Efficacy of the ViziLite System in the identification of oral lesions

Source: Sciencedirect Author: Esther S. Oh DDS and Daniel M. Laskin DDS, MS Purpose Early detection of oral cancer is crucial in improving survival rate. To improve early detection, the use of a dilute acetic acid rinse and observation under a chemiluminescent light (ViziLite; Zila Pharmaceuticals, Phoenix, AZ) has been recommended. However, to date, the contributions of the individual components of the system have not been studied. The present study was done to investigate the efficacy of the individual components of the ViziLite system in providing improved visualization of early oral mucosal lesions. Patients and Methods A total of 100 patients, 39 males and 61 females, age 18 to 93 years (mean age, 44 years), who presented to the Virginia Commonwealth University School of Dentistry for dental screening were examined. There were 58 Caucasians, 29 African-Americans, 5 Hispanics, 6 Asians, and 2 of mixed ethnicity. Thirty-five patients smoked, 53 used alcohol, and 25 both smoked and drank. After written consent, the oral cavity was examined under incandescent light for soft tissue abnormalities. After 1-minute rinse with 1% acetic acid, the mouth was re-examined for additional mucosal abnormalities. Then, the mouth was examined once again using the ViziLite system’s chemiluminescent light. Any lesions detected by these 3 examinations that were clinically undiagnosable were brush biopsied (Oral CDx) for determination of cellular representation. Results In the original examination of the 100 patients, 57 clinically diagnosable benign lesions (eg, linea alba, leukoedema) and 29 clinically undiagnosable lesions were detected. After the rinse, 6 [...]

2010-03-01T18:45:46-07:00February, 2010|Oral Cancer News|

Dentists your first defence in fight against oral cancer

Source: Timescolonist Author: Johnathan Skuba In 2003, an estimated 3,100 Canadians were newly diagnosed with oral cancer. That same year, 1,090 people died of the disease. In the U.S., oral cancer kills roughly one person per hour, 24 hours a day. Of those newly diagnosed, only half will survive five years later, and this terrifying death rate has not declined for decades. Those statistics are frightening, but the good news is that early detection plays a major role in preventing or curing oral cancers. The first line of defence is the dentist. They are specifically trained to recognize even subtle changes in the mouth and take action. Pre-malignant lesions usually manifest as white patches (leukoplakias) that can look like small calluses. They could be benign and nothing but skin thickened by trauma or normal wear and tear of oral tissues. Of greater concern are spots that become ulcers, bleed, rapidly change appearance or that are obviously getting larger. Red patches (erythroplakia) should also be examined as they too could represent cancerous tissue. If any such spots are present and either enlarge or don't improve within 10-14 days, or if they disappear and then recur, patients are advised to see their dentists as soon as possible. Once in the chair, patients will find that dentists do not take chances, especially when the spots appear in areas where normal trauma is unlikely, such as the soft palate of the mouth or under the tongue. When such spots are seen, and particularly when [...]

2009-11-09T12:23:32-07:00November, 2009|OCF In The News, Oral Cancer News|

Autofluorescence-guided surveillance for oral cancer

Source: cancerpreventionresearch.aacrjournals.org Authors: Vijayvel Jayaprakash et al. Early detection of oral premalignant lesions (OPL) and oral cancers (OC) is critical for improved survival. We evaluated if the addition of autofluorescence visualization (AFV) to conventional white-light examination (WLE) improved the ability to detect OPLs/OCs. Sixty high-risk patients, with suspicious oral lesions or recently diagnosed untreated OPLs/OCs, underwent sequential surveillance with WLE and AFV. Biopsies were obtained from all suspicious areas identified on both examinations (n = 189) and one normal-looking control area per person (n = 60). Sensitivity, specificity, and predictive values were calculated for WLE, AFV, and WLE + AFV. Estimates were calculated separately for lesions classified by histopathologic grades as low-grade lesions, high-grade lesions (HGL), and OCs. Sequential surveillance with WLE + AFV provided a greater sensitivity than WLE in detecting low-grade lesions (75% versus 44%), HGLs (100% versus 71%), and OCs (100% versus 80%). The specificity in detecting OPLs/OCs decreased from 70% with WLE to 38% with WLE + AFV. Thirteen of the 76 additional biopsies (17%) obtained based on AFV findings were HGLs/OCs. Five patients (8%) were diagnosed with a HGL/OC only because of the addition of AFV to WLE. In seven patients, additional HGL/OC foci or wider OC margins were detected on AFV. Additionally, AFV aided in the detection of metachronous HGL/OC in 6 of 26 patients (23%) with a history of previously treated head and neck cancer. Overall, the addition of AFV to WLE improved the ability to detect HGLs/OCs. In spite of the lower [...]

