In spite of the advances in medical sciences and the improvement of care, oral cancer is still a disease with an unfavorable prognosis unless early diagnosed; the dentist can detect it in patients complaining for specific symptoms or signs or during routine examinations.
Oral cancer can affect any part of the mouth, the tongue and the lips. The most common symptoms and signs are represented by a non healing lesion or ulcer or plaque or white or red area in the oral mucosa lasting more than two weeks.
Unfortunately, the proportion of younger patients affected has increased during the last decades and, unlike other malignancies, survival rates have not significantly improved since the seventies, and are among the worst figures recorded for major malignancies: after five years about fifty to sixty percent of subjects are still alive.
Mouth cancer is a devastating malignant disease with significant consequences for patients, their families and society.
Current scientific evidence shows that early-stage diagnosis is critical for improving both survival and quality of life of patients, as well as for reducing morbidity resulting from the disease and limiting public costs connected to treatment, rehabilitation and social reintegration of patients.
Although not directly involved in the specific care for oral cancer, the dentist plays a fundamental role in the prevention of the disease through the promotion of healthy lifestyles, in its initial diagnosis through the detection of premalignant and malignant lesions, and eventually in assisting the patient on the consequences of oncological therapies.
The recommendation to submit all patients to a clinical examination of the oral cavity during routine dental care and periodic recalls is therefore justified by the simplicity of the procedure and the low risk involved with respect to the great potential benefits of an early detection of a silent malignant or premalignant disease of the mucosa.
The implementation of the so-called “two-week rule” can lead the clinician to a prompt diagnosis and save lives: it is mandatory to submit the patient to a proper diagnostic assessment whenever a lesion of the oral mucosa does not heal within two weeks.
The promotion of global and oral health should be pursued by dentists and dental hygienists not only in the prompt setting up of an adequate and correct diagnostic procedure in case lesions or conditions in the oral mucosa are detected, but also in their capacity as health educators, by informing and counseling patients about the risks associated with the use of tobacco and alcohol, by promoting healthy lifestyles, by instructing them to maintain high standards of oral hygiene and to undergo a clinical examination of the oral cavity at periodic intervals.
Silvio Abati
MD, DMD
Professor of Oral Pathology
Director of the Oral Medicine and Pathology Unit
Dept. of Dentistry and Dental School (Prof. E. Gherlone)
IRCCS San Raffaele Hospital
University Vita Salute San Raffaele – Milan, Italy
