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The recent link between periodontal disease, cardiovascular disease, and strokes has affirmed the importance of dentistry as an essential medical provider. More people than ever are taking bisphosphonates such as Boniva and Fosamax to build up their bones to treat osteoporosis.
Head and neck radiation treatments for cancer destroys the tiny blood vessels in the jaws contributing to  osteoradionecrosis (dying bone due to radiation). Radiation treatments can destroy the major salivary glands causing  xerostomia (dry mouth), and xerostomia can cause radiation caries (cavities). Multiple common pharmaceuticals such as high blood pressure medications can cause xerostomia, drying up the mouth causing dentures to not fit, and dental cavities. Diabetes mellitus can cause dramatic infections in the mouth that will compromise routine treatments such as scaling and root planing and implant placement. Esophageal reflux and GERD (gastroesophageal reflux disease) can cause acid erosion of the teeth contributing to cavities, loss of enamel, and tooth sensitivity. Scleroderma– a connective tissue disease causing the skin of the face to tighten so much it may be hard to open the mouth wide enough to work inside. Cancers that start in other parts of the body can show up in the mouth with signs of metastasis and visa versa. Every dental office in the modern world requires their patients to fill out a medical history of some kind.
Symmetry: Although the face is generally not exactly symmetrical, you can tell that something is wrong if one side is grossly different from the other. Color: localized redness (heat?), brown or black pigmented lesions, telangiectasia, lesions, scars. Lumps or bumps-palpation of the lips can reveal abnormalities within the lips themselves that cannot be seen with the naked eye. The gums around the teeth are called the gingiva- this is keritinized attached tissue that is usually hard enough to resist the scrapping trauma of crunchy foods.
Hard and soft palate- The soft palate is more often seen as a place for pathosis than the hard palate. Tonsillar, adenoids, nasopharnyx- These areas can be hard to see without a special scope (ENT). The parotids are the largest salivary glands and are situated in the cheek areas in front of the ears. Jugular chain first: Along the side of the neck following the sternomastoid muscles from the ear to the clavicle. Smoking: Researchers have discovered cigarette smoke slows the production of a protein called FANCD2. Sun: Prolonged exposure to the sun can cause pre-cancerous (actinic keratosis) and cancerous (basal cell carcinoma, squamous cell carcinoma and melanoma) skin lesions. History of past cancer: Having a past history of cancer means you once had the right conditions to have cancer, and those same conditions may pop up again. Our office has joined the Head and Neck Cancer Alliance (formerly known as the Yul Brynner Head and Neck Cancer Foundation). We offer free Head and Neck Oral Cancer screening by appointment at our office during regular working hours.


THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT. Aphthous ulcers:  These lesion are so common and obvious, they can be diagnosed over the phone.
Pyogenic granuloma: Also known as a pregnancy tumor because it common forms on the gum lines of pregnant women.
Peripheral Giant Cell Granuloma:  Looks like a pyogenic granuloma and can only be differentiated by histology.
Dental radiographs cannot tell if you have cancer, they can just show the doctor where something abnormal is located.
Tonsillar Hemangioma: Congenital blood vessel mass on right tonsillar pillar and soft palate that could become life threatening if it was traumatized and bleed enough to obstructed breathing. Radiation Caries: This is decay that was caused by a lack of salivary flow and ineffective oral hygiene. Cervical cancer usually does not have symptoms until it is quite advanced, very serious and hard to treat. Other HPV-related cancers might not have signs or symptoms until they are advanced and hard to treat. HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. There is no way to know which people who have HPV will develop cancer or other health problems. This treatment has been reported in the literature to cause an increase risk of osteonecrosis (dying bone) in the maxilla and mandible. The old treatment for this was fluoride trays, but now we are having good success with the  Perio Protect Trays and Xylitol.
The eyes should be roughly the same size and level with the ground, the cheeks the same height and size, the nose should appear normal (huge variations), and the lower jaw should be the same from one side to another. Although we take many of the initial courses that medical doctors take in school, we quickly divert into our own specialty in which few medical doctor understand.
Red spots, white spots, ulcerations, rough areas, asymmetry, growths, or other masses may be the first sign of a cancer. We usually use a 2X2 inch gauze to pull out the tongue and a mouth mirror to look down the throat.
Some people have the habit of chewing their cheek and this results in a white line on the cheek called the linear alba (normal and does not cause cancer).
It damages the cells and when they try to repair themselves, it may lead to DNA changes in the cells which can be a step toward cancer.
Some mandibular tori are very small and some can be so large they can crowd out the tongue space.
Treated by first removing the cause of the sore spot and letting the lesion shrink away, then relining the denture. Benign.  Ill-fitting denture can cut into the softer tissues causing a sore spot that is easily treated. This patient had been on cancer chemotherapy and spontaneously developed this dead boney lesion under her partial denture.


The patient had head and neck radiation for cancer and this destroyed their salivary glands.
Caused by trauma to the oral mucosa such as biting the cheek and is usually slightly raised. These include cancers of the vulva, vagina, penis, anus, and oropharynx (cancers of the back of the throat, including the base of the tongue and tonsils). It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer). The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers. We have seen and have been referred a few cases from oncologists for this in the past few years.
If the uvula doesn’t hang down in the midline of the soft palate, a mass may be pushing it to one side or vagal nerve palsy. If you do not make enough FANCD2 to fix the damaged DNA inside cells, it can causes the faulty cells to go hay-wire (cancer). The bullous form has fluid-filled vesicles that can break and cause some irritation. The erosive forms is erythematous (red), ulcerated and uncomfortable. Viral infection.  Herpes can form inside the mouth on fixed tissue (tougher gum tissue) and is usually unilateral (not crossing the midline of the body). Tobacco and alcohol use after head and neck cancer treatment: influence of the type of oncological treatment employed. Screening tests can find early signs of disease so that problems can be treated early, before they ever turn into cancer.
A very hard lump in the midline of the hard palate may be a torus palatinus which is a normal variation of anatomy (a normal abnormality). OHSU Cancer Institute, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA. Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA. Debreceni Egyetem OEC, Fogorvostudomanyi Kar, Parodontologiai Tanszek, Restaurativ Fogaszati Tanszek, Debrecen. HPV is so common that nearly all sexually active men and women get it at some point in their lives. He said, “I showed that lump to my primary care physician and he said it was probably nothing to worry about.
But since you were concerned with it and told me to get it checked out, I went to an ENT on my own and he biopsied it.
You can develop symptoms years after you have sex with someone who is infected, making it hard to know when you first became infected.



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