Introduction
Oral cancer is a significant global health concern, affecting millions of people worldwide. It is among the most prevalent cancers, and its impact on individuals and communities is substantial. The burden of oral cancer can be reduced through effective prevention strategies targeted at the community level. The premature recognition of oral cancers significantly aids in identifying the clinical features of the disease in affected individuals, leading to an astounding 90 percent increase in the five-year survival rates, according to recent oral oncologic research. Unfortunately, it remains a fact that only 60 percent of these tumors are detected in advanced stages, resulting in a mere five-year survival rate of around 20 percent. This is precisely why the early detection of precancerous and cancerous lesions in the oral cavity needs to be prioritized at various levels in society and the community.
What Is the Importance of the Healthcare Provider in Preventing Oral Cancers?
Both the general public (GP) and dentists, and maxillofacial surgeons play a critical role in the early diagnosis of oral cavity or orofacial tumors. The dental community, comprising healthcare practitioners or dentists, bears the responsibility of spreading oral health awareness and detecting oral cancers. It is imperative that GPs or general physicians and dentists work in coordination to systematically approach the diagnosis, treatment, and long-term success rates of affected patients, which is achievable through early detection of oral cavity cancer lesions.
Improving oral health awareness, emphasizing the importance of regular dental check-ups, and discouraging detrimental lifestyle habits such as tobacco chewing, smoking, and chronic alcoholism play crucial roles in preventing potential cancerous lesions in the oral cavity. Researchers also agree that early diagnosis of oral carcinoma not only greatly improves the prognosis rates of affected individuals but also minimizes impairment and deformity of the orofacial structures. Moreover, since most oral cancers arise from the pre-cancerous stage, early detection by dentists can significantly reduce the severity of the lesion. Therefore, early detection holds the key to a positive prognosis.
What Are the Prevention Phases of Oral Cancers?
The prevention phases include:
1. Primary Prevention Phase: This phase or strategy aims to prevent the development of cancer by avoiding risk factors. At this prevention level, it mainly involves reducing exposure to tobacco, alcohol, betel quid, and other induced risk factors implicated in the incidence of oral cancer. Dental surgeons or dentists play a crucial role in motivating individuals to maintain oral hygiene, have regular dental follow-ups, undergo health checkups, and discourage detrimental habits through effective communication. For example, primary prevention may commonly involve using radio, newspapers, films, programs, folk arts, or posters to raise preventive awareness about oral cancers. In day-to-day clinical practice, dentists can follow simple approaches like encouraging tobacco users to quit, providing information about the worldwide rise of oral cancers due to tobacco, and using routine questionnaires to assess tobacco use. Displaying suitable educational materials in the waiting room of the dental clinic and distributing oral health awareness to patients can also help spread the preventive message. Regular follow-up examinations, whether for precancerous or tobacco- or alcohol-related oral lesions, will also help people recognize the detrimental effects of tobacco, alcohol, and encourage them to quit these habits soon.
Research studies have shown that simple information conveyed by dentists as part of their clinical practice can have a positive impact on improving patients' knowledge, attitude, and oral health behaviors. This communication also strengthens the bond between the dentist and the patient, emphasizing the significance of regular dental check-ups and cancer screenings for all age groups, particularly individuals predisposed to oral cancer risk factors.
2. Secondary Prevention: Secondary prevention aims to achieve early detection of cancer. For instance, in easily accessible sites of the oral cavity, where such lesions commonly occur in people predisposed to cancer risk factors, early diagnosis can significantly improve long-term survival rates. Prompt treatment is essential for successful secondary prevention, which is colloquially referred to as "cancer control" in medical literature. At the public health level, secondary prevention requires a collaborative effort from an interdisciplinary team of oral surgeons, general dentists, and clinicians. This is particularly crucial in regions with low literacy and limited access to healthcare, where the lack of oral health awareness can lead to the avoidance of risky and life-threatening lesions in individuals.
The ideal time to detect cancer is when the lesions are small and observable clinically. Generally, a greater size or extent of the cancer lesion in the oral cavity is associated with a poor prognosis. On the other hand, prolonged survival is achievable when small extent or locally constrained cancers are clinically detected and treated. Therefore, cancer screening of the oral cavity should be performed in every new patient and during all recalls by every dentist or dental surgeon in this phase of secondary prevention.
3. Tertiary Prevention: The tertiary prevention phase aims to address the terminal stages of cancer lesions. It is a fact that nearly 70 percent of cancer patients experience very severe pain, oral discomfort, and distressing symptoms in the advanced stages. During this stage, it becomes clinically challenging for the dentist to reinforce pain control. However, the primary focus should be on relieving the patient's severe clinical symptoms, pain, and discomfort, along with providing palliative care. These should be the major strategies adopted for tertiary prevention.
Conclusion
Prevention of oral cancers on a community basis is a multifaceted endeavor that requires the collective efforts of healthcare professionals, community leaders, and individuals. In conclusion, public health awareness of oral cancers is crucial to prevent the increasing global incidence of neoplastic oral lesions. Dentists and maxillofacial surgeons not only have a wealth of information related to public health behaviors and oral pathologies but they can also play a significant role in promoting oral health awareness among the patients and implementing preventive measures at various community levels.
