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Free oral cancer screenings were recently carried out in Bombay, India.

This is a much quicker process for time-strapped dentists, but perhaps helps to explain why there has been no improvement in mortality rates for oral cancer over the past 50 years. "The problem is that if a dentist finds it at this stage, oral cancer is usually fairly advanced and patients only have a five-year survival rate of about 25-50%," claims Malcmacher.

The poor survival rate for oral cancer should be a mark of shame for the dental industry. When compared to other serious diseases, the lack of progress in tackling oral cancer is bewildering. Malcmacher believes that the fault lies with the regulatory bodies.

"The topic is absolutely not given enough importance by dental associations and government bodies," he states flatly. "Oral cancer is one of the few cancers where mortality rate has gone up in the last 40 years while most other cancers have gone down. The key is that the entire dental industry works together to make people pay more attention to the oral cancer arena."

Still, the dental industry itself seems to be catching on. New screening technologies for oral cancer are starting to reach the market and make their way into practices. But first, the technology needs to be accepted by the industry and incorporated into academic curriculum.

"At the moment, they do cover oral cancer screening in dental schools but they do not cover screening technologies," says Malcmacher. "The one I use the most is the Vizilite Plus - this is the most well-tested oral cancer screening test on the market and also is the only one that helps identify the oral cancer lesion."

Malcmacher even argues that dentists should be given incentives to pursue continuing education in the area of screening technologies.

Playing it safe

But is the case for screening technology really that clear? Dr Vinod Joshi, the founder of the UK's Mouth Cancer Foundation, is not convinced. "In the past there have been treatments that are supposed to make it easier to screen for mouth cancer, but what they found was that, when compared to the normal screening method with a good light source, there was not really a significant improvement," he claims.

"I think most professional dentists are actually waiting for a little more evidence to come out before deciding if this is something they should be using."

Because the early diagnosis of oral cancer is so vital, Joshi believes it borders on malpractice to pass-up traditional methods completely for newer screening technology. He also points out that it can be very damaging to your practice's reputation if a screening technique led to a misdiagnosis.

"During every normal check-up a dentist should be examining the patient for mouth cancer - it is very important that they are able to distinguish between normal ulcers and the symptoms of mouth cancer," he warns.

Joshi cites a court case underway in the UK where a dentist stands accused of not diagnosing mouth cancer early enough. Proof, he says, that you can never be to too careful, or too vigilant, when it comes to oral cancer screening.

Where money might be more effectively spent, is by increasing the amount of resources available on the topic to dentists. "One of the things that you hear often from both medical and dental professionals is that they feel that they could do with more information about mouth cancer and its risk factors," Joshi remarks.

These aids would be particularly useful for doctors, he adds. In a recent study, only 5% of doctors surveyed in a specific region of the UK knew that a red patch of oral mucosa could be a symptom for oral cancer.

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