Kimberley Lloyd- Rees: Oral Health is About More Than Just teeth

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Kimberley Lloyd-Rees says: “Mouth cancer must be a priority all year round”

November was Mouth Cancer Action month – your practice may have posted ‘blue lip selfies’ on social media to show its support. Since its creation, the annual awareness campaign has grown considerably and this has been driven by necessity. Over 8,000 new cases of mouth and oropharyngeal cancer are diagnosed in the UK every year and numbers continue to rise [1].

Mouth Cancer Action Month is well supported across the dental profession. There is a comprehensive range of resources to help patients recognise the signs and symptoms to look for and the importance of early diagnosis.

Mouth cancer awareness is a year-round issue. It brings together key elements at the heart of prevention; good lifestyle choices, regular dental appointments, effective oral hygiene and patients becoming alert to any changes in their mouths. This is perhaps what is so frustrating about the figures for mouth and oropharyngeal cancers; the message is clear and simple, yet new cases are increasing.

Practising better preventive care, every day, must be at the top of patients’ New Year’s resolutions lists to reduce the risk of dental problems, including cancer of the mouth, head and neck, as well as a host of other conditions. Dental care professionals need
to find new ways to encourage people to make long-term changes and learn to think differently about what ‘oral health’ actually means – because it’s way more than just clean teeth.

If you asked your patients what purpose a dental check-up serves, most answers would be tooth-related, such as “to see if I need a filling”, or “to find out what’s causing my toothache”. But true prevention is about getting people to understand how to keep the whole mouth healthy – the gums, cheeks, tongue and lips as well as head and neck.

Regular appointments give people a time to talk about anything and everything
that relates to the mouth, head and neck. Sore lips? Recurring ulcers? Pain when swallowing? These are things that should be discussed to find a solution or to decide if further investigation is required.

Self examination

Rather like breast checks, patients should be shown how to check their mouth at home, so they can quickly see and feel if something is amiss. As part of Mouth Cancer Action month, there are practice resources that show people how to conduct a thorough self-examination; self-assessment should be recapped at every preventive-maintenance appointment and include a demonstration too.

Good prevention is helping patients understand how all the components of a preventive approach rely on each other. The impact of poor lifestyle choices, like drinking too much alcohol, won’t be diminished by good toothbrushing and using an expensive mouth rinse. Regularly drinking more than the recommended alcohol limit is a risk factor for seven types of cancer, including mouth, pharyngeal, oesophageal and laryngeal cancer [2].

When combined with smoking, the risk is increased further. Eating a balanced diet including plenty of fruit and vegetables will also reduce the risk of mouth cancer plus a host of other systemic and serious diseases. These are known health messages of course, but the advantage that a DCP has over a GP is they will be talking with patients when they are feeling well. Preventive-maintenance appointments should start with a discussion of the ‘basics’ like alcohol limits, diet and smoking cessation – with referrals made if required.

Another topic that can be discussed is the importance of the HPV vaccine, for teen patients and parents bringing their teenagers to the practice. The ‘anti-vaxx’ movement has grown in profile; there is great deal of misinformation on social media about the safety of vaccines which DCPs can talk through with worried patients. Some cancers of the head and neck are caused by the HPV virus and the vaccination is now rolled out for all Year 8s.

For patients diagnosed with a form of mouth cancer, effective cleaning is an essential part of their daily routine. However, due to their cancer treatment they might find this uncomfortable or difficult. You can consider adding new tools to their home care, especially softer, gentler aids.

Mouth and oropharyngeal cancer rates are rising and motivating people in good behaviours to reduce their risk should be a priority all-year round. For dental care professionals, it’s about encouraging a shift in patients’ thinking. Oral health is about far more than teeth and toothbrushing. It’s about being aware of the whole mouth and how the different components of preventive care interact.

Patients may be more receptive if instructions and advice are given in a less ‘formal’ setting, by a dental hygienist or dental therapist. With so much to do to improve the nation’s oral health and cancer rates, practices should grab any opportunity for the whole team to get involved in supporting patients.

Author:

Kimberley Lloyd- Rees graduated from the University of Sheffield in 2010, where she now works as a clinical tutor in Dental Hygiene and Therapy as well as working in practice. She has spent her career working across a variety of specialist private and mixed dental practices, for the MOD and volunteering her time to a dental charity in Nepal.

She suggests: “The TANDEX UltraSoft range has solutions including toothbrushes and FLEXI™ UltraSoft interdental brushes, which are gentle on gums and designed specifically for use after surgery. Why not visit the Facebook page for the latest information?”

References:

1] Oral Health Foundation. The State of Mouth Cancer UK Report 2018/2019. Link: https://www.dentalhealth.org/stateofmouthcancer (accessed October 2019).

2] Cancer Research UK. Does alcohol cause cancer? Link click HERE. (accessed October 2019).

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