Preventative Oral Health

Oral and pharyngeal cancers represent 2-3 percent of cancer deaths in the United States. Cancer of the mouth, throat, pharynx, lips, cheeks, gums, and tongue are included within the category of oral cancer. Oral cancer is the sixth most common cancer. Due to this prevalence, as well as its relatively high mortality if gone unchecked, the Surgeon General has emphasized preventative oral health, including regular oral examination. It is important to remember that oral cancer may begin insidiously with painless lesions. Oral examination should not only consist of visual inspection but include thorough palpation of the buccal mucosa, tongue, palate, gums, and sublingual areas. A gloved hand should be used in conjunction with a gauze square (4x4) to grasp the tongue. It is good practice to describe this process to the patient as it is performed. The patient may then be able to employ self-detection techniques between clinician visits.

In addition to the usual oral concerns stated above, the clinician should be aware that dental abnormalities are common in persons with Down syndrome. Common problems include delayed eruption of primary teeth, misshapen or missing teeth, delayed loss of primary teeth, narrow palate, bruxism (grinding one's teeth), and periodontal disease. A small oral cavity is often seen in young persons with Down syndrome, potentially resulting in overcrowding of teeth and possible malocclusion. Orthodontic consultation may be required.

Burnham, D. (2004). The oral cancer exam. RDH, August 2004, pp 70-74