Early detection of oral cancer: how do I ensure I don't miss a tumour? Graham R Ogden Rowena Lewthwaite Simon D Shepherd Dental Update 2024 40:6, 707-709.
Authors
Graham ROgden
Professor of Oral Surgery, University of Dundee, Park Place, Dundee, UK
The GDC recommend that early detection of oral cancer should form part of every dental surgeon's Continuing Professional Development. It is arguably the most serious condition that can arise within the oral cavity and regular screening practices may also help mitigate spurious claims of prior negligence for failure to detect the cancer at an early stage. Results for routine screening of the entire oral mucosa, together with risk status assessment, should be recorded in a patient's notes at every visit (both negative and positive findings).
Clinical Relevance: A knowledge of how to detect oral cancer early is an essential part of the dentist's armamentarium.
Article
The General Dental Council (GDC) of the UK made certain topics (eg medical emergencies, disinfection) core subjects for Continuing Professional Development (CPD). More recently (2012), they have issued guidance that has made the early detection of oral cancer, along with legal and ethical issues and complaints handling, a recommended topic.1
As dental surgeons, we have a responsibility to screen for potentially serious conditions within the mouth. Another reason for this recommendation regarding oral cancer is the possibility that some patients may claim professional negligence for failure to identify their oral cancer at an early and more manageable stage. One of the best ways to guard against both eventualities is to screen all the oral mucosal surfaces every time the patient presents for treatment, regardless of the nature of the treatment (or the age of the patient), and to record the findings, even if negative. Once it becomes routine practice, it can be easily carried out. In the absence of any other clinical technique that can reliably confirm malignancy (other than biopsy), we are left with the use of a powerful dental light and mirrors for detecting signs and symptoms suggestive of cancer, particularly altered oral mucosal appearance in patients with increased risk of such disease (see below).
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