Would you describe what an oral screening is and what you are looking for?
Dr. Darren McKeever: Well, usually when we refer to an oral screening other than a typical clinical dental examination, we’re talking about reviewing the mouth for diseases and pathologies that are a lot more significant and serious than just decay or gum disease. The number one target we’re always looking for, always on watch, trying to find and hopefully we never find it, is oral cancer. And that’s usually what we’re talking about when we refer to oral screenings.
What type of oral cancers are there?
Dr. Darren McKeever: Well, in my opinion, there’s only one type of oral cancer – bad cancer. Regardless of the different types of cancers that are out there, none of them are good and they all have to be eradicated. They all need to be treated. None of them should ever be watched or “Let’s keep an eye on that” so they all fall into the same category as far as I’m concerned. Try to never, ever find one. Always look for them but if you do fine one, you can’t sit on it. You have to have treatment and they all need to be removed.
Is oral cancer treatable if caught in the early stages?
Dr. Darren McKeever: That is one of the most important questions probably of all. Oral cancer, if caught early enough, is one of the most easily eradicated cancers that is out there. You remove it. If it’s small enough, it’s gone for good usually. Obviously, we have to monitor. Sometimes you’re not sure if it’s all been eradicated. There’s always a chance that it might be a little bigger than we think and it could have metastasized into other areas. It could have been transmitted into the lymph nodes but if you find it early, you remove it. It’s pretty much gone for good.
Who is greatest at risk for developing oral cancer? What are some risk factors?
Dr. Darren McKeever: Well more often than not, we think anything associated with tobacco usage but there are other reasons why people get oral cancer but the most common is tobacco usage. Any kind of tobacco usage. Cigarette smoking, cigar smoking, pipe smoking or even smokeless tobacco are all situations that can promote cancers in the mouth. Smokeless tobacco being the one that everyone thinks is the most innocent but it causes issues for the tissues that can make the tissue start to transform and if the tissue (the soft tissues) in the mouth transform into a different type of tissue, they’re only a step away from becoming a potential malignancy.
Another thing that can actually cause oral cancer, from what we’re seeing in the research is people who clench their teeth because the soft tissues (as they press up repeatedly over the years against the teeth) start to form something analogous to a callus and that callus is a different type of tissue in the mouth. Now if that callus is allowed to last long enough because people don’t prevent the clenching that they’re doing, it can become what’s called a ‘dysplasia’. Dysplasias are very similar to what a gynecologist would be looking for periodically with a pap smear and a dysplasia is only a half a step away from becoming a cancer. That’s a much less rare condition than the tobacco usage but usually the biggest risk factors that we see in dentistry is anything associated with tobacco.
Is an oral screening conducted during every routine cleaning visit?
Dr. Darren McKeever: Well, in my office it is! And in my opinion, it should be throughout the nation. More often than not, we’re always looking for it and we’re making note of it to the patient that we’re looking for it. Some people don’t like to hear that because they like to keep their head in the sand but even if I don’t mention to the patient, “I’m going to check you now to make sure there’s nothing in there that could kill you,” we’re doing it constantly. My original training is with the Veteran’s Administration and unfortunately that population has a lot higher exposure to cancer treatments for some reason so from day one that I started in private practice, I’ve always been looking for it and I still pray that I never find it.
If you are interested in speaking with Dr. Darren McKeever, visit www.mckeeverdentalcare.com or call 973-839-8180 to schedule an appointment.