2009-11-05T13:17:24-07:00November, 2009|Oral Cancer News|

Assessing oral cancer early detection: clarifying dentists’ practices

Source: J Public Health Dent, September 17, 2009 Authors: Charles W Lehew, Joel B Epstein, Linda M Kaste, and Young-Ku Choi Abstract Objective: This study explores new methods for assessing in greater detail what dentists do when they perform oral cancer early detection examinations. It clarifies practice behaviors and opens opportunities to identify factors that facilitate thorough early detection examinations by clinicians and to assess the relative effectiveness of different examination procedures. Methods: A 38-item survey instrument was e-mailed to dentists in a western US, multistate dental practice group. Questionnaires were received by 241 dentists, and 102 responded. An Oral Cancer Knowledge scale (0 to 14) was generated from correct responses on oral cancer general knowledge. An Oral Cancer Examination Thoroughness scale was calculated from the two dimensions of reported usage and frequency of procedures in oral cancer examinations. Results: Nearly all responding dentists were in general practice (90%), with a median year of graduation from dental school of 1994. The Oral Cancer Knowledge scores ranged from 5 to 14 with a mean of 10.4. The mean Thoroughness of Examination score was 11.34 (range 0 to 20). The two scales were not statistically correlated (r = -0.015, P = 0.883). Statistically, recency of continuing education was significantly associated with knowledge (P = 0.0284) and appears to be marginally associated with thoroughness (P = 0.075). Conclusions: This study documents considerable variability in dentists' knowledge and thoroughness of examinations. The scales provide tools for future studies for improving understanding of early detection [...]

In push for cancer screening, limited benefits

Source: nytimes.com Author: Natasha Singer "Don’t forget to check your neck,” says an advertising campaign encouraging people to visit doctors for exams to detect thyroid cancer. In another cancer awareness effort, Representative Debbie Wasserman Schultz, a Florida Democrat, has more than 350 House co-sponsors for her bill to promote the early detection of breast cancer in young women, teaching them about screening methods like self-exams and genetic testing. Meanwhile, the foundation of the American Urological Association has a prostate cancer awareness campaign starring Hall of Fame football players. “Get screened,” Len Dawson, a former Kansas City Chiefs quarterback, says in a public service television spot. “Don’t let prostate cancer take you out of the game.” Nearly every body part susceptible to cancer now has an advocacy group, politician or athlete with a public awareness campaign to promote routine screening tests — even though it is well established that many of these exams offer little benefit for the general public. An upshot of the decades-long war on cancer is the popular belief that healthy people should regularly examine their bodies or undergo screening because early detection saves lives. But in fact, except for a few types of cancer, routine screening has not been proven to reduce the death toll from cancer for people without specific symptoms or risk factors — like a breast lump or a family history of cancer — and could even lead to harm, many experts on health say. That is why the continued rollout of screening campaigns, [...]

Early detection is the key

Source: Newstime.com Author: Sandra Diamond Fox Standing before nearly 500 graduates of New York University's School of Dentistry at Madison Square Garden in Manhattan last month, two-time Emmy Award nominee Colleen Zenk Pinter stepped forward to accept the Dr. Harry Strusser Memorial Award for public service. While Pinter, 56, was accustomed to being on stage -- for more than 30 years she played the character of Barbara Ryan on CBS' "As The World Turns" -- speaking at NYU's graduation held very special meaning for her. She was being honored for her work in bringing awareness to oral cancer. Little more than two years ago, the Redding resident for 23 years and mother of six received the news that would change her life -- she was diagnosed with stage 2 squamous cell carcinoma of the ventral tongue. Oral cancer. Pinter's nightmare began in 2005 when she noticed a change in her speech. After an examination, her dentist said it was the result of her teeth shifting, which can sometimes occur after age 50. The following summer, when she developed a painful cold sore under her tongue, an oral surgeon eventually diagnosed it as a bacterial and fungal infection. Once the infection was treated, however, a tumor was discovered underneath it. Pinter started researching oral cancer. "I was in shock," she said. "I didn't fit the profile of people who had this type of cancer." Up until recently, oral cancer was often referred to as "the old man's cancer," and was mostly contracted by [...]

2009-06-19T09:56:13-07:00June, 2009|Oral Cancer News|

Early oral cancer detection: Why you? Why now?

Source: www.rdhmag.com Author: Jonathan A. Bregman, DDS, FAGD What motivates any of us as dental health-care providers? Specifically, what motivates us to do a complete early oral cancer screening? As I travel around the country discussing the topic of early oral cancer detection, four key motivators stand out. 1. Malpractice risk Are you familiar with these malpractice facts? - Lack of diagnosis or delayed diagnosis of oral cancer is the No. 2 reason for malpractice claims in the U.S. -The average claim is settled for approximately 1 million ? yes 1 million ? dollars - The average age of claimants is early 40s - It is the hardest suit to defend Did that get your attention? I hope so! Why do so many dentists lose these lawsuits, with some dentists literally now unable to purchase malpractice insurance at all? The answer is simple: The lack of a complete and properly recorded early oral cancer screening examination. Maybe this could be your motivator to incorporate an early oral cancer screening system into your office. 2. The right way to practice dentistry In dentistry, as with all professions, the terms "best practice" or "excellence in service/care" are very broad. How dentistry is performed on a daily basis is up to the individual practitioner and his/her dental team. Also, included in the mix is the number of "unique" or "different" procedures performed in the office. Thus, defining excellent care or "the right way to practice dentistry" varies. A complete early oral cancer screening may [...]

