Oral Cancer: Update on Risk Factors, Adjunctive Diagnostic Aids, Management Strategies, & Complications

Course Overview

Over 40,000 new cases of oral and pharyngeal cancer are diagnosed annually in the United States, many as a consequence of an oral soft tissue examination provided by an oral health care provider. Predominant risk factors for OPC development include tobacco and alcohol use and exposure to HPV. This course will provide a review of the shifting risk factor profile of the OPC patient.
Several adjunctive aids have been introduced to the marketplace with the promoted goal of improving the dental practitioner’s ability to screen for and identify oral premalignant and malignant lesions (OPMLs). These products include the OralCDx Brush Test®, ViziLite® Plus with TBlue®, Microlux™, VELscope® Vx, Sapphire® Plus, Identafi®, and the DOE Oral Exam System. They are all marketed as aids for the clinician to use in addition to, not in lieu of, the accomplishment of a conventional oral examination (COE). This course will discuss the efficacy of these products when used in the general practice setting to screen for OPMLs.
While contemporary research has improved long term survival of the oral cancer patient, successful cancer therapy often incurs life-long impairments which may adversely affect the patient’s quality of life. As many of the impairments directly affect the oral cavity, the dentist will be frequently called upon to manage many of these impairments such as mucositis, xerostomia, increased caries, and disfigurement. In contrast to many facets of dentistry, the management of the oral cancer patient often requires compromise on the part of both the patient and the dentist regarding therapeutic outcome. This course will briefly review contemporary strategies to manage the oral cancer patient.
Topics discussed include: Risk Factors including: Tobacco, Alcohol, Solar radiation, Infectious agents, Immunological Diet, Socioeconomic. Diagnostic Adjuncts including: Role of the FDA, Review of the conventional oral examination, Brush test, Chemiluminescence, Vital Stain, Autofluorescence, Real-world considerations. Management Strategies & Complications including: treatment modalities, and treatment complications such as: Radiodermatitis, Mucositis, Pain, Salivary impairment, Taste dysfunction, Radiation caries, Osteoradionecrosis, Trismus and management strategies such as: Pre-treatment care, During-treatment care, After-treatment care

Education Objective: After completing this section, the participant should be able to:

• Identify the main risk factors associated with oropharyngeal cancer risk
• Understand the variability of tobacco risk
• Understand the role of the FDA in device evaluation
• Implement a consistent and effective oral soft tissue examination protocol in his or her practice
• Understand the real-world strengths and weakness of adjunctive diagnostic aids as it pertains to oral cancer
• Understand the basic treatment modalities used to treat oropharyngeal cancer
• Recognize the main complications associated with oropharyngeal cancer therapy
• Implement strategies to best manage the complications associated with oropharyngeal cancer therapy

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