Helaine Smith DMD

Did you know that 7,500 men and boys will contract HPV-related cancers each year — and that 1,000 will die?

That’s the statistic cited in the article by Sarah Wildman, “HPV Vaccine: Why Boys — Not Just Girls — Need a Shot in the Arm.”

Whether boys should get the vaccine or not has become political. Women and girls are getting the $360 shot in order to prevent contacting HPV — a sexually transmitted disease.

By getting the shot, they’re effectively shouldering the burden of STD prevention in addition to birth control.

But boys are at risk too and can contact anal and penile cancers and throat and oral cancers. The FDA recommended in September that boys get the Gardasil shot.

When it comes to the shot for boys, however, the discussion centers on whether it’s cost effective — not whether it will increase boys’ promiscuity as some have argued about the shot for girls.

Oral cancer, which can be caused by HPV infection, is serious. It kills. The question isn’t whether the HPV vaccine is cost effective or if it increases promiscuity. The question really is, how valuable is your child’s life?

Estelle, a lovely woman, came to my practice on the advice of two 90-year old women in her senior club.

Over a year ago she had been experiencing pain in her mouth, which her general dentist diagnosed as an infection.

As she describes in the video below, the dentist sent her on to a periodontist and after realizing her infection wasn’t responding to antibiotics, the periodontist sent her to an oral surgeon. The oral surgeon did a biopsy and, realizing she had oral cancer, sent Estelle to Dana Farber for treatment.

Estelle didn’t drink or smoke and definitely did not have multiple partners (her exact words!), so she definitely was low-risk with regard to oral cancer.

She also had all her teeth, which were in great shape, and perfect bone.

Due to the advanced state of her cancer, Estelle had to have more than half of her maxilla (upper jaw) removed and underwent radiation treatment every day for months.

In the video she describes how oral cancer has affected her life.

Despite her travails, she remains upbeat.

But here’s the deal: Every single dentist in the United States should be performing an oral cancer screening every single time he or she sees a patient for a routine checkup.

And, any type of sore or “infection” that looks even slightly suspicious should be checked — pronto. It’s a shame that a woman as beautiful as Estelle lost half of her upper jaw bone due to her cancer not being caught in time.

Don’t let this happen to you. It’s your right to insist on oral cancer screenings. If your dentist doesn’t do them, find a new dentist.

As a dentist, I can tell quite a bit about you just by looking at your tongue.

A heavy white coating, for example, tells me you might have dry mouth, as this coating is dead bacteria that used to thrive in the moist environment of the mouth.

Dentists look at your tongue for signs of stress, gum disease and other disorders. A healthy tongue is pink with some texture to it. This article, Tongue Terror: What is Your Tongue Telling You? from AOL Health explains what else your tongue can tell you. Be sure to read it — it’s fascinating!

A tongue with a sore on it that doesn’t heal is a warning sign of possible oral cancer . . . which is a great segue into the topic of the week. It’s Oral, Head & Neck Cancer Awareness Week and as one of 230 participating medical facilities around the world, we offered free oral cancer screenings on Monday.

Participation from the local community was hmmmm . . . limited, but we still had a great time. Suzy (pictured above, right) our hygienist, explained how she teaches her patients about oral cancer and gave us a demonstration of how she does an oral cancer screening.

She has a patient stick out their tongue, for example, so that she can look at the back and sides, where oral cancer often begins — unnoticed. She also looks below the tongue and at the back of the mouth. In addition, she advises patients to wear Chapstick or lip balm with sunscreen, as the lips are susceptible to skin cancer, and she feels the back and sides of the neck for any swelling or lumps.

“All hygienists and/or dentists should be performing oral cancer screenings as a matter of course,” said Suzy. “If your dentist isn’t doing it — then he/she is shirking his duty and is missing an important patient education opportunity.”

If you’re still not convinced, be sure to read this article from CNN Health — Oral Cancer’s Toll Cruel.

