A dental check-up can reveal a lot about your health just from a look inside your mouth. Crucially, it can also highlight the early signs of oral cancer and, as we lead up to Mouth Cancer Action Month, it's important you know what it is your dental professional is looking for when they probe around your mouth.
Dental hygienist and dental therapist Melonie Prebble, shares some key insight and advice about what's involved. "As a dental therapist, it's my job to assess the health of not only your teeth and gums but of the soft tissues, too. Just in case you don't know, this is the tongue, the inside of your cheeks, floor of the mouth, soft palate, the base of the tongue and both the side and back walls of the throat. Far more is expected of us now than simply attending to your teeth!"
Organised by the British Dental Health Foundation (BDHF), Mouth Cancer Action Month promotes the message 'if in doubt, get checked out' in a bid to save thousands of lives through early detection and it's supported by hundreds of dental practices throughout the UK. It serves as a timely reminder for us all to regularly attend dental check-ups.
Last year, a YouGov report revealed that the biggest reason people did not visit the dentist was not fear or nervousness as traditionally accepted, but price.
But, as YouGov's James McCoy commented at the time: 'While it is still true that for many, a trip to the dentist is tantamount to their worst nightmare, YouGov research shows that cost is now the most practical barrier to attending a routine check-up.
'The obvious implication is that many people may be avoiding the dentist and therefore missing more serious problems that would be picked up at a check-up, which would cause more pain and indeed cost, in the long run.'
Oral cancer is particularly aggressive and by simply missing one opportunity for an early diagnosis or prompt referral, it can have serious consequences for prognosis.
Interestingly, in a recent survey*, oral health screening was among the top eight factors important to dental patients, with 63% citing this as a key part of the visit.
Indeed, the figures speak for themselves. Statistics, published by the BDHF, reveal there were 6,767 new cases of oral cancer in 2011, a rise of 33% since 2000. Additionally, deaths from mouth cancer surpassed 2,000 in 2011 for the first time - and it is one of few cancers that experts predict will continue to increase in the coming years.
However, early detection for mouth cancer results in a survival outcome of 90%, with delayed diagnosis meaning survival rates plummet to as little as 50%. The most significant contributory factors are smoking and heavy drinking, while the use of smokeless tobacco, chewing betel nut, and a poor diet can also increase the risk.
The human papillomavirus (HPV) is also a precursor for oral cancer and, currently, there is a vociferous campaign for the UK's HPV vaccination programme (currently offered to girls only) to extend to all adolescent boys too, in order to stem its rise in future generations.
Earlier this month, the publication of a government head and neck cancer audit revealed that more than two thirds of patients with cancer of the oropharynx - the part of the throat directly behind the mouth - tested positive for HPV.
Melonie Prebble says: "By removing or minimising risks, the patient's future oral health can be protected or improved. Remember too, dental hygienists and dental therapists can offer an alternative route to a dental health check-up for those who have a fear of the dentist so don't put off that dental visit any longer. We are here to offer care and advice as well as health screening.
So, please don't be surprised if we ask you about your lifestyle and dietary habits and point smokers in the direction of professional smoking cessation guidance."
What to expect in an oral screening? Your dentist or dental therapist will…
• Look at all areas of the mouth, including the floor of mouth, the gums, palate, tongue and the part of the throat just behind the mouth
• Examine by touch any unusual ulcers or abscesses
• Note the site, size, colour and consistency of any such lesion
• Check the salivary glands, lymph nodes and bones of the lower face
• Make a referral to an appropriate specialist for further investigation if necessary
• Assess nerve function, particularly if there is facial pain, and will refer any sensory loss associated with pain to a maxillofacial surgeon or neurologist
• Assess any facial nerve weakness that may suggest rapid growth associated with malignant change
• Possibly use an oral cancer screening device, such as a VELscope®, that relies on light-based detection technology.
Three steps to a healthy mouth
1. Stop smoking, and cut down on the amount of alcohol you drink
2. Eat a balanced, healthy diet with at least five portions of fruit and vegetables a day. This can also help protect against many other cancers
3. Visit your dental team regularly, as often as they recommend.
*Data taken from research dated 2008-2011 conducted by dental business consultant, Sheila Scott.