43,000 people in the U.S. are diagnosed with it each year — and the 5-year survival rate is just 57%. One reason for the relatively low survival rate is that oral cancer isn’t usually detected until it has reached a later stage, when it’s much harder to treat.
What can you do to reduce your risk for oral cancer? Clearly, you should stop using tobacco products of any kind. Moderating your intake of alcohol, and eating more plant foods and less red meat can also have an impact. And don’t forget to have regular dental checkups: cancer’s warning signs can often be recognized in an oral examination — and early detection can boost survival rates to 80-90 percent.
How does Schilling feel about chewing tobacco now? “I lost my sense of smell, my taste buds for the most part. I had gum issues, they bled, all this other stuff,” he told the Globe. “I wish I could go back and never have dipped. Not once.”
If you have questions about oral cancer or cancer prevention, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Chewing Tobacco” and “Diet and Prevention of Oral Cancer.”
Many people have questions about the proper use of antibiotics — especially today, as the overuse of these medications has become a concern. It isn’t necessary for most people to take antibiotics before having a dental procedure. But for a few — notably, those with particular heart conditions and, in some cases, joint replacements — pre-medication is advisable. The question may be even more confusing now, because the standard recommendations have recently changed — so let’s try and sort things out.
First, why would anyone need antibiotics before dental treatment? Essentially, it’s because of the chance that an open wound could allow bacteria from the mouth to enter the bloodstream. For people in good health, the body is capable of quickly containing and neutralizing the bacterial exposure. But people with some types of heart disease, heart transplants, and/or total joint replacements have a greater likelihood of developing a bacterial infection, which can be dangerous — or even life-threatening. The same may be true of people whose immune systems are compromised.
At one time, people with a broad range of heart problems and artificial joints were advised to pre-medicate; today, new research indicates that fewer people need to take this step. Antibiotics are currently recommended before dental procedures if you have:
- An artificial heart valve, or a heart valve repaired with artificial material
- A history of endocarditis
- A heart transplant with abnormal heart valve function
- Cyanotic congenital heart disease (a birth defect where blood oxygen levels are lower than normal) that hasn’t been fully repaired — including children with surgical shunts and conduits
- A congenital heart defect that has been completely repaired with artificial material or with a device — but only for the first six months after the repair procedure
- Repaired congenital heart disease with residual defects, such as leakage or abnormal flow
In addition, not everyone who has an artificial joint needs antibiotic premedication. Instead, your health care providers will rely on your individual medical history to determine whether this step is required in your situation. However, having a compromised immune system (due to diabetes, cancer, arthritis, chemotherapy and other factors) is still an indication that antibiotics may be needed.
The question of whether or not to pre-medicate is an important one — so it’s vital that you share all relevant medical information with your doctors and dentists, and make sure everyone is in the loop. That way, the best decisions can be made regarding your treatment.