Thank you, Suzy, for your enthusiasm and support. And thank you to the OHANCAW folks who sent us some really nice posters, buttons and T-shirts. We had a great time and while it would have been nice to see more support for this important event from the local media, we’re happy to have participated and look forward to next year!

(And remember, when the Boston media starts covering oral cancer in the next year or two, you can pat yourself on the back for already being educated as you read about oral cancer and HPV infection on this blog first. I’ve been talking about it since 2008!)

As part of Oral, Head & Neck Cancer Awareness Week, April 12 – 18, 2010, my Dedham Family Dental office is offering free oral cancer screenings.

We’re one of 200 medical centers throughout the world that’s participating in this fabulous event!

If you’re in the Dedham, MA area, please feel free to drop by between 9:00 and 1:00 PM on Monday, April 12, and our hygienist, Suzy (whom you’ll love), will do the screening. This is absolutely free — and you do not have to be a patient.

The Head and Neck Cancer Alliance (HNCA) has expanded its list of at-risk populations for oral, head and neck cancers to include sexually active adults who engage in common sexual behaviors, such as open-mouth kissing and oral sex.

The HNCA is urging all who may be at risk for these cancers to take advantage of free screenings during the 13th annual Awareness week.

For a full list of participating medical centers, visit the OHANCAW Website. You can also follow them on Twitter.

Dedham Family Dental is located at 30 Milton Street in Dedham. We have plenty of free parking, so come on by! I and my staff look forward to meeting you.

Day: Monday, April 12
Time: 9:00 AM to 1:00 PM
Location: Dedham Family Dental, 30 Milton Street, Dedham, MA
Phone: 781-326-4600

The death rate for oral cancer is higher than that of more “famous” cancers, such as cervical, Hodgkin’s lymphoma, laryngeal, testicular, and skin (malignant melanoma).

And, oral cancer is growing at double-digit rates — despite declines in alcohol and tobacco use.

What is the cause for the increase? The spread of HPV-16 and HPV-18 via all forms of sex.

For this reason alone, oral cancer is showing up in the younger adult population — and the fastest growing group is young women.

Thus begins the introduction to New York dentist Lawrence A. Hamburg’s story about fighting oral cancer, Living 15 Minutes at a Time, in the March issue of Inside Dentistry. Dr. Hamburg hopes that by telling his story he’ll educate dentists and patients alike — and encourage both to give and ask for oral cancer screenings.

Dr. Hamburg noticed a “superball-sized mass” at the base of his tongue and a secondary tumor the size of a baseball in a lymph node in his neck. He ignored both for about six months until he asked his hygienist and then a doctor friend what they thought.

He then had an MRI — which showed he had cancer. Once he was diagnosed, he underwent five months of chemo, 33 radiation sessions, radiation implant therapy, and surgery at Beth Israel in New York.

Two years later, he’s in remission, but as he says, he’s one of the lucky ones. That’s because 78% of those diagnosed with Stage IV oral cancer are dead five years later.

Dr. Hamburg has gone “public” with his story because he wants his fellow dentists to perform oral cancer screening on all patients. According to Brian Hill, president of the Oral Cancer Foundation, people diagnosed with Stage One oral cancer have an 80% to 90% survival rate.

And early detection is easily done using new technologies such as Trimira Identafi or ViziLite Plus coupled with the ADA recommended conventional visual and tactile examination. The gold standard for detecting oral cancer continues to be biopsy.

What can you do to help lower your risk for oral cancer?

• Limit alcohol consumption and don’t smoke.
• Practice safe sex — use a condom each and every time.
• Don’t have oral sex with multiple partners as this increases your chance for oral cancer.
• Ask your dentist to screen for oral cancer each time you go in for your regular check-up.

Most important, if you have type of suspicious sore, lesion or lump in your mouth, see your dentist. The earlier you get this problem diagnosed, the better off you’ll be.

The following video from Trimaira shows how its technology screens for oral cancer.

Oral cancer — and how people contact it through sexual activity — is traditionally associated with men over the age of 40 who smoke. However, as this May 2007 Time article points out, young men and women are at risk for oral cancer due to the transmission of HPV during sexual activity.

