Mouth Cancer

When it comes to dental implants, there is no one-size-fits-all answer to the question of whether or not the surgery is painful. While some patients report little to no discomfort during and after the procedure, others may experience some level of pain or discomfort. However, it is important to keep in mind that any pain or discomfort that does occur is usually temporary and can be managed effectively with medication. In most cases, patients are able to return to their normal activities the same day or the day after surgery.

Mouth Cancer – Learn, Check , Talk and Educate.

We can make a huge difference in raising oral cancer awareness and detecting it earlier in general dental practice by taking some key steps and implementing a systematic approach to the problem. In my practice, we took a some step approach:-

• Step 1 – Have a Management Strategy for Oral Cancer in Your Practice.

The objectives laid out in your strategy should include robust mouth cancer check for every patient, talking to and educating your patients about the disease and training your team to deliver an oral cancer service. The end goal is that every team member is confident in their role within your oral cancer service, that your patients can see that you are safeguarding their oral and systemic health and very importantly that you are meeting your duty of care to do so.

• Step 2 – Clarifying Each Team Member’s Role and Responsibilities  

Every member of your dental team has a role to play in the early detection of oral cancer in your practice. From triaging on reception to a robust intra and extra-oral mouth cancer check in surgery, everyone needs to sign up to their responsibilities. Decide what each person’s role should be and build these responsibilities into their job description.  When signing a contract of employment, an individual is agreeing to the details of their job description and has a legal obligation to carry out the tasks listed. As with any other strategic plan, every team member needs to buy into achieving the objectives. If one link in the chain is broken, the strategy is likely to fail.

• Step 3 – Train All Staff to Talk About the ‘C’ Word. 

Do you talk to your patients about ‘oral cancer’ when you are checking them for it? Does your reception team know how to answer questions sensitively and appropriately if patients ask about oral cancer? And do your dental nurses know how to support a patient if a referral is made for suspected oral cancer? If the answer to any of these questions is ‘No’ then I would suggest training your team to talk about oral cancer.

The results of a survey highlighted by the Oral Health Foundation estimates that 90% of dentists check for oral cancer but only a small percentage discuss what they are doing with patients. The survey also showed that 9 in 10 patients would like to be checked for the disease, however, only 14% indicated that their dentist had discussed what they were doing during a mouth cancer check.

So as a profession, why do we still avoid the ‘C’ word? It appears that we are the ones afraid to use the word, not our patients. Is this due to our fear of litigious activity if the patient knows too much? Or is it because dentists lack knowledge, confidence and experience in dealing with oral cancer management? Either way, training the team to talk about cancer in a confident, knowledgeable and appropriate way will alleviate whatever it is holding us back from these essential communications. Raising awareness and teaching patients to self-check will also help to save lives.  

 The GDC advises that oral cancer management CPD is delivered as a core topic for dental clinicians. However, my recommendation is that your administration team should be included in the training. Which practice wants to miss an oral cancer at the first port of call on reception and be sued as a result? 

• Step 4 – Triage Every Patient

Every patient should be triaged for oral cancer by the reception team when booking an appointment, particularly if they are a new patient. Train your reception team to ask the correct and appropriate questions when booking an appointment to ensure that a lesion, that could be potentially suspicious, is not missed. Cold sores are an area for concern as many people do not associate them with being a symptom of oral cancer. Some practices choose not to see patients with cold sores for fear of bringing Herpes Simplex onto the premises. However, a triage system that picks up early signs of oral cancer, including cold sores, and drives appropriate and timely intervention by a clinician, can avoid litigation and save lives.

• Step 5 – Check Thoroughly

I spend much time observing mouth cancer checks in practice and often see the extra-oral component totally missing. In many cases, a lesion is not visible intra-orally but can be detected extra-orally through palpation of the cervical chain of lymph nodes. Oral cancer lesions are synonymous with an ‘iceberg’. Often, what is visible on the surface is insignificant but what lies beneath is the killer. A full 50:50 intra:extra mouth cancer check takes between 90 secs to 2 minutes to perform and may save someone’s life and avoid you being faced with a litigious situation. 

• Step 6 – Educate Your Patients About Oral Cancer and Self-Checking 

Dental professionals in general practice are perfectly positioned to educate their patients and the public about oral cancer. As there is currently no Government initiative to tackle the escalating problem that this hidden killer presents, it is our professional obligation to do something about it. To combat oral cancer, people firstly need to know about it! So, talk to your patients about oral cancer whilst you are conducting your check and educate and advise them to self-check on a monthly basis. Advice leaflets and posters in your waiting areas are essential to getting the ball rolling and instigating conversations about oral cancer and mouth cancer checks.

Publicize your oral cancer management system on your website and use social media to blog about oral cancer and get the message out there. The only way we will make a difference and save lives is to tell the public what we are doing to safeguard people’s health and educate them to avoid and detect this little known cancer themselves.

• Step 7 – Use a Systematic Approach

Does your practice want to know if it makes a difference by checking thoroughly for oral cancer? Well, the only way to be sure, is to run reports and audit your activity. To ensure that variables are minimized, a systematic approach needs to be taken, that is, the examination needs to be done in exactly the same way every time. I would advise using oral cancer custom screens on your software package in surgery. They are usually laid out in a tick box fashion and it is then simply a case of the dental nurse calling out the area to be examined and the dentist giving a response to be recorded. This method also ensures that nothing is missed and a 50:50 intra:extra oral exam is always done too.

 If you don’t have custom screens but have a maintenance package with your software provider, the company will normally install one for you. Otherwise, for a small fee, companies will build one in for you.

Custom screens – a simple tool for saving lives!

A Word from Ingle Family Dental

If any reader needs any help to integrate the above steps into their practice, please contact me. I would be very happy to help!