Oral cancer remains the 6th deadliest cancer, with 35,000 cases discovered yearly in the United States alone, and only half of those patients surviving 5 years post-diagnosis. The high death rates for oral cancer are contributed to the fact patients do not generally detect signs or symptoms until it has advanced and further metastasizes. Fortunately, when detected early, patients with oral cancer have an 80-90% survival rate. The American Cancer Society recommends a complete oral examination for signs of cancer once a year. The dentist’s position in preventing oral cancer from going undetected is essential since most people are not examined under other circumstances until it is too late. By offering oral cancer screening for every patient, you save lives and enhance patient satisfaction.
Of the 60% of people who see dentists regularly, only about 15% receive a yearly oral cancer examination. This means far too many people are missing out on an opportunity to protect themselves. Even if you have implemented oral cancer screening in your practice, how can you be sure every patient says “yes” to testing? There are many reasons patients turn down a request for screening, including:
One of the main reasons patients refuse the screening is that they believe they do not need it. Patients who do not smoke or drink heavily, or who are young often feel they are not at risk for the disease.
Patients already experiencing anxiety at their dental visit may become increasingly fearful when an oral cancer screening is recommended. No one likes to hear they are going to be tested for something they probably were unaware of before their visit, and may worry that something you see prompted the suggestion. Patients may also fear that the examination will be painful or uncomfortable, again increasing stress and apprehension.
Most insurance companies do not cover the cost of oral cancer examinations. Patients often remark that if it’s not covered, they do not want it.
Due to the link between oral cancer, tobacco use, and the human papillomavirus (HPV), asking sensitive questions prior to the screening is necessary. Patients generally do not expect to provide personal information about their social habits and sexual health history while visiting the dentist. The fact that most patients do not realize these types of questions and treatment are in the scope of your care leads to another form of resistance to the examination.
Getting Patients Onboard
Nearly all of the above concerns patients raise when approached about oral cancer screening stem from a lack of understanding of the disease and examination itself.
- Patient Education
The last thing you want is a fearful, resistant patient, so taking the time to thoroughly explain the statistics of oral cancer and the process of the screening will help ease your patients and prepare them to accept the exam. Explain the facts about the importance of early detection, and that dentists are often the first to catch signs of the cancer. Next, make sure your patients know the screening is quick, routine, and completely painless.
You should also explain that while smoking, tobacco use, and heavy drinking do contribute to about 75% of oral cancer cases, there are other factors in its development as well. The presence of HPV, causer of cervical cancer in women, and affecting 20 million Americans today, has been a proven risk factor for contracting an oral cancer. Perhaps your patients will be surprised to learn that the “face” of oral cancer is not only smokers, those over 45, or males. While these were once the key demographics of the disease, it has now grown to inflict a range of patients, with over 25% of cases occurring in patients with no known risk factors.
Once patients are informed, they should be more receptive to the exam.
- Cost Acceptance
Depending on your practice preference, it may be an option to make a minimal one-time fee increase for all dental hygiene procedures, and thereby offer the oral cancer screening “for free.” No one likes fee increases, but explaining your dedication to investing in equipment that will lead to potentially saving lives may actually impress patients rather than turn them off.
If you choose to charge patients individually for the screening, helping patients accept the additional fee can be achieved in the same way you help them accept treatment for a cavity or gum disease. Patients need to understand the necessity of the treatment, or in this case, the exam, in order to accept the cost. You should explain that treatment in all aspects of your practice does not depend on whether it is covered by insurance, but rather on the patient’s need. You have already proven that anyone is at risk for oral cancer, meaning all patients can benefit from and need the exam.
There are many options for additional accuracy when screening a patient for oral cancer. Though you should always visually examine a patient, feeling for lumps and searching for lesions or suspicious spots, these devices can aid you when signs are not visible to the naked eye, as is the case 70% of the time.
- Light Technology
There are a variety of light technology devices available that work by identifying abnormal tissue. First, your patient rinses with a solution. Next, when the device is placed and shined in the mouth, normal tissue will absorb the light and appear dark, while abnormal tissue will appear white. This process generally takes about 2-3 minutes.
- Brush Biopsy
Another option for testing specific spots is a brush biopsy. The brush biopsy is performed by scraping a lesion with a small brush. The contents of the brush are then transferred to a microscopic slide and sent to a pathology lab, where the cells are tested for abnormalities.
Benefiting Your Practice
By offering oral cancer screening at your practice and encouraging every patient to accept the examination, you will succeed in not only potentially saving lives, but also in promoting your practice. In the same way people appreciate and support businesses dedicated to helping charities or advancing a cause, once educated your patients will feel similar loyalty based on your efforts to extend cancer awareness. Offering the very best possible care, even when it comes to cancer prevention, results in patient approval, increased satisfaction and additional patient referrals.