April is Oral Cancer Awareness Month, and according to the Oral Cancer Foundation, 49,750 Americans will be diagnosed with oral cancer this year. Because most are found in late stages, oral cancer will cause over 9,750 deaths, killing roughly one person per hour, 24 hours per day.
Smoking cigarettes and chewing tobacco are certainly risk factors for oral cancer, but evidence indicates the human papillomavirus, or HPV, is causing the fastest growing segment of the oral cancer population, people in the 25-50-year-old range. This is the same virus that is thought to be responsible for cervical cancer.
HPV is the virus that also causes the common wart, but before you panic, be aware there are over 200 strains of HPV, and only a few are known to cause cancer. Some strains are harmless, such as warts that occur on the hands, arms and other areas of the skin. The HPV strains responsible for oral cancer are known to be sexually transmitted.
In the mouth the HPV appears flat and nearly invisible, making identification difficult. There is a saliva test available to dentists that can determine if HPV is present; however, currently there is no cure for the virus.
In all my years of practice I have treated thousands of patients and only witnessed three cases of oral cancer. Unfortunately, all three looked entirely different. Dentists are trained to be suspicious of any white, red or black lesion, but none of my patients had cancer’s classical appearance. One patient had a swelling in the back of the mouth, another had multiple holes in the gums around the teeth and the third had bleeding gums that resembled gingivitis.
I also have had many patients with white, red and black lesions that were biopsied and came back benign. So identifying cancer is not possible with just a visual exam. If you try to do a self-exam, pull back your cheeks and look around your mouth for any red or white patches. Check the gums, cheek and floor of the mouth. It doesn’t hurt to check the tongue, although that is not a frequent place for cancer. If you see a suspicious lesion, give it time to resolve before seeing a dentist. Most benign oral lesions take two weeks to go away. A cancer evaluation of your gums and mouth should be part of every dental visit.