What You Don’t See Will Hurt You... and Your Patients!

By L. Don Wilson, DDS

Every hour in our country a patient dies of oral cancer! Oral cancer is increasing at the rate of 11% annually. The death rate from oral cancer is now higher than cancers like cervical, thyroid, Hodgkin’s lymphoma, testicular, laryngeal, or malignant melanoma. Over 5,000 men and more than 2,000 women die each year of oral cancer primarily due to late diagnosis. More physicians diagnose oral cancer than do dentists, and we should certainly be the frontline of defense against oral cancer.

Over 40% of patients diagnosed with oral cancer have a non-contributory history–they don’t smoke or use smokeless tobacco, and they do not drink alcohol in excess. There is a 500% increase of oral cancer among young people due to the sexual transmission of HPV 16 and 18 (Human Papilloma Virus).

Unfortunately, 62% of the cases of oral cancer diagnosed are Stage III or Stage IV with a poor prognosis. With early detection, there can be an 80 to 90% survival rate; however, the disease is not always apparent in the early stages. There has been little improvement in the survival rate over the past 40 years.

Thanks to such technology as the Identafi® Oral Cancer Screening System with its “multispectral” imaging technology (triple-wavelength spectroscopy), better patient care and early detection are possible! The device’s violet wavelength is the best excitation wavelength to discriminate between neoplastic and non-neoplastic tissue areas.

With early detection, there can be an 80 to 90% survival rate; however, the disease is not always apparent in the early stages.

White Light Hard Palate

The Identafi uses white, green-amber, and violet wavelengths of light to differentiate between normal and abnormal tissue.

First, the 12 areas of the oral cavity are observed with the concentrated white light to provide a conventional look at the tissue. Next, the same areas are observed with the violet wavelength which enhances the tissue’s natural fluorescence. The clinician wears filtered glasses that block the violet excitation light and allows the observation of the tissue’s natural florescence.

Violet Light Hard Palate

Suspect tissue appears dark because of it’s loss of florescence. Third, when suspect tissue areas are detected with the violet wavelength, the green-amber wavelength is used because it enhances normal tissue’s reflectance properties. The clinician can observe the difference between normal and abnormal tissue vasculature. Normal tissue has a more defined vascular appearance while abnormal tissue has a more diffuse vascular appearance.

Green-Amber Light Hard Palate

This can minimize false positives and decrease the number of biopsies performed. In reality, only 10% of the noted areas actually have something that is of concern. In this case the vasculature did not look diffuse; however, because of a history of smoking, a biopsy was done anyway. The results of the biopsy showed the lesion was benign.

In the first six months of implementing the Identafi into my practice, we diagnosed two cases of squamous cell cancer, two of pre-cancerous lesions, and a benign, but very serious, jugular glomerulus. If this enhanced oral cancer screening device saved just one life, it would be well worth the investment.

Watch Dr. Wilson complete an actual oral cancer screening with the Identafi by visiting www.identafi.net and clicking “New Training Video”.