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  • Sticking Your Tongue Out at Oral Cancer

    "Open please, and stick your out your tongue," the dentist says, peering intently into your mouth. One gloved hand wraps gauze around your tongue, grabs hold and pulls, lifts and wags it from side to side. Fingers run along your gums, checking the top and
  • The first time it happens as part of your dental checkup, you might be caught unaware because it definitely feels odd to have somebody tugging on your tongue. It's part of a routine screening for early detection of oral cancer that should be happening every time you visit the dentist. As for many cancers, early detection is key to survival.
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    • A new tool to help
      Researchers at the University of British Columbia discussed the use of fluorescent visualization to detect precancerous tissue in the November 15, 2006 issue of Clinical Cancer Research.

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      A new tool to help
      Researchers at the University of British Columbia discussed the use of fluorescent visualization to detect precancerous tissue in the November 15, 2006 issue of Clinical Cancer Research.

      Here in the valley, Dr. Keith Ogawa with Eagle Point Dental is using a similar approach to diagnose early signs of cancer—the Velascope. The Velascope has an intense light that shows the natural fluorescence of normal tissues and the absence of fluorescence in abnormal cells. "It is a way of finding things before any signs are visible to the naked eye," explains Dr. Ogawa.

      Dr. Ogawa always performs a brush biopsy if the Velascope reveals suspicious cells. "One thing that's nice is that even if it's not, cancer and it is pre-malignant, or even just abnormal, we know cellular change is going on," he says. That means that you and your dentist will be extra vigilant to watch for cancer at its earliest stage. You'll have an even better reason to avoid tobacco and have routine dental examinations.

      According to Dr. Ogawa, a Velascope exam to detect precancerous cells costs $30 and is not covered by some insurance companies.
  • The first time it happens as part of your dental checkup, you might be caught unaware because it definitely feels odd to have somebody tugging on your tongue. It's part of a routine screening for early detection of oral cancer that should be happening every time you visit the dentist. As for many cancers, early detection is key to survival.
    Medford dentist Dr. Brandon White describes the 90-second physical exam he performs on patients, looking for a lingering sore or a lump that might signal cancer. "There's basically six areas: we check the neck, the floor of the mouth, the lips and the cheeks, the tongue, the roof of the mouth, the back of the mouth, throat and tonsils."
    Anyone can get mouth cancer. Risk factors do include family history. Tobacco use in all forms (cigarettes, pipes, chewing tobacco and snuff) is a major cause. "Eighty percent of the people who get oral cancer are tobacco users and people who use both alcohol and tobacco are at highest risk," warns Dr. Keith Ogawa of Eagle Point. "The scary thing is that 20 percent [of those who develop oral cancers] have done neither of those things." And more people under the age of 40 are showing signs of oral cancer.
    "Increasingly, oral cancer is becoming more prevalent in younger adults because the human papilloma virus (HPV) is a risk factor," notes Dr. Ogawa. He adds that "oral cancer kills one person every hour in the United States, almost 29,000 people every year."
    There are early warning signs of oral cancer. Dr. White ticks them off on his fingers: "A sore in your mouth that won't heal, bleeding in your mouth, loose teeth, difficulty or pain when swallowing, dentures that won't sit down where they belong, a lump in your neck or an earache."
    "A fever blister on your lip, or if you bite your tongue, or cut your cheek on a chip — [all of these] will generally heal up within a few weeks," says Dr. White. But if the sore lasts more than a few weeks, you should be concerned that something's going on and get your dentist to check it out.
    If your dentist finds something suspicious, you'll need to rule out cancer. The first step would be a brush biopsy to collect surface cells that are examined by a pathologist. "If the cells on the brush are malformed, or cancerous or precancerous, we'll do a formal biopsy on the tissue," explains Dr. White. A surgical biopsy involves snipping out all or part of the lesion for a fuller examination. Treatment may include surgery, radiation therapy or chemotherapy.
    Dr. Ogawa stresses that with early detection and treatment, about 80 percent of those who are diagnosed with oral cancer will survive, but only 30 percent of oral cancers are diagnosed in the early stages.
    Reduce your risk of oral cancer by avoiding tobacco in all of its forms, especially if you have additional risk factors. Increase your chance for early detection and treatment, and make sure that screening is a routine part of your regular dental checkup. It may feel strange to have someone pull your tongue, but it's for your own good.
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