(Information submitted by Elizabeth Southern Puette, MSDH, CTTS)
Organizers and providers at an oral cancer screening and awareness event at West Virginia University were eager to host an outreach project they believe could be lifesaving.
“Oral cancer that is diagnosed early has better outcomes in terms of treatment, quality of life and life expectancy,” said Dr. Juan Bugueno, oral medicine expert and assistant professor at WVU School of Dentistry.
As part of its mission to provide comprehensive oral healthcare and support overall patient wellness, the dental school, supported by the Academy of General Dentistry Foundation (AGDF), hosted “Catch It Early”, a free oral cancer screening and awareness initiative September 25, 2021.
Adults 18 and older were invited to the downtown campus and WVU campus recreation for oral cavity screenings where dental and dental hygiene students checked for irregularities on all sides of the tongue and underneath. By feeling the tissues in the mouth and neck, the future providers tried to detect lumps or abnormalities. In five hours, 175 people received screenings.
The outreach event afforded dental school students the opportunity to share tobacco and nicotine cessation strategies, information about human papilloma virus and its connection to oropharyngeal oral cancer and suggestions on when patients should see a dentist, especially to detect lesions early.
“While oropharyngeal cancer can be most prevalent in middle aged men and women, a younger population is not exempt from developing oral or oropharyngeal cancer,” said Elizabeth Southern Puette, assistant professor in the dental school’s department of dental hygiene.
Patients were educated to look for symptoms like sores, lumps or even difficulty chewing.
“Oral cancer is the appearance of lesions in any part of the mouth that need immediate attention and appropriate care. First, we want patients to avoid the development of oral cancer. Secondly, we want patients to be aware of suspicious lesions in the mouth,” Bugueno said.
Volunteers also provided information about WVU Dental resources and clinical services that include but are not limited to teledentistry and specialty services such as a biopsy service, oral medicine clinic, oral and maxillofacial radiology, forensic dentistry and other oral diagnostic specialty services.
Thanks to support from WV Mountains of Hope Cancer Coalition, participants received a self-oral cancer screening kit; a plastic mouth mirror, a flashlight, and self-oral screening instructions. Participants were taught how to conduct their own two-minutes self-screening at home and were encouraged to do so once a month in front of the bathroom mirror, right after they brushed their teeth.
Packets also contained literature about oral cancer, early diagnosis and tips to reduce risk factors.
Providers discussed personalized tobacco cessation information with patients, distributed 18 Nicorette samples and made referrals to the WV Quitline.
Of the 175 participants at the screening, 72 were recommended for dental hygiene services resulting in five appointments for dental prophylaxis appointments two days after the event. Another 28 participants were recommended for “further evaluation and treatment by a dentist”, and two patients were referred to the WVU Dental Diagnostic Sciences department for further review of a suspicious lesion.
Continuing Education for Providers
In addition to patient screenings, the dental school and WV Oral Health Program hosted a free continuing education webinar open to professionals in fields including dentistry, medicine, nursing, pharmacy and respiratory therapy.
Continuing education presenters encouraged the use of evidence-based strategies in tobacco cessation counseling. Health professionals learned the importance of implementing routine screening strategies to identify oral cancer lesions early and next steps; including an overview of risk factors, referrals, biopsy services, and adjunctive aids to help identify suspicious lesions. Other objectives of the course included:
- Educate oral health professionals on the importance of teaching patients how to reduce their risk factors and how to complete oral cancer self-exams between visits
- Provide updates on the incidence of oral cancer and resources available in WV to improve access to care for patients with suspicious lesions
- Provide updated recommendations for screenings, vaccinations, and referral procedures from sources such as ADA, Academy of General Dentistry, American Cancer Society, and West Virginia Department of Health and Human Resources
Suann Gaydos, director of the dental school’s Certified Tobacco Treatment Training Program and dental hygiene professor, provided updates regarding the United States and West Virginia oral and orophyarngeal cancer burden report and shared oral cancer screening tips. She explained the American Dental Association (ADA)Resolution 65H-2019, which promotes early detection and prevention of oral cancer to include oropharyngeal cancer and cover all patients, not just those previously thought to be at an increased risk due to a history or habit of tobacco and alcohol use.
Dr. Susan Morgan, founder of the WVU School of Dentistry CTTTP, former CTTTP director and dental school professor, detailed oral cancer risk factors such as cigarettes, smokeless tobacco, cigars, alcohol and E-cigarettes. She also reviewed prescribing methods and made recommendations for seven FDA approved tobacco cessation pharmacotherapy agents.
Dr. Bugueno reviewed oral examination techniques and provided examples of cases, including some his own, of premalignant and malignant oral mucosal lesions, intra and extra oral exam techniques, a review of HPV association in both oral and oropharyngeal lesions, and the importance of documenting patient symptoms such as dysguesia and other oropharyngeal cancer related symptoms. Adjunctive screening aids were discussed as well as when to refer for further evaluation and or a biopsy.
Ms. Puette, dental hygiene professor, provided a history of FDA approvals related to the HPV vaccine spanning from 2006 to the most current June 2020 FDA approval of Gardisil 9 for the prevention of “oropharyngeal and other head and neck cancers caused by Human Papillomavirus (HPV) types 16, 18, 31, 33, 45, 52, and 58”. She provided resources to aid in talking to patients about the HPV vaccineand shared the American Dental Association and American Academy of Pediatric Dentistry’s stance of recommending and advocating for the HPV vaccination as cancer prevention.
Thank you to the student volunteers and patients who participated in the Oral Cancer: Catch It Early event. Click to see an online gallery of photos from the event.. Faculty volunteers included specialist ranging from oral medicine, to pathology, to smoking cessation, to oral cancer related dental care. Additional faculty volunteers included Dr. Fotinos Panagakos, associate dean for research, Dr. Brian Whitaker, interim chair of the department of diagnostic sciences, and assistant professor Dr. Hiba Qari. Dental hygiene students served as site managers.
Supporters of Oral Cancer: Catch It Early included:
Academy of General Dentistry Foundation
Mountains of Hope West Virginia Cancer Coalition
WV Oral Health Program
Crest and Oral B
WVU Cancer Institute
WVU Dental Diagnostic Sciences
WVU Dental Dental Hygiene
WVU School of Dentistry
3M Science. Applied to life.
American Cancer Society
Precautions during COVID
Prior to any screenings, student volunteers were responsible for COVID pre-screenings. All volunteers passed a COVID screening upon arrival to the oral cancer screening sites that included questions about history, current symptoms and a temperature check. Participants were required to pass a COVID screening, as noted in promo and advertising leading up to the event. Distancing and masking protocols were in place. Hydrogen peroxide pre-rinses were used as an additional precaution.