Oral screening involves an assessment of the patient’s risk factors, a thorough examination of the head and neck area and all the tissues of the mouth. Clinicians look and palpate for any colour or texture changes.

Oral cancer screening will aid in the early identification of lesions potentially at risk for oral precancer and cancer as well as lesions that may be signs of other mucosal diseases or systemic diseases. Lesions can then be biopsied or referred for biopsy for an actual diagnosis. 
Oral cancer found early has a much better prognosis than late stage oral cancer. 

Lesions found while at the precancerous stage (dysplasia) may further improve survival rates.

Oral cancer screening takes less than 2 minutes.

At present, our consensus recommendation is to offer this annually to all individuals from age 40.

There is no upper age limit. Oral cancer is a disease of the soft tissues not the teeth so all individuals regardless of whether they have their natural teeth or not should be screened regularly for oral cancer.

Approximately 3200 Canadians will be diagnosed with oral cancer this year and many more will be diagnosed with dysplasia (precancer).

There were more oral cancer cases diagnosed in BC in 2003 than cervical, ovary, testicular, brain, Hodgkin's lymphoma, kidney and multiple myeloma to name a few.

• Age (the risk increases as we get older)
  
• Tobacco (smoked or chewed)
  
• Alcohol (more than 2-3 drinks/day)
  
• The use of tobacco AND alcohol greatly increases a person’s risk of oral cancer
  
• Paan, betel quid
  
• Previous head and neck cancer or precancer
  
• Immunosuppression (medications, previously diagnosed disease)
  
• Ultraviolet light (sun damage) (lips, perioral)
  

A normal oral cancer screening requires no further follow-up. 

Document that a screening was completed. 

Patients with a normal screening will be followed up annually.

What does it mean? If an abnormality is found it does not mean your patient has oral cancer. 

Only a small number of people with abnormal screens will be found to have oral cancer. 

It does mean, however, that further investigation is needed to rule out oral precancer and cancer. 

Further investigation may include a biopsy of the area in question.

It can be difficult to introduce new procedures to our patients. Keep it as simple as possible. Tobacco and alcohol use is a risk factor for not only oral cancer and both can be contributing factors towards periodontal disease and other oral conditions. 

An extraoral exam can be explained as a "quick lumps and bumps" check.

There are two sources of toluidine blue that we are aware to date. One is marketed by Zila Pharmaceuticals in Canada, and by ViziLite R Plus in the United States. The second is a generic version (Mashberg, 1983) prepared either in the research lab or through a local pharmacy.