As part of my effort to educate consumers, I’ll be posting information about oral cancer through April as April 12 – 18 is Oral, Head and Neck Cancer Awareness Week. Over 140 medical offices across the U.S. are offering free oral cancer screenings — including my own (more details forthcoming!).

Today I’m happy to introduce Dr. Robert Miller, M.D. of WellSpring Oncology Cancer Center from Pinellas Park, Florida. He took some time to answer basic questions about oral cancer.

Dr. Miller, are you seeing more oral cancer patients and are these patients young, older, male or female?

Dr. Miller: Yes, we’re seeing more oral cancer patients who are a little bit younger –- due to smoking. The patients tend to be younger but are equal in male and female.

In the patients that you see with oral cancer, is the cancer advanced? What brought the patients in to see you? Had they seen a dentist first who performed an oral cancer screening?

Dr. Miller: In the patients that we’re seeing, they do tend to be more advanced because they were not screened. Unfortunately, a lot of patients who have oral cancer are heavy smokers and/or drinkers. They are socially disadvantaged because of this and are pretty advanced in the disease.

By the time they see us, an oral surgeon or an ENT (ear, nose and throat) physician has already made the diagnosis.

Of the patients that you’re seeing, do they know about oral cancer? Are they shocked when you tell them they have oral cancer — esp. if they’re young and don’t smoke?

Dr. Miller: Most patients are surprised. It didn’t occur to them that they had cancer in the mouth. They may have had concerns over lung cancer [due to smoking and such] but not oral cancer.

In addition to oral sex and HPV, what other risk factors exist and what can young women do to reduce their risk?

Dr. Miller: Mainly smoking and alcohol. Those are the two biggies. Obviously, to not smoke or drink excess amounts of alcohol. Having multiple sexual partners is a risk, so practicing safe sexual behavior by using condoms and protection would reduce the risk.

Do you think that getting screened annually by a dentist who uses tests such as ViziLite (or any other test) is one thing they can do?

Dr. Miller: Yes, if a person thought they were particularly at a high risk, they should be screened because dentists are trained to inspect the mouth for anything suspicious. Competent dentists will inspect for white lesions or leukoplakia.

Early signs of irritability or continuing to smoke are high risk factors, oral surgeons or dentist should be encouraged to perform a thorough screening in these cases.

The problem with oral cancer is that no standard or official screening is in place. What I mean is that when you go for your yearly physical, the doctor doesn’t look in your mouth and check for any signs of cancer. It’s not like breast cancer that can be screened with mammograms, prostrate cancer which can be caught with a prostate exam or colonoscopy which can catch colon cancer.

No oral cavity screening exists as a separate exam. A patient has to pay attention to changes on their own skin (skin cancer) or mouth — and then call a doctor or dentist if he/she notices anything unusual.

Have you found that your patients know about tests that exist for oral cancer?

Dr. Miller: In short: No.

I have found that the media is simply not addressing this issue. Why do you think that is?

Dr. Miller: The media has so many diseases to cover; if a disease is not on the radar because it’s not that common, then it won’t be discussed.

High volume diseases like breast cancer, colon cancer or prostate cancers are covered because of the amount of people those diseases affect. The media doesn’t pay attention to the others.

And too, topics about oral cancer that include oral sex may be uncomfortable to talk about and therefore the topic is avoided, although the media will cover it indirectly by discussing the dangers of smoking for example.

Some diseases that have began to get attention were due to celebrities that experienced it i.e. Farah Fawcett who succumbed to anal cancer. However, if it’s an “uncomfortable” cancer, you won’t see much about it in the media.

Another example is Katie Couric who lost her husband to colorectal cancer in 1998. Because of this, colorectal cancer was mentioned more in the media.

Dr. Miller, thank you for your time and insight!

Do you have a question about oral cancer and HPV that isn’t answered here? Please post it in the comments section below and if I don’t know the answer, I’ll find someone who does.

