“In dentistry, oral cancer has always been a serious concern,” says Dr. Alastair Nicoll, President of the British Columbia Dental Association. “But it has not really been on the radar screen of Canadians.” Most oral cancers begin in the cells on the surface of the tissue of the mouth. They are shallow but over time penetrate deeper into the tissue and potentially the bone. If caught early, they can be treated while still a surface problem. The bad news is that the majority of oral cancers are detected as late stage disease, when it is most difficult to treat. According to Dr. Simon Sutcliffe, President of the BC Cancer Agency, one-third of Canadians diagnosed with oral cancer die within five years for precisely this reason.

“Tobacco use is the primary cause of oral cancer,” says Dr. Nicoll, “including smoking cigarettes, pipes and cigars, smokeless tobacco, and chewing tobacco.” Excessive use of alcohol also increases risk and is a factor in oral cancer for 75% of Canadians diagnosed with the disease. Too much exposure to the sun is a key risk factor for cancers on the lips. At the same time, 25% of oral cancer patients don’t share these habits, so it’s important for everyone to know how to spot problems:
    • White or red patches anywhere in the 
       mouth
    • Mouth sore that bleeds easily and/or won’t 
       heal
    • Bleeding in the mouth
    • Loose teeth or dentures that stop fitting
    • Pain or problems swallowing
    • Lump in the neck
    • Persistent earache.

Your dentist is trained to care for all aspects of oral health. Conducting cancer checks at regular appointments and more elaborate screening for higher risk patients is the first step to early detection. Educating patients about the risks of certain behaviours and how to detect a potential problem is also an essential role for dentists. “As dentists, we have the specialized training, equipment and facilities to offer the best care for the mouth,” says Dr. Nicoll. “It’s not easy to see into the mouth properly, in your bathroom or in your doctor’s office. In the dental office, we have the right equipment, lighting and tools to see every area fully so we can be sure to check every area of the mouth.” 

putting 
FEAR TO REST
Public speaking may be the number one fear for most, but visiting the dentist ranks highest on the list of things to avoid for some Canadians. Without question, worry about the unknown or lingering memories from past experiences in the dental chair prevent some people from getting regular checkups and from seeking treatment when they have problems in their mouths. But is there any reason for fear anymore?

Those who have been avoiding the dentist’s office might be surprised to learn that modern dentistry is very different in many ways. According to Dr. Deborah Stymiest, President of the Canadian Dental Association, “Technology and equipment have revolutionized treatment such that it can be a virtually pain-free experience.”

At the same time, the philosophy of dentists has shifted to make patient education a priority. “We are here to work with our patients to develop strategies to cope with their fears so that they can get the care they need,” says Dr. Stymiest. Tell your dentist what you are most apprehensive about. Once specific concerns are identified, you and your dentist can address these fears. 

“The first step for an apprehensive patient is to acknowledge their fears,” says Dr. Joel Antel of the Manitoba Dental Association. “Arrange a dental appointment to discuss what concerns you most and to develop strategies to cope with treatment. It’s easy to be afraid of something you don’t know about.”

Your first appointment may not involve any treatment. You may not even have your teeth cleaned. It could be limited to a discussion of your apprehension and planning to overcome this barrier to a lifetime of dental health. 

Delaying treatment because of fear is common. According to Dr. Stymiest, however, even a minor oral health problem can become a very serious and complicated problem if left untreated. “Since oral health is an important part of overall health, you shouldn’t ignore a problem in your mouth,” says Dr. Stymiest. “Poor oral health can affect a person’s quality of life unnecessarily.”

If you suffer from dental anxiety, talk to your dentist. Your dentist is your partner in your oral health and can devise strategies to make you relaxed and comfortable during your dental visits.