Oral cancer affects thousands of Americans every year. As many as 10.5 adults per 100,000 develop oral cancer, according to data from the National Institute of Dental and Craniofacial Research. The average age of diagnosis is 62, but oral cancer can happen to anyone, at anytime. This article discusses oral cancer treatment from the perspective of dentistry, focusing on the ways in which oral medicine can support quality of life in patients.
Understanding Oral Cancer
There are two major types of oral cancer: those occurring in the oral cavity and those in the oropharynx. The oral cavity cancers include the lips, roof and floor of the mouth, gums, and most of the visible tongue. The oropharynx refers to the middle of the throat, where the tonsils and base of the tongue are located. More than 90% of head and neck cancers arise from squamous cells in the tissues that line the structures of these anatomical areas.
Men are twice as likely as women to develop oral cancer. The primary risk factors for oral cavity and oropharyngeal cancer include tobacco use, alcohol use, human papillomavirus infection, sun exposure, and a weakened immune system. Precancerous conditions of the mouth can become oral cancers and therefore need to be monitored.
What Are the Symptoms of Oral Cancer?
Early signs of oral cancer may go unnoticed or may be difficult to detect on examination. However, if symptoms persist, it is important to see a doctor as soon as possible. The most common signs and symptoms of oral cancer include:
- Lump or thickening in the cheek
- White or red patch on the gums, tonsils, or mouth lining
- Persistent mouth pain
- Difficulty chewing and swallowing
- Numbness of the tongue
- Jaw swelling
- Loosening of the teeth
- Pain in the teeth or jaw
- Voice changes
- Persistent bad breath
- A lump in the neck
- Unexplained weight loss
As with any kind of cancer, it is crucial to detect oral cancer early on when more treatment options are available. At Penn Dental Family Practice, we recommend that all patients over 60 come in for a checkup every 6 months. Each visit includes a professional dental cleaning and cancer screening. These visits are important not only in promoting strong oral health, but also in ensuring that we can address incipient cancers while they’re most treatable.
Treatment is most successful when started as soon as possible, however, data shows that patients who begin treatment when the cancer has progressed to moderate and advanced stages have a survival rate of less than 60%. That’s why we remind patients that getting regular cancer screenings may be the single most important strategy to protect your oral health.
The Role of Oral Medicine During Cancer Treatment
Oral medicine plays a crucial role in the continuing care of cancer patients. This specialty combines the fields of medicine and dentistry to treat conditions of the oral cavity. An oral medicine specialist provides non-surgical management of these conditions, including many that occur as a result of cancer.
Since most cancer treatments cause side effects in the mouth, teeth, and salivary glands, patients often need additional targeted oral care. Your oral medicine specialist will be an important resource and support throughout the therapeutic process.
Dry Mouth
It is not uncommon for the salivary glands to be affected by cancer or its treatment. In some cases, a customized oral hygiene regimen may be sufficient in addressing dry mouth. In others, your oral medicine doctor may prescribe a medication to stimulate the salivary glands. Depending on the severity of the dry mouth, other treatments may also be recommended to prevent cavities from developing during this period of limited salivary flow.
Mouth Sores
Cancer can cause mouth sores to form on the inside of the mouth or on the lips. These sores, also known as oral mucositis, may be accompanied by a painful burning sensation, which can range in intensity from a mere inconvenience to a severe complication.
Patients who receive radiotherapy alone or with chemoradiation are at risk for developing mouth sores and ulcers. When the mouth membranes become inflamed, patients may experience considerable pain while eating and drinking.
Unfortunately, there is no widely accepted treatment for this side effect of cancer treatment, but topical numbing agents (e.g. mouthrinses) may help relieve symptoms. Penn is currently conducting a study to test whether regular oral cleanings by dental providers can help. The ARMOR Trial will examine whether this dental protocol can delay the onset and reduce the severity of mouth sores and prevent infections during cancer treatment. If you are interested in learning more about the study and whether you may be eligible to participate, please call 917-586-9089 or email PDM-ARMORTrial@dental.upenn.edu.
Infection
Poor oral health prior to cancer treatment can increase the risk for infection and other problems. Bacteria and fungi can live in the mouth and develop into an infection while the immune system is weakened from radiation or chemotherapy. Other factors that contribute to greater susceptibility include the cancer type, the amount of radiation used, and stability of blood cell counts.
Before undergoing cancer treatment, we recommend addressing any underlying or long-term dental issues with an appropriate specialist. At Penn Dental Family Practice, we offer a wide array of dental specialties under the same roof, such as periodontics, prosthodontics, endodontics, and oral surgery. If an infection does occur during the course of cancer treatment, your oral medicine doctor will work with you to prescribe the right medication.
According to the American Academy of Oral Medicine (AAOM), patients visit an average of 2.2 doctors in a 17-month period prior to seeking support from an oral medicine specialist. For patients who have been diagnosed with oral cancer, it is even more important to expedite this process. An oral medicine doctor is uniquely equipped to diagnose and treat the causes of oral pain when complex conditions such as cancer are involved.
Oral Medicine at Penn Dental Family Practice
If you or a loved one has been recently diagnosed with oral cancer, there are many things to consider as you prepare for treatment. Including an oral medicine doctor on your health care team from the outset will provide pain relief and peace of mind as you go through oral cancer treatment. With the support of an oral medicine specialist, you can address oral complications quickly and minimize the discomfort of common side effects.
At Penn Dental Family Practice, we will work with you to find affordable solutions to your oral conditions, so that you can receive the care you need in a timely manner. You can schedule an appointment with one of our oral medicine specialists using this form or by calling 215-898-7337.
