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Oral Cancer Screenings

There are two distinct pathways by which most people come to oral cancer. One is through the use of tobacco and alcohol, a long term historic problem and cause, and the other is through exposure to the HPV-16 virus (human papilloma virus version 16, a newly identified etiology, and the same one which is responsible for the vast majority of cervical cancers in women. A small percentage of people (under 7 %) do get oral cancers from no currently identified cause. It is currently believed that these are likely related to some genetic predisposition.

While some think this is a rare cancer, mouth cancers will be newly diagnosed in about 115 new individuals each day in the US alone and a person dies from oral cancer every hour of every day. If you add the sub category of laryngeal throat cancers, the rates of occurrence (about 12,000 additional new cases per year) and death are significantly higher. When found at early stages of development, oral cancers have an 80 to 90 % survival rate. Unfortunately at this time, the majority are found as late stage cancers, and this accounts for the very high death rate of about 43% at five years from diagnosis (for all stages and etiologies combined at time of diagnosis), and high treatment related morbidity in survivors. Late stage diagnosis is not occurring because most of these cancers are hard to discover, (though some like HPV origin disease have unique discovery issues), it is because of a lack of public awareness coupled with the lack of a national program for opportunistic screenings which would yield early discovery by medical and dental professionals. Worldwide the problem is far greater, with new cases annually exceeding 450,000.

Nashville Brighter Smiles is here to help identify the possibility of Oral Cancer. An oral cancer screening is done at each 6 month cleaning appointment.

Let me introduce you to the latest technology called Identafi. The Identafi uses white, violet and amber wavelengths of light to excite oral tissue in distinct and unique ways. As a result, biochemical changes can be monitored with fluorescence, while morphological changes can be monitored with reflectance. The combined system of fluorescence and reflectance uses the body's natural tissue properties as an adjunctive tool for oral mucosal examination. Conventional examination of tissue is performed using a highly concentrated White light.

Wearing reusable Identafi filtered eyewear to enhance visual effects and allow transmission of reflected light, the health professional then switches to Violet for a second observation.

The clinician's photosensitive glasses block the violet excitation light and allow the observance of the tissues natural fluorescence. Violet light enhances normal tissue's natural fluorescence; however, suspicious tissue appears dark because of its loss of fluorescence.

When suspect abnormalities are present the selector is switched to Amber light, which enhances normal tissue's reflectance properties so the clinician may directly observe the difference between normal and abnormal tissue's vasculature. This independent view of vascular architecture may assist in the assessment of confounders when screening for oral cancer.

Studies indicate abnormal tissue has a diffuse vasculature, where normal tissue vasculature is clearly defined. The combination of all three Multi-Spectral wavelengths provides Dr. Meacham or his hygienist with more visual information, improved results over direct visual exam alone and increased confidence for recommending biopsies.

Sources:

http://www.oralcancerfoundation.org/

http://www.identafi.net/