8 role of profession in prevention of oral cancer 03 Lama K El Banna

1. The Role of Dental
The Role of DentalProfession in Detection and
Profession in Detection andPrevention of Oral Cancer
Prevention of Oral Cancer
Dr. Ahmed Salman
Al Shawi

2. 0At present, total prevention of cancer before its
occurrence is nearly impossible.
0 It can be prevented from causing rapid destruction
of tissues and death to the patient by early detection
and treatment.
0In other words, early detection and the use of control
methods can prevent mutilation of tissues and
metastasis of the disease, providing a greater chance
for survival and complete cure for the patient.

3. 0It is important for the health professionals to develop
awareness for the high degree of variability in the
appearance of oral cancer.
0 This applies that the main function of the dental
health worker is not that of a thorough diagnosis but
that of suspecting a lesion and consulting a
specialist.
0Recognition of the predisposing factors is of great
importance.

4. 0In case of oral cancer, take into consideration
illfitting dentures, broken teeth or teeth with
sharp edges, excessive use of tobacco, poor
diet and systemic diseases known to be
predisposing to cancer .

5. 0In case of suspecting lesion to be neoplastic, do not
hesitate in consultation, which may save a life.
0 The observation over a period of time may be
essential to detect changes in the size or character of
the suspected lesion.
0 Ulcers in the mouth of unclear cause and not
responding to indicated treatment should not be
neglected for long time.
0Do not apply local drug or medication and caustics
in particular to an ulcer with uncertain diagnosis.

6. 0The dentist can apply simple tests (in case of doubt)
to suspected lesions.
Cytodetection, exofoliative cytology and oral smears
provide the dentist another diagnostic measure.
It is estimated that 80% of the deaths from oral
cancer could prevented by early detection and
prompt adequate therapy .

7. Oral cytology or oral exofoliative cytology:
0Is the study of normal and abnormal desquamated
cells of the oral cavity.
0Cells may be scrapped from surfaces or aspirated
from natural fluid and examined special staining.

8. Toluidine blue test:
0Toluidine blue is an acidophilic metachromic nuclear
stain, which has an affinity for areas of carcinoma in
situ and invasive carcinoma but not for normal
mucosa .

9. Technique:
1. The patient is instructed to rinse with water. Excess
saliva is removed by suction.
2. A mucolytic agent, 1 % acetic acid is applied to the
mucosa with a cotton applicator.
3. Toluidine blue, 1 % is then applied with a cotton
applicator. The dye should cover the entire lesion and
clinically normal margins.

10. 4. Excess Toluidine blue is removed by rinsing with
water.
5. Lesions which retain the dye stain blue and are
classified as positive. Negative lesions do not retain
the dye.
6. Lesions which retain the stain should be biopsied.
Negative lesions should be followed clinically for
variable periods and restaining.