Oral cancer ranks in the top three of all cancers in India, which accounts for over thirty per cent of all cancers reported in the country and oral cancer control is quickly becoming a global health priority. Oral cancer screening is an examination performed by a dentist or doctor to look for signs of cancer or precancerous conditions in your mouth. The goal of oral cancer screening is to identify mouth cancer early, when there is a greater chance for a cure.
Position the patient so that he or she is comfortably sitting and is at your eye level. Inspect the face for asymmetry, swelling, discoloration or ulceration. The entire face should be examined with an external light source (overhead light or headlight) to evaluate for pigmented (red, brown, black), raised, ulcerated, or firm areas of the skin, including the hair bearing regions of the face and scalp. The facial bones, skeleton and soft tissue should be palpated particularly noting asymmetry or masses.
A thorough oral, head and neck cancer examination can easily be completed in less than 5 minutes. It primarily consists of inspection and palpation. Once good rapport has been established with the patient, the clinician is ready to begin the exam. It is important to explain to the patient exactly what you are doing before doing it. Not only will this help put the patient at ease, but it also gives you the opportunity to educate your patient about the signs and symptoms of oral, head and neck cancer and how to detect it at an early stage. It is important for clinicians to understand the complex systemic effects of malignancy on the body
For this portion of the exam patient positioning can vary. Dental patients tend to lie on their backs, while their dentist exams their oral cavity. Physicians, on the other hand, usually have their patients sit up straight and face them eye-to-eye during the exam. It is imperative that the mouth be examined with an external light source, which allows both hands free for bimanual palpation or to hold gauze or tongue blade(s) for improved visualization. If a hands free light source is not available, an assistant may provide invaluable help in visualization of difficult areas such as the posterolateral border of the tongue and floor of mouth. Before beginning this part of the examination, ask the patient to remove all dental appliances. When examining mucosal surfaces, it is important to gently dry those surfaces with a gauze or air syringe, so that color or texture changes will become more obvious. Multiple studies have consistently shown that the earliest manifestation of many oral and oropharyngeal squamous cell cancers is a persistent erythroplastic lesion (3). Clinicians must therefore be on the lookout for both red and white (leukoplakia) lesions on the oral mucosa, as well as detection through palpation of indurated and fixated masses with in the tissues.