Dentists have an advantage because with our dental chairs and lights, we can see more of the oral cavity than most other health care professionals. Dentists have an opportunity to educate patients about HPV and to play a role in prevention and early detection of oropharynx cancer. “Because HPV is sexually transmitted, it might be a challenge at first for dentists to have conversations with patients about it,” Dr. Samim says. “I encourage dentists to include sexual activity as part of their medical history questionnaires.” Oral cancers sometimes present with pain, but not always. “Look for ulcers, redness, changes in tissue, tissue that looks different from adjacent tissue. Tissue that has red or white areas is especially concerning,” says Dr. Samim. If patients are experiencing oral pain, joint pain, sore throat, voice change, or difficulty in swallowing, these are all possible symptoms of oropharyngeal cancer. Dr. Samim adds that it is extremely important to examine the lymph nodes as part of a head and neck examination because large lymph nodes are an indicator of late-stage oropharyngeal cancer. “If anything strikes you as unusual, refer your patient to an oral and maxillofacial pathologist or an ear, nose, and throat (ENT) specialist who can do a biopsy,” she says. “Don’t wait. Early detection makes a huge difference.” To date, HPV vaccines have not been proven to prevent oropharyngeal cancer, but Dr. Samim would encourage patients to get HPV vaccines. The Centers for Disease Control and Prevention (CDC) says that the use of barrier contraceptives, such as condoms and dental dams, during oral sex reduces the risk of developing oropharynx cancers. HPV-related oropharyngeal cancer has a bimodal age pattern, occurring most often in young men and men in their 60s. It is more common among white people of high socioeconomic status. “Though a few years ago, we also noticed an increase in oral cancers among women between age 30 and 40, who had no risk factors, so I believe that screening everyone for oropharynx cancer is important,” Dr. Samim says. A comprehensive clinical examination of the oral cavity is an essential screening method. “Dentists have an advantage because with our dental chairs and lights, we can see more of the oral cavity than most other health care professionals,” says Dr. Samim. Watch Dr. Samim’s conversation on CDA Oasis: bit.ly/3SnU45e 23 Issue 1 | 2024 | Issues and People
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