tooth pain

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 - THE FACTS

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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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

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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.