Perceptronix Reports Clinical Study Underway to Evaluate OralAdvance(TM) for Early Detection of Oral Cancer

Source: www.earthtimes.org Author: press release Perceptronix Medical Inc. announces that a clinical study of OralAdvance(TM), a test for the early detection of oral cancer, is now underway. The clinical study will assess the performance of OralAdvance(TM) compared to the gold standard biopsy and histology for its ability to differentiate between visually suspicious oral lesions with cancer or pre-cancer and visually suspicious benign oral lesions. "Unlike many other types of cancer, the incidence and mortality rates of oral cancer have not shown significant improvement over the past 30 years. By the time most oral cancers are diagnosed, they are already symptomatic late-stage disease. At Perceptronix we are dedicated to changing this paradigm towards early detection for better patient outcomes," says Dr. Bojana Turic, President and CEO of Perceptronix. Patients for the blinded study will be recruited from the BC Cancer Agency's Vancouver and Fraser Valley Centres. "We are pleased to be able to participate in the evaluation of the test in a clinical setting with technology that was developed in partnership with scientists at the BC Cancer Agency's Research Centre, and we are hopeful that the test will have a positive impact on the early detection of oral cancer," says Dr. Allan Hovan (Provincial Professional Practice Leader, Program in Oral Oncology/Dentistry, BC Cancer Agency). Currently, the death rate for oral cancer is higher than that of cervical cancer, Hodgkin's disease, cancer of the brain, liver, testes, kidney, or malignant melanoma. High death rate associated with oral cancer could be reduced significantly [...]

The oral cancer battle

Source: www.ladowntownnews.com Author: Beth Dunham As people look for ways to cut corners and save money in this time of economic uncertainty, healthcare sometimes takes a back seat to other expenses — putting lives at risk. A visit to the dentist is crucial and could mean the difference between life and death; someone in the United States dies of oral cancer nearly every hour, according to the Oral Cancer Foundation. Early detection is crucial in the fight against oral cancer, an aggressive, deadly disease that hasn’t seen the same improvements in survival rates as other cancers, said Parish Sedghizadeh of the USC School of Dentistry. “Oral cancer has one of the highest mortality rates among cancers,” said Sedghizadeh, assistant professor of clinical dentistry at USC. “It’s usually not noticed until the later stages, when a recovery is less likely. People have heard of oral cancer, but they don’t know what it looks like.” The disease rarely causes pain or other noticeable symptoms until it reaches a very advanced stage, he said. And while many people stay vigilant for the symptoms of more common cancers, dental care access challenges and a lack of oral cancer education means that most patients don’t know the early signs of oral cancer. “Oral cancer will often start as a small red or white plaque or sore that doesn’t go away with time, unlike other normal mouth, tongue, or lip sores that usually heal within a week or so,” Sedghizadeh said. Even if the disease is [...]

Diagnostic aids in the screening of oral cancer

Source: Head Neck Oncol, January 1, 2009; 1(1): 5 Author: S Fedele The World Health Organization has clearly indentified prevention and early detection as major objectives in the control of the oral cancer burden worldwide. At the present time, screening of oral cancer and its pre-invasive intra-epithelial stages, as well as its early detection, is still largely based on visual examination of the mouth. There is strong available evidence to suggest that visual inspection of the oral mucosa is effective in reducing mortality from oral cancer in individuals exposed to risk factors. Simple visual examination, however, is well known to be limited by subjective interpretation and by the potential, albeit rare, occurrence of dysplasia and early OSCC within areas of normal-looking oral mucosa. As a consequence, adjunctive techniques have been suggested to increase our ability to differentiate between benign abnormalities and dysplastic/malignant changes as well as to identify areas of dysplasia/early OSCC that are not visible to naked eye. These include the use of toluidine blue, brush biopsy, chemiluminescence and tissue autofluorescence. The present paper reviews the evidence supporting the efficacy of the aforementioned techniques in improving the identification of dysplastic/malignant changes of the oral mucosa. We conclude that available studies have shown promising results, but strong evidence to support the use of oral cancer diagnostic aids is still lacking. Further research with clear objectives, well-defined population cohorts, and sound methodology is strongly required. Author's affiliation: Oral Medicine Unit, Division of Maxillofacial, Diagnostic, Medical and Surgical Sciences, UCL Eastman Dental [...]

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