April Is Oral Cancer Awareness Month – 2022

Check your mouth

Oral cancer kills! Avoid this disease by learning to recognize early symptoms, talk to your dentist about any suspicions and have your dentist perform an oral cancer exam twice a year. Caught early, everything from treatments to final outcome, are reduced in severity.

The wise thing to do is to engage in a routine self-exam, easily done in about 5-10 minutes once a month. What you need:

• A mirror – use a handheld mirror that lets you to get the closest look, clearly inside your mouth.
• A light source – illumination is critical to be able to see any subtle changes in your mouth.
• Piece of gauze –to effectively examine the tongue; top, both sides and underneath. A small package of 2X2 gauze is available at any drug store.

Start by looking at yourself in the mirror. Both sides of your face and neck should look relatively symmetrical. If you are not, and an area is swollen and it stays that way, perhaps you have a reason to seek out a professional opinion.

Examining your neck. You’ll want to look and feel your neck, under your jawline, and even in the hollow above your collarbone. You’ll want to look and feel both sides of your neck, under the jawline, along the muscle that runs down each side of your neck, then ending with feeling the hollow above your collarbone.

There are many lymph nodes in these areas that give us a lot of information about our health. They tell us about the presence of an infection in our body, and also can be related to cancer. Most often they are related to an infection and this causes swelling and tenderness. But lymph nodes that swell and enlarge, are not tender to the touch and feel firm and fixated in place are a red flag. In general, painful means infection, not cancer (which if it does not go away still needs to be evaluated), swollen and not painful nodes, a warning sign that needs to be evaluated by a professional.

Using your fingertips, use a circular motion or rolling stroke to check the lymph nodes from the corner of your jaw all the way forward to under your chin. You likely will feel nothing, and that is good. It is the hard, painless, swollen ones we are concerned with. They are usually about the size and shape of a small almond.

Next with your fingertips on the inside of the muscle that runs down each side of your neck, roll your fingertips from under the jaw down to your collarbone. Turn your head one way then the other to feel the area occupied by the deeper nodes along this muscle. It is not unusual to feel a number of different lymph nodes in this area. Healthy ones are soft and move about easily when you push against them. Next check the lymph nodes above your collarbone. To do this, you will want to raise your shoulders and round them forward. This allows you to feel inside the hollow area above your collarbone.

What am I looking for?

There are 100’s of lymph nodes in your neck. From time to time, they may enlarge. This is often related to an infection, a cold, or a sore throat for example. If infection related, they will often be tender/sore, moveable, and will feel like a pea or blueberry. In contrast, if you find a hard lump like a small stone, first compare it to the other side. If it feels different from the other side, if it doesn’t move around, if it is not tender/sore, and persists for more than two weeks, have it checked by a dental or medical professional.

Now it’s time to look inside your mouth.

The examination of your mouth should include your lips, your gums, the inside of your cheeks, your tongue, the floor of your mouth, the roof of your mouth and back of the throat including your tonsils. It is best to follow a system each month when checking your mouth so you don’t overlook an area as you will have a routine. Here’s what you’ll need; a tongue depressor, light source, mirror, and a piece of gauze. We recommend the lit tongue depressor from Throat Scope because it combines full lighting to the area while working as a tongue depressor to move your tongue around. Look for any unusual sore, thickened area or lumps on your lips, discoloration, ulceration, sore or grows on your gum, tissue of a different surface texture, inside your cheeks and around your tongue including under your tongue (With a piece of gauze get a good hold on your tongue, pull it forward and move to the right and then to the left). Examine the floor of your mouth for discolorations or ulcerations. Examine the roof of your mouth to also be free from any sores or ulcerations.

Your job is to find things, it is the job of a professional to determine that what you discover, which has met the criteria of persisting for more than 2-3 weeks is dangerous or not. Out of hundreds of things that you may come across in your mouth, we cannot teach you enough to decide that something is cancer or not. The professional community itself is more than aware that from a visual exam, many times even they cannot with certainty definitively say what something is. This means that if they, like you, find it suspect, they will take a small piece of it (biopsy), and send it to an oral pathologist who will examine it under a microscope, and that person will come up with a gold standard, black and white answer as to what it is.

Catching a change early, and referring yourself to a professional to have them decide it needs to be removed, treated, or monitored, or not. Finding a precancer will likely save your life. Finding the very earliest stage of something that is already a cancer, will mean that your treatment to remove it and have it no longer part of your life, will be a much less invasive and difficult process, accomplished with a high degree of success and ultimately long-term survival.

Doctor Ionescu, here at Dentistry by Design performs thorough oral cancer exams every six months as part of our Professional Cleaning appointment. Oral cancer is a serious disease that can affect all parts of the mouth. We are taking it very seriously! Are you going to do the same?