1. 1 Detecting Oral Cancer A guide for health care professionals U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES NATIONAL INSTITUTES OF HEALTH National Institute of Dental and Craniofacial Research

2. 2 Incidence and Survival of Oral or Pharyngeal Cancer 30,000 new cases diagnosed yearly 8,000 deaths each year 5 year survival rate: 50%

3. 3 Early Detection Saves Lives 5-year survival for localized disease is 76% 5-year survival for metastatic disease is 19%

4. 4 Early Detection is Often Possible Tissue changes in the mouth that may signal cancer can often be seen and felt easily

5. 5 Warning Signs Leukoplakia Erythroplakia

6. 6 Other Possible Warning Signs Lump or thickening of oral soft tissue Soreness or “lump” in throat Difficulty chewing or swallowing Ear pain Difficulty moving jaw or tongue Hoarseness Numbness of tongue or mouth Swelling of the jaw

7. 7 Risk Factors Tobacco use Alcohol use Exposure to sunlight Age Gender Race

8. 8 Examination Overview Head and neck exam should be a routine part of dental and medical check-ups. Take a history of alcohol and tobacco use. Follow up on suspicious signs.

9. 9 Tools and Time Proper lighting Dental mouth mirror Gauze squares Gloves 5 minutes

10. 10 Extraoral Examination

11. 11 Perioral and Intraoral Soft Tissue Examination: Lips

12. 12 Perioral and Intraoral Soft Tissue Examination: Labial Mucosa

13. 13 Perioral and Intraoral Soft Tissue Examination: Labial Mucosa

14. 14 Perioral and Intraoral Soft Tissue Examination: Buccal Mucosa

15. 15 Perioral and Intraoral Soft Tissue Examination: Buccal Mucosa

16. 16 Perioral and Intraoral Soft Tissue Examination: Gingiva

17. 17 Perioral and Intraoral Soft Tissue Examination: Dorsum of the Tongue

18. 18 Perioral and Intraoral Soft Tissue Examination: Left Margin of the Tongue

19. 19 Perioral and Intraoral Soft Tissue Examination: Right Margin of the Tongue

20. 20 Perioral and Intraoral Soft Tissue Examination: Ventral Surface of the Tongue

21. 21 Perioral and Intraoral Soft Tissue Examination: Floor of the Mouth

22. 22 Perioral and Intraoral Soft Tissue Examination: Hard Palate

23. 23 Perioral and Intraoral Soft Tissue Examination: Oropharynx

24. 24 Perioral and Intraoral Soft Tissue Examination

25. 25 Oral Lesions Suspicious for Oral Cancer Homogenous leukoplakia Leukoplakia with early squamous cell carcinoma Nodular leukoplakia with severe epithelial dysplasia Erythroleukoplakia with candida infection

26. 26 Homogenous Leukoplakia

27. 27 Leukoplakia with early squamous cell carcinoma

28. 28 Nodular leukoplakia with severe epithelial dysplasia

29. 29 Erythroleukoplakia with candida infection

30. 30 In Appreciation Slides for this program were graciously provided by Joseph Konzelman, D.D.S. and Jens Jorgen Pindborg, Dr. Odont.

31. 31 Detecting Oral Cancer: A Guide for Health Care Professionals was developed by the National Institute of Dental and Craniofacial Research, one of the federal National Institutes of Health. The program is not copyrighted and may be reproduced. For additional information about oral cancer, contact: National Institute of Dental and Craniofacial Research National Oral Health Information Clearinghouse 1 NOHIC Way Bethesda, MD 20892-3500 nohic@nidcr.nih.gov www.nidcr.nih.gov