A dental checkup is much more than cleaning your teeth
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Dr. Kregg Delange
You may not think of your dentist as an investigator but when it comes to your oral health, I take on that role.
At every dental check-up with me, you’ll notice that I use a gloved finger to feel the sides, roof and bottom of your mouth. I will also lift your tongue to look under it, and I will palpate your neck. What’s going on?
I’m looking for signs of oral cancers. These cancers are abnormal cells in any part of your mouth or lips. Oral cancers are relatively uncommon, but because they are not easy to detect, they may not be found until a later stage when they can become very serious. That’s why every dentist checks your mouth for lumps, bumps and red or white patches. The base, sides and back of your tongue are common sites for oral cancer, which is why it gets a thorough inspection, too.
My job as a dentist is to recognize that something may not be normal and then to either conduct more testing or send you to an oral surgeon or a head and neck physician. When I check for oral cancers, I can do a visual inspection as far back as what I can see when my patient says, “Ahhhh.” If I find sores in your mouth, I’ll ask how long they have been there because they should resolve in two weeks. If you mention new pain or numbness in the mouth, or difficulty swallowing or changes in your voice, I’ll probably refer you for further testing. When I spot red and white patches in your mouth, I may identify them as non-cancerous infections, or I may do a biopsy or refer you for further testing.
While anyone can be vulnerable to oral cancers, they used to be most common among older men of any ethnicity, particularly those who smoke or drink a lot of alcohol. Now, however, I see oral cancers in younger men and women, too, and we dentists believe it is due to HPV – the human papillomavirus. Dentists have joined the chorus that urges young teens be vaccinated against HPV.
We also see lip cancers. I remind my patients to use lip balms with sunscreen as well as avoid exposure while using tanning beds. About 10 percent of oral cancers can’t be traced to a specific cause.
When an oral cancer is identified, treatment is surgery, radiation or chemotherapy, or a combination. I will work with you and your physician before treatment to ensure that you have as healthy a mouth as possible so you tolerate the treatment better and heal more quickly. For example, an infection must be resolved before treatment, but because I coordinate case management with Kaiser Permanente medical providers, we can work as a team to ensure that we’re taking care of all aspects of your treatment.
Preventive care includes the usual preventive steps for good oral health: brushing, flossing, fluoride, a healthy diet, no smoking or use of chewing tobacco, HPV prevention and vaccination, and alcohol in moderation only. Be sure to maintain your regular dental check-ups. Eat more fruits and fiber-rich vegetables, which help to create and maintain a healthier mouth. In addition, stand in front of a mirror and look inside your mouth. Establish a baseline of what’s normal for your mouth and then, over time, be alert for any changes.
Unfortunately, we cannot totally eliminate the risk of oral cancers. However, your preventive actions and my dental detective work can either reassure you that we will catch any oral cancers early or that your mouth is healthy.
Kregg Delange DDS is a Kaiser Permanente dentist in Eugene. Read more about Kaiser Permanente at kp.org/lane
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