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Let's talk about mouth cancer...

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November is ‘Mouth Cancer Action’ but do you know the signs to look out for? Countess Governor and dentist of 33 years Caroline Stein blogs about mouth cancer and how a dentist can spot the dangers

Dental phobia – a fear of visiting a dentist – is quite common, but it’s something you all have to put to one side, because honestly, we are here to help…

As a dentist in general practice, I often hear people saying ‘I wish I hadn’t left it so long to come and see you’, but I never hear ‘that was a waste of time’.

I totally understand that sitting directly under a bright light, having a stranger stick their fingers into your mouth and the sound of the drill - rizzzzzzz rizzzzzz rizzzzzzz – can cause anxiety, but it’s really worth it for peace of mind. Plus, it’s not like we bite… in fact we’re more in danger of getting bitten than you!

Most people make their regular trips to the dentist to maintain a perfect smile of pearly whites, which is important, but there are also other things to consider. One of them is mouth cancer.

You might not have heard much about mouth cancer, with it covering only around 2% of cancers suffered in the UK, however it is one of the only ones on the rise in this country. That is why this November has been mouth cancer awareness month, encouraging people to talk about the disease.  Are you surprised that last year 7000 people were diagnosed and that sadly, mouth cancer takes more lives every year than road traffic accidents on British roads?

Like other cancers early detection is vital, giving people a 90% chance of survival. Larger more established cancers are unsurprisingly harder to treat and 5 year survival rates fall to nearer 50%.

If left to reach an advanced stage the surgery required for oral cancer can also be life changing, with sections of jaw bones sometimes being removed to leave people with eating and speech difficulties.

Cases like that should be few and far between though, according to Oral and Maxilo-Facial Associate Specialist Dr Tom Healey: “Changes within the mouth that indicate cancer are visible, unlike bowel cancer, for example, when you only find out once symptoms appear. This makes it much easier to detect early and take steps to remove it.”

Dentists like me look out for these changes as part of routine check-ups with our patients, which is why keeping regular appointments even when you think all is well, can be so important. If we spot anything that’s a concern we can refer you on to specialists like Tom at the Countess, as can your local GP if you go down that route.

What are the warning signs?

The biggest thing to look out for is an ulcer that stubbornly sticks around for more than three weeks, as well as red and white patches and unusual lumps or swellings in the mouth, head or neck area. I always encourage my patients to take the time to inspect their lips, tongue, inner cheeks, throat and neck areas in the mirror before brushing their teeth.

“Pain-free ulcers that stick around for longer than two or three weeks are a red flag,” Tom added. “Anyone can bite their lip or cheek from time to time and get an ulcer, but the difference is the lack of initial irritation and its failure to clearly improve. If an ulcer fits this description people should get it checked out by their dentist or GP.”

What happens next?

Tom says: "If a patient is referred to one of our clinics with a suspicious lesion we will arrange appropriate tests and investigations, including a small biopsy of the lesion. This is a simple procedure generally easier than having a filling in a tooth. With the results we can quickly either reassure the patient that all is well or, if cancer is confirmed, refer them on to the regional oral and maxillofacial oncology unit. We are lucky to have a great oncology team at Aintree Hospital who can provide patients with any necessary treatments, usually surgery or radiotherapy." 

Risk factors

Some people are unfortunately genetically pre-disposed to getting oral cancer, but there are some things which have been known to increase the risks such as:

  • Smoking
  • Drinking alcohol to excess
  • Chewing tobacco – paan or gutkha
  • Human papilloma virus (HPV) – transmitted via oral sex

Cutting down on all these risk factors, especially smoking and high alcohol consumption can make a huge difference, but there is still no guarantee.

The best defence is for people to be aware of mouth cancer, keep a watch for warning signs as mentioned above and visit their dentist regularly.

If you haven’t visited the dentist for a few years or are concerned that you might have some of the warning signs that Caroline mentions in her blog, book an appointment today. Don’t delay – be #mouthaware  

About the Author

Caroline Stein

Governor at the Countess of Chester Hospital

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