Oral Cancer Screenings

Early Detection Can Protect Patients.

In 2002, Bruce Paltrow, an acclaimed television and film director and producer, died after suffering for years from complications due to oral cancer. He was 58 years old. After Paltrow's death, Blythe Danner (an accomplished actress and Paltrow's wife), partnered with the Oral Cancer Foundation to raise awareness for early screening of the disease. In 2006, Danner told ABC News, "Because [the tumor] was hidden way back in [his]throat, it was hard to detect. [If he had] stage I or stage II, he'd still be with us, I think." Danner emphasized the need for early detection of oral cancer. She said, "Early detection, prevention, it just has to be out there much more, and it hasn't been out there in the mainstream media."

The Oral Cancer Foundation reports that fewer than 25 percent of those who regularly visit a dentist routinely receive an oral cancer screening. 

Dentist can play key roles in making screenings of oral cancer as common as mammograms and colonoscopies. With massive advertising campaigns in the past few decades, mammograms and colonoscopies have become household terms. The Centers for Disease Control and Prevention (CDC) reports that about 66 percent of women aged 40 and over have had a mammogram in the last two years and 65 percent of adults aged 50 to 75 have had a recent colonoscopy. In contrast, the OCF reports that fewer than 25 percent of those who regularly visit a dentist receive an oral cancer screening. Your patients are likely unaware how pervasive oral cancer is and that you can help them with early screenings. Here are some important facts and risk factors for you to know. 


Oral cancer (any cancer that originates in the mouth or throat) is the sixth most common cancer worldwide. Oral cancer includes mouth cancer, tongue cancer, tonsil cancer, throat cancer, and cancer in the middle part of the throat behind the mouth (the oropharynx). For 2016, the American Cancer Society estimates that about 48,330 people will get oral cavity or oropharyngeal cancer. 

More than 8,500 Americans die from the disease each year. The OCF reports that "the death rate for oral cancer is higher than that of cancers which we hear about routinely such as cervical cancer, Hodgkin's lymphoma, laryngeal cancer, cancer of the testes, and endocrine system cancers such as thyroid, or skin cancer(malignant melanoma)."

When caught early, the five-year survival rate for oral cancer is about 83 percent. This number drops to just 32 percent when the cancer is not discovered until its later stages, after it has begun to spread. 

According to the OCF, the death rate for oral cancer has been historically high because it is usually not discovered until late in development. In the early stages, when the cancer is more easily treatable, it is typically painless and symptomless. By the time a patient begins noticing symptoms, the cancer has often spread to the lymph nodes in the neck, and has grown deep into the tissues where it began. At that point, the prognosis is significantly worse. 

The key to prevention and succesful treatment of oral cancer is early detection. Changes in tissue that signal the beginnings of cancer can be easily seen and felt by a trained medical professional. The best way to screen for oral cancer is through visual and tactile exam. Because an estimated 60 percent of Americans visit dental practices once a year, dental professionals are in a great position to detect early signs of this cancer. Every person who enters a dental office represents an opportunity to catch oral cancer in its early stage. 

With shifting at-risk populations, it is now more important than ever to screen as many people as possible. On its website, the OCF reports that, "opportunistic screening of ALL patients must become the norm if the death rate is to be reduced."

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Guided Implant Placement: the new standard

With the latest technology, guided implant surgery is the new standard to achieve accurate, predictable, and safe implant placement. Using a CT scan and a custom made stent based on the ct scan offers the surgeon the most accurate tool and guide to place the implants.  However, using guides for implant surgery has remained rare.  In 2014, less than 150,000 computer-generated surgical guides were generated, and this number is predicted to increase by two fold by 2019.  In 2012, there were more than 21 million dental implant placements, so utilizing surgical guides is just a tiny fraction of the implant surgery. 

What are the reasons for the low number of surgical guides?  There are many different factors, including high and additional cost, time-consuming labor, complex work flow, working with a third party, learning new technology, etc.  Other reasons include complications of using guides, such as cooling the surgical instruments and reduced irrigation during the surgery, increased surgical time, patient factor, and cost of the software. 


A Tough Pill to Swallow

A painful truth about the prescription opioid epidemic is that dental prescribing habits are inadvertently contributing to it. In 2012, healthcare providers wrote an astounding 259 million prescriptions for opioids, such as hydrocodone (eg, Vicodin, Lortab) and oxycodone (eg, OxyContin, Percocet). Dentists are among the leading prescribers of opioid analgesics, and surgical tooth extraction is one of the most frequently performed dental procedures. Opioids are regularly prescribed following this procedure. This may represent an important area of excessive opioid prescribing in the United States. While no one wants to see patients in pain, dentists have to step back and ask if there is a better way to resolve the pain while protecting patients from harm. 

Drug overdoses are the leading cause of accidental deaths in the United States, with opioid addition making up 18,893 of the 47,055 drug overdose deaths in 2014. This is a dramatic increase over the past 15 years. Meanwhile, the problem does not end with opioid overdoeses. While many believe these drugs are not dangerous because they can be prescribed by a doctor, abuse often leads to dependence. For some people, opioid misuse and dependence spirals into heroin addiction-four in five heroin users started their addictions misusing prescription painkillers. 

