by Scott Benjamin, DDS
The dental hygienist plays a critical role in the discovery, surveillance, and management of oral cancer and other mucosal abnormalities. Management of these conditions is truly a clinical team effort which normally begins with the initial discovery being made by the hygienist as a result of a systematic visual examination of all the soft tissues of the mouth, including:
- Manual extension of the tongue to examine its base
- A bi-manual palpation of the floor of the mouth
- A digital examination of the borders of the tongue, as well as the lymph nodes surrounding the oral cavity and neck.
This examination should incorporate the use of an adjunctive enhanced visualization device to aid in the earliest possible detection of mucosal abnormalities.
After diagnosis and treatment of a potentially malignant lesion, the patient once again returns to the hygienist for ongoing surveillance and case management. The entire dental team needs to be involved in this process, assisting patients in understanding the risk factors, the disease itself, and education on proper home care and surveillance requirements.
Oral squamous cell carcinoma is highly curable if it is detected and appropriately treated at its earliest stages. This is especially true if it can be discovered, diagnosed, and treated in a precancerous or, as it is more correctly termed, potentially malignant stage. The hygienist can be a key factor in the discovery and treatment phase and thus ensure better treatment outcomes.
Scott Benjamin, DDS, is Visiting Professor at the SUNY at Buffalo School of Dental Medicine and is a general practitioner in private practice in Sidney, New York.