Dr. Craig Delange
You may not think of your dentist as a researcher, but when it comes to your oral health, I take on that role.
At every dental checkup with me, you’ll notice that I use a gloved finger to feel the sides, roof, and bottom of your mouth. I will also lift your tongue so you can look down and feel your neck. What happens?
I’m looking for signs of oral cancer. These cancers are abnormal cells in any part of your mouth or lips. Oral cancers are relatively uncommon, but because they are not easy to detect, they may go undetected at a later stage when they can become very serious. That’s why every dentist checks your mouth for lumps, bumps, and red or white patches. The base, sides, and back of your tongue are common sites for oral cancer, which is why it’s thoroughly checked.
My job as a dentist is to recognize that something may not be normal and then either do more tests or send you to an oral surgeon or a head and neck doctor. When I’m checking for oral cancers, I can do a visual inspection as far as I can see when my patient says “Aaaah.” If I find sores in your mouth, I’ll ask how long they’ve been there because they’ll go away in two weeks. If you report new pain or numbness in your mouth, or difficulty swallowing, or changes in your voice, I will likely refer you for further testing. When I spot red and white patches in your mouth, I may identify them as non-cancerous infections, or I may perform a biopsy or refer you for further testing.
While anyone can be vulnerable to oral cancers, they were more common among older men of any ethnicity, particularly those who smoke or drink a lot of alcohol. Now, however, I see oral cancers in younger men and women, and we dentists believe they are caused by HPV – the human papilloma virus. Dentists have joined the chorus urging young teens to get vaccinated against HPV.
We also see lip cancers. I remind my patients to use lip balm with sunscreen as well as to avoid sunbed exposure. About 10 percent of oral cancers cannot be traced to a specific cause.
When oral cancer is found, treatment is surgery, radiation or chemotherapy, or a combination. I will work with you and your doctor before treatment to ensure you have the healthiest mouth possible so you can tolerate treatment better and heal faster. For example, an infection needs to be resolved before treatment, but because I coordinate case management with Kaiser Permanente medical providers, we can work as a team to make sure we take care of all aspects of your treatment.
Preventive care includes the usual preventive steps for good oral health: brushing, flossing, fluoride, a healthy diet, no smoking or chewing tobacco, HPV prevention and vaccination, and alcohol only in moderation. Make sure you have regular dental checkups. Eat more fiber-rich fruits and vegetables, which help create and maintain a healthier mouth. Additionally, stand in front of a mirror and look inside your mouth. Establish a baseline of what is normal for your mouth and then, over time, be alert for any changes.
Unfortunately, we cannot completely eliminate the risk of oral cancer. However, your preventive actions and my dental detective work can either reassure you that we will catch any oral cancers early or that your mouth is healthy.
Kregg Delange DDS is a Kaiser Permanente dentist in Eugene. Read more about Kaiser Permanente at kp.org/lane