One way to help our patients is through educating ourselves about the problem and strategies through which each one of us can help control the epidemic. In fact, the American Dental Association encourages continuing education on this very issue in order to "promote both responsible prescribing practices and limit instances of abuse and diversion."  

Along with reading this excellent article, dentists can register with the state prescription and drug-monitoring program to help determine which of the patients may be doctor shopping for opioid medications.  Dentists can also encourage patients to take advantage of National Prescription Drug Take-Back Day events and prescription drug disposal sites in their areas. 

Patient experience


While the importance of advanced in-office treatment options is stressed, it's essential to address digitally-minded patients' expectations of out-of-office experiences as well.

Many patients are aware they should visit the dentist at least twice a year, but it can be all-too-easy to procrastinate or forget about the appointments altogether. It's no longer sufficient to politely notify the patient at the end of a visit when they should return; tech-savy patients expect reminders delivered on their mobile devices.  Reaching out to patients with text messages or emails with appointment reminders is an effective way to communicate with patients out-of-office.

Having a proper online and social media presence is a necessary element in keeping patients engaged and creating return patients.  In order to get the most of the practice's website, it is vital that the site is built with search engine optimization in mind, is mobile-friendly and allows patients to schedule appointments with little-to-no hassle. 

A report from Google showed that 97 percent of consumers research local businesses online, so a website that is search engine optimized will appear higher in google search results than websites that are not.  A mobile-friendly website where patients can schedule appointments from their smartphones is also key for gaining and retaining tech-savy patients. This kind of website can be used in conjunction with reminder texts or emails: reminder messages can now be sent that include a link back to the scheduling section of the website where patients can book their next appointment right from their smartphone. 

Dentistry from a patient perspective: Expectations of a tech-savy patient

The interactions between patient and professional will always be at the core of dentistry; however, as time progresses and patients become more technologically inclined, they expect more from their dental treatments in terms of in-office experience and out-of-office communications and engagement. 

In-Office Experience

Many patients expect new dental technologies to play a major role in their in-office treatment.  It's the convenience offered by these innovative technologies that make them a must-have for practices looking to grow by attracting the ever-increasing number of digitally advanced patients.  

Convenience is the major benefit across all consumer technologies that have become cultural staples over the past decade.  Why boot up your laptop or desktop if you want to check emails or social media when you can look at your smartphone, tablet or smartwatch in a fraction of the time? With this mindset, it's easy to understand why patients desire increased in-office convenience from various technologies.  

Offering single-visit treatment is invaluable in attracting and retaining tech-savy patients.  Patients are likely missing work or using their limited number of vacation days to attend dental appointments, and the prospect of using more vacation days for second or third visits is immediately off-putting. 

Replacing a cracked or chipped tooth with a CEREC restoration in one-visit ensures a great patient experience, and an increased chance of referral where 91 percent of patients at CEREC practices said they would refer their dentist to family and friends.  

Next - Out-of-Office Experience


I have been using CEREC since 2000 and have seen significant growth over the last 16 years, but the growth over the last 2 to 3 years since the launch of Omnicam has been the biggest jump.  I think that now that the learning curve for imaging has become so minimal with Omnicam, people are jumping in and excelling out of the gate. 

Practice Impact

CEREC has allowed me to profitably create accurate and esthetic restorations in my office.  This has become even more the case now that I can restore implants and create bridges in office with IPS-emax and zirconia.  I love having the control of the process and not dealing with a second seating appointments.  The second big impact that CEREC has on my practice is from the patient perspective.  they love the technology and the 1-visit aspect of the procedure.  As dentists, we view the second patient visit simply as a 15-30 minute appointment, but that is just the time we see them.  Many patients have to arrange it with work or a sitter, and with travel time to and from the office, this 15-minute appointment can take up to a few hours for them.  The third impact that CEREC has had on my practice is that it makes doing dentistry fun for me and has made me a better dentist.  It's hard to put a value on enjoying what you do, but I love doing CEREC procedures.  

The Oral Health Crisis in America

Here are some fun facts!

1. More than a quarter of all Americans 60 years of age or older have lost all of their teeth.

2. Dental disease (caries) is the most common chronic disease in children. It is 5X's more common than asthma.

3. Every year across the U.S., children miss 51 million school hours due to dental problems and visits. Adults lose close to 164 million work hours.

4. About 1 in 4 elderly adults have untreated tooth decay. The rate among low income adults is twice that for adults with more income.

5. An estimated 17 million low- income children in America go without dental care each year. This represents about 1 out of every 5 children

6. It is estimated that in 2010, Americans spent $ 106 billion on oral care.

7. More than 64 million Americans have moderate to severe forms of periodontal disease.

8. Dental disease is nearly 100% preventable.



Restorations with CEREC

Thanks to CEREC, we can provide our patients with inlays, onlays, crowns and veneers in only one appointment. There is no more gooey impression material, temporary crowns, or second visits.  We have used the CAD/CAM system for a good 30 years now and over 250 scientific studies have confirmed the clinical safety of tried and tested CEREC tooth restorations. Worldwide, more than 30 million tooth restorations have been produced with CEREC. 

Make an appointment at DNL Dental. We are #1 dentists in Fairfield, CT.