Becoming Comfortable with the Uncomfortable

We all need to start somewhere. Think of the first time you put a mirror and explorer into your hands- uncomfortable right? I am going to start with a few stories where I am certain you can relate, followed by a challenge to become comfortable when discussing HPV, a known risk for oral pharyngeal cancer. My son, like many children, was always trying to one-up us. Kids love to do that to their parents. When he was about 11, we were sitting at the dinner table, where we often discussed the ...
Read More

What Our Patients Should Know About Oral Cancer & HPV

There are over 100 types of Human Papillomavirus (HPV), and more than 42 million Americans are infected with types of HPV that cause disease. The CDC says nearly everyone will get a form of HPV at some point in their lives, and about 13 million Americans, including teens, become infected each year1. There are strains of HPV that are more virulent than others which divides HPV into 2 main groups: Low-risk HPV types such as 6, 11, 42, 43, and 44 have a reduced association with cancer but can ...
Read More

The Co-management of an Esophageal Cancer Survivor

Background: The patient is a 75-year-old female with a history of esophageal cancer in 2013. The origin of the cancer was determined to be lichen planus. Surgical removal of the lesion occurred, and no reconstructive surgery was needed. However, post-surgery to present date, the patient experiences severe acid reflux and sleeps with her head elevated. She has great home dental care and follows a 3-month periodontal maintenance. During the head and neck exam, no significant findings were disc...
Read More

Salivary Diagnostics for Gum Disease and Oral Cancer Risk Assessment

Clinical laboratory testing is a common practice for the medical professional. DNA testing, including genetic testing, has led to healthier patients. Cross over to dentistry, and let’s review 2 examples of what’s available. Presently, in my office, we perform MyPerioID® IL-6, a test for the genetic marker interleukin 6 (IL-6) to screen for genetic risk of periodontal disease and a viral DNA test for the human papilloma virus (HPV) to screen for risk of oral cancer.  The collection is relativ...
Read More

Do You Speak HPV? Part 3

In my previous blog, I explored three common positive responses I’ve encountered from patients when offering a test for oral HPV and how I would respond to them.  In this blog, I will address some of the objections from patients and how I would further educate the patient about oral HPV and testing options. Patient 1: I don’t think I need that test.  I’ve never been exposed. Response 1: I understand but in case you’re ever curious, remember we have this potentially life-saving service ...
Read More

Do You Speak HPV? Part 2

Dental clinicians have been on the front lines of oral cancer prevention and early detection for many years. We have been trained to do very thorough oral cancer exams and to use various light systems to visualize tissue changes; however, according to the Oral Cancer Foundation, the death rate for oral cancers has remained higher than that of many other types of cancers which we hear about routinely.1 Many studies support that the human papilloma virus (HPV) is responsible for a large number...
Read More

Do You Speak HPV? Part 1

Dental professionals are often uncomfortable approaching patients on topics that are unfamiliar or that feel outside the realm of “traditional” dentistry.  One such topic is Human papillomavirus (HPV).  As a hygienist of 40 plus years, I can tell you this topic never came up in my education.  Several years ago, I had to educate myself about this near epidemic viral infection. Most importantly, I had to step out of my comfort zone to find a way to share this crucial knowledge with my patients...
Read More

Rethinking the Dental Examination

It’s 2018 and I am dumbfounded by the number of adult new patient appointments that begin in the hygiene chair. We all recognize this is an ‘old school’ practice, but maybe we still secretly believe it’s the right thing to do for our patient. Maybe we somehow believe it’s financially beneficial to the practice. Neither of these could be further from the truth. The dental examination of today is all about the patient of today. From a health standpoint, the patient of today is more complica...
Read More

Oral HPV Awareness Campaign: Part 2

Currently about 72% of all OPCs (Oropharyngeal Cancers) are the results of an oncogenic HPV infection—and very few of these cancers are found in the front of the mouth. HPV-Oral Pharyngeal Cancer (HPV-OPC) develops at the deep base of the tongue or behind of the curtains of the tonsillar pillars. Sadly, there is no effective screening method for early cancer detection. While we fumble with the words to say and the warnings to issue, we are literally watching the HPV epidemic unfold before...
Read More

Oral HPV Awareness Campaign: Part 1

As a Total Health Dental Practice, there was one particular oral disease my team was not comfortable discussing—even though it is deadly and its epidemic has escalated to horrific proportions. You guessed it…HPV-related Oral Pharyngeal Cancer (OPC). Don’t get me wrong; our responsibility to complete our 9-point screen for oral cancer is routinely completed. But we knew the screening exam—was completely ineffective in screening for the risk of HPV-OPC. In brainstorming about our weakness, ...
Read More