Methods of Screening

1. Visual Examination:Dentists and healthcare providers visually inspect the mouth, including the lips, tongue, cheeks, floor, and roof of the mouth, and the throat for any abnormalities such as red or white patches, sores, or lumps.

2. Palpation:The healthcare provider feels for lumps or irregularities in the oral tissues, including the lymph nodes in the neck.

3. Toluidine Blue Staining:This involves applying a special dye to the oral mucosa. Areas that retain the dye may indicate abnormal cells.

4. Brush Biopsy:A special brush is used to collect cells from suspicious areas. This method is non-invasive and helps in identifying dysplastic or cancerous cells.

5. Fluorescence Visualization:Special lights are used to examine the mouth. Normal tissue reflects the light in a specific way, while abnormal tissue appears darker or shows fluorescence.

6. ViziLite, VELscope, and Identafi:These are adjunctive devices that use different light sources to detect abnormalities in the oral tissues.

Biopsy

When an abnormal area is identified during screening, a biopsy is often performed to obtain a definitive diagnosis.

Types of Biopsies

1. Excisional Biopsy:
   • The entire suspicious area is removed. This method is often used for small lesions.
2. Incisional Biopsy:
   • Only a part of the suspicious area is removed for analysis. This is typically used for larger lesions.
3. Fine Needle Aspiration (FNA):
   • A thin needle is used to extract cells from a lump or mass for examination.
4. Punch Biopsy:
   • A circular blade is used to remove a small core of tissue from the suspicious area.

Procedure

1. Preparation:
   • The area to be biopsied is cleaned and numbed with a local anesthetic.
2. Tissue Removal:
   • Depending on the type of biopsy, a small piece of tissue or cells is removed from the suspicious area.
3. Handling and Analysis:
   • The tissue sample is preserved in a fixative solution and sent to a pathology lab.
   • A pathologist examines the tissue under a microscope to identify any abnormal, pre-cancerous, or cancerous cells.

Post-Biopsy Care

1. Wound Care:
   • Patients are advised on how to care for the biopsy site to prevent infection and promote healing.
2. Pain Management:
   • Over-the-counter pain relievers or prescribed medications may be recommended.
3. Follow-Up:
   • Results from the biopsy typically take a few days to a week. A follow-up appointment is scheduled to discuss the results and any further steps, if necessary.

Importance of Screening and Biopsy

• Early Detection:
  • Identifies oral cancer at an early stage when it is more treatable.
• Prevention:
  • Detects pre-cancerous conditions, allowing for early intervention to prevent progression to cancer.
• Improved Outcomes:
  • Early treatment of detected abnormalities often leads to better treatment outcomes and higher survival rates.

Regular oral examinations and prompt biopsies of suspicious areas are vital components of oral health care, contributing significantly to the prevention and early detection of oral cancer.