DENTISTS ACROSS the State will open their practices to the public for free oral examinations in the autumn as part of a national drive to raise awareness about mouth cancer, the new president of the Irish Dental Association (IDA) has announced.
Speaking at the IDA’s annual conference in Cavan at the weekend, Dr Conor McAlister said mouth cancer was a growing issue that killed two people a week in the Republic – more than the number killed by cervical cancer and skin cancer – and yet it had a far lower profile.
“Mouth cancer is a highly lethal disease and is one of the most debilitating and disfiguring of all malignancies...Recently there has been an increase in the incidence among women and in younger men, particularly in respect of cancer of the tongue. Where previously the male-female incidence ratio was six to one, it is now less than three to one.”
Claire Healy, director of teaching at the Dublin Dental University Hospital, said the survival rate for mouth cancer was about 50 per cent, but the prognosis was far better if this cancer was detected early.
“Unfortunately we have not seen improvements in survival rates. They are much lower than for breast or prostate cancer.”
One of the key factors was patient delay in presenting for diagnosis, often because what are actually tumours or cancer may appear initially to be mouth ulcers or discoloration in the mouth.
Dentists, she said, were key to primary prevention as they had the opportunity to screen their patients, by examining their mouths and lips for persistent ulcers and lumps.
Paul Cashman, clinical lecturer at Eastman Dental Institute in the United States, gave a graphic address on the treatments for mouth cancer, in which he showed pictures of people who had to have parts of their jaws and even whole tongues removed and had to have faces rebuilt after cancerous tissues had been surgically removed from their mouths and skulls.
Dr McAlister said notwithstanding cutbacks to the medical card and PRSI dental schemes, people “must remember they are entitled to a free check up and should avail of that entitlement”.
The conference also heard from Bruce Matis at Indiana University School of Dentistry, an expert on tooth whitening.
He expressed concern at over-the-counter products used to bleach teeth at home.
He said “teenagers across the US are going wild bleaching their teeth every night”.
He said if a person over-bleached their teeth they would eventually go grey, and this was irreversible.
Dr McAlister said he would like to see tooth-whitening “clinics” regulated.
“If done correctly teeth whitening can be very effective,” he said.
“If done incorrectly there can be extreme tooth sensitivity. We would prefer this whole area was regulated.”
CASE STUDY: 'THEY TOOK BONE FROM MY LEG TO REBUILD MY FACE'
FIVE YEARS ago Lia Mills, from south Dublin, had what she thought was a mouth ulcer that “wouldn’t go away”. After about eight months she went to her GP, who was immediately unhappy with the persistent sore.
“I was sent straight to St James’s Hospital, where they did a biopsy, and by the time they came back with a diagnosis, they said it was a stage four tumour.
“I assumed there were about 10 stages when I asked how many there were. They said there were four. I said, ‘Oh flip, I’m in trouble now’.” She concedes that by this stage the ulcer was “very big”. She was “desperate to have the cancer out”, fearing it might spread to her eyes. She also feared losing all or part of her mouth. “I began to think of all the things you do with your mouth, that you never think about – speaking, tasting, inhaling, kissing, even smelling. The mouth is so important, so sensitive.”
She had part of her lower jaw, seven teeth, all the lymph nodes and some nerves in her neck removed. “They took bone from my leg to rebuild my face, along with some titanium too. I am the Bionic Woman,” she laughs.
“There were various complications which delayed radiotherapy, though I then had radiotherapy for two months.”
This got rid of the cancer, and she is now well. “One half of my face is very concave, and I have very little sensation in part of my face. I am quite a messy eater now as I can’t open my mouth very wide. People can be very curious. Kids especially are, but that’s okay. I am used to how I look and don’t even think about it any more.”
She wants people to be more aware of mouth cancer and to see their dentist immediately if they have lumps or sores in the mouths or on their lips that won’t go away.