58 - prophylaxis and early diagnosis of oral cancer

what are the major risk factors of oral cancers?

"TAH SIP"

T = Tobacco - snus, cigarrettes etc

A = Alcohol

H = HPV

S = Sunlight

I = Immunosuppression (HIV/drugs)

P = Premalignant disorders (leukoplakia/erythroplakia)

>55 yrs

what are the clinical manifestations of oral cancers?

"PATCH" - painless initially

P = Pain/persistent ulcer

A = Altered sensation (numbness) -> IAN involvement

T = Tooth loosening

C = Chewing/swallowing difficulty

H = Hemorrhage (bleeding)

E = exophytic growth

how is 1ry prevention carried out for oral cancers?

- stop smoking + drinking

- safe sex - reduces HPV transmission

- sun protection - spa lip balm

what are the different types of screenings?

what are the different diagnostic aids used for early diagnosis?

1. toluidine blue

2. diffused white light examination

3. autofluorescence

4. chemiluminescence

what is toluidine blue staining?

oSimple, inexpensive

For identiying early oral squamous cell carcinoma and high grade dysplasias

o How to use

Rinse mouth with:

• 1% aceNc acid for 20s

• Plain water for 20s

• 1% toluidine blue for 60s

• 1% aceNc acid for 20s

• Plain water for 20s

o Detecting changes:

= Dark blue lesions

what is autofluorescence

- VEL scope emits blue light

- normal tissue = bright green fluorescence

- dysplasia/ carcinoma = loss of fluorescence

how does chemiluminescence work?

ViziLite

- acetic acid removes surface debris

- step 1 = rinse with acetic acid for 1 minute

- step 2 = darken the room

- step 3 = activate ViziLIte capsule

- step 4 = examine the oral cavity

suspicious lesions appear bright white