Oral Cancer Awareness and Early Detection

April is Oral Cancer Awareness month, and we are offering free VELscope® oral cancer screenings to every patient that gets their teeth cleaned during April. Many patients refuse the additional VELscope® oral cancer screening offered by their hygienist. Most insurance companies do not provide coverage for it and it costs around $50.

A multitude of head and neck cancers begin in the oral cavity, which includes your lips, tongue, gums, lining inside the cheeks and lips, and the bony top of the mouth.  Cancer found in its early stages is the most treatable, thus early diagnosis is important.

Your annual check up includes visually examining your head, neck, face and mouth for any masses, lesions, swelling, or any facial asymmetry. In your mouth, we look for both red and white lesions on the mucous membrane, as well any masses with in the tissues. We examine your tongue for ulcers, swellings or other abnormalities, in addition to examining the inside of the back of your throat with a laryngeal mirror.

The additional oral cancer screening offered is the VELscope® Vx Enhanced Oral Assessment System.  It is a handheld scope that provides a more thorough tissue examination than a visual exam.  It uses natural tissue fluorescence to illuminate dysplastic or keratinized tissue. In other words, it helps visually detect tissue abnormalities or tissue that has changed that may not be noticeable in a visual exam.

The best strategy in the fight against cancer is early detection. The VELscope® Vx is a widely used adjunctive device for the enhanced visualization of oral mucosal abnormalities, such as oral cancer or pre-malignant dysplasia.  It makes abnormalities that might not seen by the naked eye visible, thus it is a helpful tool in early detection.

When we find tissue abnormalities, the patient is immediately referred to a specialist for evaluation. While $50 may seem like an unnecessary out-of-pocket expense for a  VELscope® Vx oral cancer screening, how much is your peace of mind worth?

If you have lifestyle (excessive tobacco and/or alcohol consumption) or genetic contributing factors, HPV (human papillomavirus), or a prior head or neck malignancy that could increase your likelihood of developing oral cancer, you should elect to have an annual VELscope® Vx oral cancer screening. Being proactive is essential to early detection and diagnosis.

Additional information regarding VELscope® Vx Enhanced Oral Assessment System can be found at http://www.velscope.com/.

Prevention: Big Cavities and Bad Reviews


Chandler Cosmetic Dentist, Kelly Jorn Cook, DDS

I recently received a bad review on Yelp.  Two stars.  Yikes.  Essentially my patient felt I was recommending unnecessary preventative treatment.  The assertion bothered me, but forced me to think about how I could have better explained the clinical narrative.  Saying the phrase “early caries detection” to most people translates as babble.  In my discussion of treatment, the patient left thinking “preventative” meant “unnecessary”.  What I said to my mind was, “your enamel is soft on the biting surfaces of these teeth indicating the early stages of decay.”  The patient heard “you do not have a full blown cavity yet, but we recommend a filling anyway.”  Clearly I did not effectively explain my clinical recommendation, because the patient left with the impression that unnecessary treatment was being recommended.

In this day and age, dental diagnostic technology has progressed.  We have tools that allow us to detect the early stages of decay beyond what an x-ray will show or an explorer can find.  We use DIAGNOdent™ laser technology engineered to detect early invasion of decay into tooth enamel. Sub-surface caries lesions can be extremely difficult to detect using an explorer, thus the DIAGNOdent™ is a useful diagnostic dental tool. It is especially useful for pit and fissure areas (the grooves on the biting surfaces of your teeth).  The laser reads the density of the tooth enamel to detect softening. Depending on the number value that the laser reads, we will recommend “watching” a tooth for any progression of the decay or removing the decay to prevent the need for a larger restoration in the future.

The grooves of natural teeth often form small cavities over time, which can be treated conservatively without anesthetic and with very little natural tooth structure removed. The preventative nature of the smaller restoration placed at the early detection of decay diminishes the likelihood of a more invasive treatment in the future.

I appreciated the feedback, even though it was through a negative and public review. I regret that my patient was not provided with thorough explanation regarding early caries detection, but this is how we learn and grow.

We try to provide our patients with a conservative approach and the best service for optimal dental health.  If you happen to be interested, additional information regarding DIAGNOdent™ technology can be found www.kavo.com/us/caries-detection.

Flossing – You Know I Know

If you are my patient, you get asked how much you floss at least twice a year. It’s my job as your dentist to get this information.  And yet, I get lied to roughly fifty percent of the time. The majority of those who tell me they are flossing are not.  You don’t have to lie, your gums are truth telling.  If you are not flossing, or think you can floss right before you see me and pass as a dedicated flosser, the jig is up.

In any event, not many people floss once a day every day. Let’s be real. If you are flossing three times a week, you are in upper echelon of oral hygiene. If you floss less than that, you have to make a habit of it. Flossing is like anything else, the more you do it, the more efficient you become at doing it.

I tell my patients to attach it to something. If you watch Jeopardy or Sports Center, bust out 18 inches of floss when you hear the theme song and get to work. Attach flossing to one of your daily rituals a few times a week it will easily become a habit.  It is a small thing you can do for yourself with great long term results.

When my patients do finally make it a habit (trust me, my hygienists and I can tell), they said how easy it is to maintain it. Regular flossing means less time and money spent in my chair, which means you can put your funds towards flossin’ your other grill.