Doctor Kulaga

From coast to coast, thousands of patients are seen everyday in dental practices, yet oral cancer is missed. Is it because doctors are not looking? Has the doctor not been trained properly to identify a suspicious mouth sores, also known as a lesion? The answer is possibly both, and I admit as a dental profession that we must become better at being able to identify these lesions early.

Recently, Dr. Abrahams, Melissa R.D.H, and myself took a course from the University of Florida on Oral pathology. This is a course we take yearly to make sure our eyes are trained to catch the small lesions. In our practice we find approximately 250 lesions a year that need a two week follow-up to make sure it resolves. Of these 250 about 40 require biopsy. Most come back as benign lesions with nothing to worry about, but since 2012 we have diagnosed at least one case of oral cancer each year. We encourage our patients to also come in if they have any type of lesion in the mouth that does not heal in two weeks to return.

Remember, anything red or white that stays in the mouth longer than two weeks needs attention. Let me give you an example: A patient had something that looked like a cold sore on his lip and we agreed to have it looked at in two weeks. At that check it was still there with the same size and he stated he cut himself there with the razor and its why he hasn’t healed. I advised him this does not seem to be the case and we recommended a biposy. He stated it was not necessary. One month later we saw him and the lesion looked the same. After much talking, he finally agreed to the biposy. The results came back as squamous cell carcinoma and required surgery with radiation. Because he waited, the cancer had spread further under the skin and he required much more facial dissection than would have been needed if he addressed it earlier leaving him with permanent dis-figuration. Remember, any lesion that lasts more than two weeks we need to see it!

You may see at other practices that they use special lights or solutions to find these oral lesions, but there is usually a charge for their oral cancer screening. At our most recent course, two instructors from the University Of Florida Pathology department stated these devices do not lead to a better exam and actually return more false positive results. Their recommendations is to do a high quality oral soft tissue exam looking at all aspects of the mouth, including the back of the throat. At White Wolf Dental, we include a high quality oral cancer screening as part of our new patient comprehensive exam. Not only do we complete a high quality oral exam, we also take a 3D scan that allows us to see pathology in the bone and sinus that traditional x-rays would miss. As of this writing our exam is $99, but at other offices an exam of this caliber would be over $569! We want to take care of our patients and want to make access to high quality care more affordable.

So the next time you go in for your yearly dental exam, make sure your dentist does a high quality oral exam. It doesn’t matter if you come to our office, one in Aspen Colorado, or anywhere in the heartland of America, make sure your dentist pays close attention to not only your teeth, but the whole mouth.

~Dr. K