Oral cancer: The type of cancer your dentist can help diagnose

When you go to the dentist to get your teeth cleaned every 6 to 12 months, you may be surprised to find them feeling your gums, studying the roof of your mouth, and even peeking under your tongue. This quick exam is an important way of checking for signs of oral cancer.

Cancer may not be the first thing you think of when you sit down in your dentist’s chair. But there is concern among doctors about cancers of the oropharynx, which can affect:

• The back third of your tongue
• The side and back wall of your throat
• Your soft palate (the back of the roof of your mouth)
• Your tonsils (lymph nodes in the back of your mouth)

Oral cavity and oropharyngeal cancer are related, but they’re often caused by different things, says Molly Rosebush, D.D.S. She’s an associate professor at LSU Health Sciences Center School of Dentistry. About 54,000 people are diagnosed with oral cavity or oropharyngeal cancer each year, and early detection is key to survival. When caught early, the 5-year survival rate is an impressive 86.3%.

Survival doesn’t necessarily mean a full recovery, however. “The people who do survive can have terrible quality-of-life issues — they’ve got aesthetic problems, and they’ve got functional problems with eating and speaking,” Dr. Rosebush says. That’s why it’s important to know the symptoms of these types of cancer and what can put you at a higher risk. Find out below.

The best way to get on top of your oral health? Having regular dental exams. A supplemental dental plan can help you afford the cost of these exams, x-rays, and cleanings. Call a licensed insurance agent at (800) 827-9990 to find dental plans in your area, or find a plan online today.]

Oral cavity cancer: Know the symptoms

It’s a good idea to schedule an appointment with your dentist or doctor if you have any of the following symptoms for more than 2 weeks:

• A sore, irritation, lump or thick patch on your lips or in your mouth or throat
• A sore throat or a feeling that you’ve got something stuck in your throat
• A white or red patch in your mouth
• Ear pain
• Difficulty chewing, swallowing or speaking
• Difficulty moving your tongue or jaw
• Numbness in your tongue or other parts of your mouth
• Swelling in your jaw

Don’t wait for your next wellness exam at the doctor’s office or your 6- or 12-month check-in with your dentist. If you have any of these symptoms, have a doctor or dentist take a look as soon as possible. It could be a lifesaver.

Oral cavity cancer: Know the risk factors

Why might you be having these symptoms? If you are a tobacco user or a heavy drinker — or a combination of both — it might increase your risk of oral cavity cancer. Here’s a closer look at why these habits are so dangerous.

Tobacco. The biggest single risk factor for oral cavity cancer is tobacco use. Current smokers are 5 to 10 times as likely as nonsmokers to develop these types of cancer. And the longer you use tobacco — and the more often you use it — the higher your risk.

On the plus side, you can cut your risk in half within 5 to 9 years of tossing out your cigarettes. Within 20 years, your risk is the same as someone who never smoked.

But don’t think you can just switch to smokeless tobacco. Snuff and chewing tobacco are also dangerous. “People who get oral cancer due to smokeless tobacco get it in the spot where they hold it, whereas people who smoke are exposing their entire oral cavity to these carcinogens,” says Dr. Rosebush.

Alcohol. If you drink heavily, you’re 5 times more likely to develop cancer of the oral cavity and pharynx (throat). For men, heavy drinking means having 5 or more drinks on any day or 15 or more drinks per week. For women, the numbers are 4 or more drinks on any day or 8 or more drinks per week. Moderate drinkers, meanwhile, face a 1.8-fold higher risk of oral cavity cancer (excluding the lips) or pharynx cancer.

What’s more, tobacco and alcohol can be a deadly combination. Heavy smokers and drinkers are about 30 times more likely to develop oral cavity or oropharyngeal cancer than people who don’t smoke or drink. “Smoking and excessive drinking work together to heighten your risk,” says Dr. Rosebush.

Other risk factors. While tobacco and alcohol can work by themselves or together to heighten your oral cavity cancer risk, there are a few other things you’ll want to watch out for as well:

• Chewing betel quid (a type of smokeless tobacco popular in parts of Asia)
• Sun exposure, which can cause cancer on the lips
• A personal history of head and neck cancer

If you fall into one of these categories, follow up with your dentist or doctor at your next visit.

Oropharyngeal cancer: Know the symptoms

Oropharyngeal cancer has many of the same symptoms as oral cavity cancer. But its symptoms can also include:

• A lump in the back of your mouth, throat or neck
• Coughing up blood

Again, you’ll want to schedule a visit with your doctor or dentist as soon as possible if you’re experiencing any of these symptoms.

Oropharyngeal cancer: Know the risk factors

While smoking and alcohol use can put you at a higher risk of developing oropharyngeal cancer, the primary risk factor is human papillomavirus (HPV). This is a virus spread through direct sexual contact with the genitals, as well as the mouth and throat. It’s the most common sexually transmitted infection in the United States, with oral HPV affecting 10% of men and 3.6% of women. It is thought to be responsible for about 70% of oropharyngeal cancers.

“Most people clear HPV infections on their own within about 2 years, but some people don’t, and they just persist and can cause cancer,” says Dr. Rosebush. “And there’s no way of knowing who that’s going to happen to.”

An HPV vaccine is available and offers protection against new oral HPV infections, although it’s difficult to say whether it helps if the virus is already in your system, according to Dr. Rosebush. “It’s approved by the Food and Drug Administration for people ages 9 to 45, but it’s really through age 26 that people are routinely getting the HPV vaccine, because that’s the age that most insurance stops paying for it,” she says.

If you’re between ages 27 and 45, she recommends talking with your doctor about whether the vaccine is appropriate for you.

Does insurance cover treatment for oral cancer?

As noted above, your dentist can check you for signs of oral cancer. But you’ll need to either have dental insurance or pay out of pocket to get a dental exam in the first place.

If you have insurance through an Affordable Care Act (ACA) plan, you won’t get adult dental services as 1 of the 10 essential benefits, although some ACA plans do offer dental coverage. Similarly, Medicare doesn’t cover most dental services, but most Medicare Advantage plans do.

Dr. Rosebush also recommends doing a monthly self-exam. To do one, follow these steps:

1. Wash your hands and make sure you have a small flashlight on hand.
2. Remove any dentures or other nonpermanent dental appliances so that you can view the inside of your mouth in the mirror.
3. Examine the outside surface of your lips; pull your lips out and examine all inside surfaces and your gums.
4. Examine the inside of both sides of your cheeks with the flashlight, then feel those areas with your fingers.
5. Check beneath your tongue on the floor of your mouth with the flashlight. Feel around with your finger.
6. Stick out your tongue, examine the top, both sides and undersurface of it using the flashlight. Feel all of these areas with your fingers.
7. Examine the back of the roof of your mouth and the back of your throat with the flashlight. Don’t stick out your tongue when you do this, because it will get in the way of seeing the back of your throat.
8. Call your dentist or doctor if you see or feel anything out of the ordinary.

If you end up needing surgery, dental insurance likely will not cover it — but your health insurance may. “That’s a medical issue that is going to be covered under your medical insurance,” says Tasha Riggs, sales leader and licensed insurance agent for HealthMarkets in Westminster, Colorado.

Need health insurance or supplemental dental insurance? Call a licensed insurance agent at (800) 827-9990 to discuss your options, or compare plans online to see what’s available to you.