The World Health Organization (WHO) has clearly identified prevention and early detection
as major objectives in the control of oral cancer worldwide.

Currently,screening of oral cancer as well as its early detection, is still largely based
on visual examination of the oral cavity most often done during a regular dental checkup!

That being said, a simple visual examination however is well known to be limited by
subjectiveinterpretation and by the potential occurrence of dysplasia ( abnormality of developement).

As a consequence, adjunctive techniques have been suggested to increase our ability to
differentiate between benign abnormalities of the oral mucosa and dysplastic/malignant
changes as well as to identify areas od tissue dysplasia of early oral squamous cell carcinoma (OSCC)
that are not visible to the naked eye.

Some of these adjunctive techniques include the use of toludine blue, brush biopsy,
chemiluminescence and tissue autofluorescence.

Although some studies have demonstrated promising results, stronger evidence to support
the use of oral cancer diagnostic aids is still lacking and further research will be required
in the future.

From what I’ve read recently, cancer of the head and neck including all oral, laryngeal and
pharyngeal sites is the 6th most common cancer accounting for approximately 643,000 new cases
annually. About 40% of these head and neck malignancies are known to be Oral Squamous cell
carcinomas (OSCC) that appear in the oral cavity.

We know that oral cancer is largely related to lifestyle with major risks factors being tobacco
and alcohol misuse. In addition to smoking, the use of smokeless tobacco has also been strongly
linked to oral cancer.

With the above being said, My Dear Mother’s oral cancer was indeed a contradiction of sorts.
She neither smoked nor drank any alcohol and yet she was a victim of Oral Squamous Cell Carcinoma.

Virtually all OSCC are preceded by visual changes that take place in the oral cavity.These changes
are usually identified as whitish lesions (leukoplakia) and reddish lesions (erythroplakia) in the
oral cavity .

Back to my dear Mother’s cancer ordeal. Although my Mothers oral cancer was not associated with
a smoking or drinking habit, she was wearing an ill-fitting,acrylic Partial lower denture.I found
out about it soon after I graduated from dental school.

My Mom knew she had denture problems but because she was waiting for me to graduate and make her new
dentures, she neglected to go to a dentist to seek out help for her ill-fitting denture problems.
This was an extremely poor and fatal decision on her part.

Needless to say, my mother more or less contributed to her premature demise because of her own naivety
and neglect. Obviously, my Mother’s dental IQ was not too good.

Soon after I graduated form dental school my Mother came to visit my family in Vancouver BC and I took
her to my office and examined her mouth. I was shocked when I identified a rather large, fibrous-like white
lesion on the lateral border of her tongue.

I asked her how long she was aware of this lesion and she said maybe three or four years. I tried hard
to conceal my emotions because even though I had just graduated, I knew I was looking at something that
was not normal and needed to be checked out ASAP.

I made her a new partial denture and sent her home to see her Family Physician.Dr Stefanelli. He immediately
performed a surgical biopsy and the first result were negative. What a relief!

But soon afterwards, a second biopsy was completed and this time the results were positive. My Mother had the
most devastating form of oral cancer OSCC. It had spread into her lower, lymphatic neck vessels and lymphnodes
as well as the surrounding anatomical tissues.

Her prognosis was highly guarded and after an extremely invasive surgical procedure followed
by heavy dosages of radiation therapy, she passed away at the age of 63. Watching my mother go through
such a painful ordeal was very difficult for me. My Dad even thought that perhaps I had something to do
with her death indirectly because I did remake her a new denture before her cancer was diagnosed.

Had my Mother seeked out professional help when she first became aware that her ill-fitting denture was
causing her some pain and discomfort, she may have lived longer and not have been subjected to such a
traumatic,disfiguring surgical procedure.

The dentist’s role in early detection of oral cancer is crucial for several reasons. Firstly,his or
her working time and interest are concerned exclusively with the head, neck and oral cavity.

On top of that, the dentist will likely be the first professional to have the opportunity to
recognize unnoticed lesions in the mouth that may be pre-cancerous in nature. Secondly, any person
who realizes that they may have a problem in her or his mouth will likely go to a dentist
before going to a Physician.

It is for this reason and this reason alone that denture wearers MUST go to a dentist when they
have denture problems and not a dental mechanic or lab technician who does not have the training
and education to identify pre-cancerous lesions in the mouth.Although chronic denture irritation
has been associated with oral cancer, its exact cause has not been clearly established. I believe
that ill-fitting dentures may have a definite influence in the initiation of a cancerous lesion of
the mouth if they exist untreated over an extended period of time.

This is why all denture wearers NEED to have a regular annual dental checkups. Every white lesion of
the oral cavity should never be ignored. If such a lesions remains noticeable for an extended period
of time after all other possible causes have been eliminated, YOU need to be concerned for your
safety and well-being.

Please don’t become a statistic like my dear Mother. The international Agency for Research (IARC)
and the World Health Organization (WHO), have recently stressed that we can reduce one 3rd of 15 million
cancer cases in the future and more effectively manage another third by planning effective cancer
control screening strategies.

Mouth cancer is often seen in association with patients with poor oral hygiene and badly neglected teeth.
For years,tobacco has also been indicated as a factor in the cause of oral cancer because of the higher
incidence of oral cancer that is found in smokers and people who chew tobacco than in non-smokers.

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