Save a life

May 1, 2004
An office manager once told me, "Hygienists are overpaid. My underpaid daughter is a nurse, and she saves lives. Hygienists don't save lives!" This made my blood boil.

by Janet Hagterman

An office manager once told me, "Hygienists are overpaid. My underpaid daughter is a nurse, and she saves lives. Hygienists don't save lives!" This made my blood boil. This is precisely the type of distinction that differentiates the hygienists of old (the mouth-maid prophy mill) from the health-provider hygienists of today and tomorrow. The new hygienist is a preventive specialist, a periodontal therapist, a business partner, an esthetic hygienist, and, yes, a lifesaver.

Hygienists can save lives in many ways, such as through early diagnosis of high blood pressure and diabetes. But clearly the most obvious example is through the early detection of oral cancer. If you think I'm being overly dramatic, you have never been affected by oral cancer personally, and you don't understand the statistics.

I hope the following statistics shock you as much as they did me.

• Oral cancer kills one person in this country every hour.
• Oral cancer is the only major cancer where the death rate has not declined over the last 40 years.
• Oral cancer kills as many Americans as skin melanoma.
• If you are diagnosed with oral cancer, your chance of being alive after five years is only about 50 percent.

This last one particularly stunned me, and I hope it stunned you too. It is well known that if oral cancer is diagnosed early it can be completely cured. How can we, as health care professionals, catch this disease so late? I am committed to changing these statistics, and I hope you will join me in this commitment.

How can we do this? First, we need to look for oral cancer. We should do a complete oral cancer exam each and every time we look in a mouth. Many hygienists ask, "Do I need to do this if my doctor already does it?" My answer is, "Four eyes are better than two." Plus, hygienists are in the mouth longer and have a better opportunity to discover seemingly benign, yet potentially dangerous lesions. Also, you don't need to know what it is, you just need to know that it not normal, healthy tissue, and bring it to the attention of your doctor.

What do you do when you find something very suspicious in its appearance? Fortunately, that doesn't happen very often, but the patient needs a scalpel biopsy when we do. A more relevant question is: What do you do when you find a very small white or red spot that is not suspicious in appearance but still "abnormal?" Instead of "watching it," we now have a reliable diagnostic tool to use in the dental office.

OralCDx is a brush biopsy test made especially for dental use in detecting oral cancer. OralCDx test kits are quick and easy to use. Having access to this remarkable diagnostic tool will certainly help change the above statistics, and contribute to the early detection of cancer. Everything you need is in the kit, and the first order comes with a short instructional video. The doctor actually performs the brush biopsy after you find a lesion. The procedure is relatively painless and requires no anesthesia.

The patient should be told, "Mrs. Jones, I see a small white spot inside your mouth; I see spots like this all the time in patients and it's probably nothing. I can use a painless test just to be sure, and, if it is something that needs further attention, we will have found it early when it is easy to treat."

This test is a must for all hygienists and dental offices. For more information contact Sullivan-Schein Dental at (800) 560-4467 or

Another excellent tool for early intraoral cancer detection is VisiLite™ by Zila, Inc. at (800) 922-7887 or VisiLite utilizes a special disposable light to detect hard-to-see lesions that may not otherwise be apparent.

What about the extraoral head and neck cancer screening? When I speak to groups of hygienists, I ask, "Who learned to do a complete head and neck exam in school?" Everyone raises their hands. When I ask who still does it, less than half raise their hands. What has happened? We are, after all, in a perfect position to examine these areas closely and regularly.

When done well, the head and neck exam is a wonderful stress reliever for patients. It's a great way to bridge the gap between social and clinical time. It's an excellent way to build value for the continual care appointment, and it's a great way to pamper patients. More importantly, it can save a life. Start with an introductory phrase such as, "Mrs. Jones, this is going to feel like a facial massage." Always proceed from least invasive to more invasive procedures. Patients love this. The hygienists I have coached to re-introduce this into their practice of hygiene have been rewarded with heartwarming and grateful compliments from their patients.

You will be amazed with the number of your patients who have had a personal experience with oral or skin cancer. The following are comments I have received from patients during a complete pampering cancer screening: "No one has ever done this before," "This is great," "Don't stop," "I want you for my hygienist next time," and "Where did you go to school?!"

In spite of our "advanced" medical technologies, the dreaded "C" word still terrorizes us, poisons the organs and breaks the minds and spirits of the bodies it pervades. You have a great opportunity to catch this deadly disease in its early stages when it is most curable or controllable. Our industry and profession must take a stand for early diagnosis of oral cancer, and then do it.

Join me in the commitment to change these statistics. Provide a complete "pampering" of the head and neck, intraoral and extraoral cancer screenings on all of your patients all of the time.

Pamper your patients. Catch the early signs. Screen, examine, and test. Save a life!

Janet Hagerman, RDH, BS, is a speaker, writer, and the director of dental hygiene for Coast Dental. She can be reached at jhager [email protected].