Amber Olinger, a 911 dispatcher in Tennessee, suddenly lost her voice in September 2006 at the age of 24. The diagnosis? Oral cancer, which proved to be the beginning of Amber’s journey with cancer. This is her story:

When she lost her voice, Amber looked to her doctor, who referred her to ear, nose and throat doctor Jack Byrd. Dr. Byrd initially prescribed a steroidal treatment for the “beefy red lesion” he detected at the back of Amber’s throat. One week later the lesion had doubled in size, prompting Dr. Byrd to surgically remove the lesion. Immediately after the surgery, her voice returned.

Two days later, Dr. Byrd called with the test results: “It’s malignant.”

Dr. Byrd referred Amber to Emory University otolaryngologist William Grist, who diagnosed her with small cell carcinoma of the larynx, a condition typically found in older male smokers. Thankfully, Dr. Grist reported, Amber’s throat was now clear of cancer cells, but they could not provide any medical reason why a person as young as Amber had gotten this type of cancer.

Throughout the end of 2006 and the beginning of 2007, at her doctors’ recommendation, Amber underwent chemotherapy and radiation treatment. When she lost her hair as a result of treatment, her husband Todd shaved his head to match hers. Throughout treatment, Amber’s tests came back clear of cancer cells, but she persisted in finishing the treatment as her doctors prescribed.

As faithful Southern Baptists, Amber and Todd Olinger, their 16-month-old son and their relatives turned to their church throughout Amber’s treatment for support and hope.

Fueled by her faith and her optimism, Amber’s dedication to her treatment paid off. In March of 2007, the month of her wedding anniversary, she was officially diagnosed as being cancer-free. To honor the faith that helped her through such a trying time, Amber got angel wings tattooed on either side of her spine where burn marks had appeared from the radiation treatment. The tattoo on her right side, where the malignant lesion was first detected, symbolically resembles a “wounded wing.”

For Amber, March 2010 signifies three years of being cancer-free. She feels stronger now than ever before for having gone through the process and has learned not to take life for granted.

Amber wants young adults to know that tobacco and smoking aren’t the only causes of oral cancer and to realize how sex can impact their lives. Recent research indicates a link between oral cancers and the human papillomavirus (HPV) infection, which can be spread by oral sex.

To promote awareness and early detection of these potentially life-threatening but highly treatable cancers, Amber is organizing a free cancer screening as part of Oral, Head and Neck Cancer Awareness Week (OHANCAW) taking place across the U.S. April 12-18, 2010.

Amber’s screening will take place at the Bradley County Relay for Life event on April 30 — May 1 at the Team Relentless “campsite.” The Relay is held around the courthouse square in downtown Cleveland, TN. The complete list of more than 100 OHANCAW nationwide screening sites is available at www.OHANCAW.com.

Amber, thank you for sharing your story and for helping to educate young women and men about the increased risks associated with oral sex and oral cancers.

If you have any kind of sore or other abnormality in your mouth, see your dentist immediately. He or she can perform a fast and inexpensive procedure to test for oral cancer. It takes only a few minutes and costs less than $100 — and it can save your life.

According to a February 26, 2010 press release, OralDNA has released its OraRisk HPV Salivary Test to help dentists assess the risks of certain types of oral cancer.

This is a HUGE HUGE medical advance. As OralLab’s Medical Director Dr. Ronald C. McGlennen stated in the release, “. . . the at-risk profile for oral cancer is rapidly changing . . . and a new profile has emerged. Research studies have identified several high-risk strains of the human papillomavirus (HPV), especially the variant known as HPV-16, as potential etiologic agents in the development of squamous cell carcinoma of the head and neck (SCCHN).”

SCCHN can be found in the oral cavity, tongue, tonsils oropharynx, and larynx — and affects approximately 40,000 individuals in the US each year.

Even more important, it is estimated that 50% of all diagnosed cases of oral cancer in the US are attributed to HPV — which is transferred via sexual activity.

As I’ve stated repeatedly in the last two years, if you have multiple sex partners, the risk of contacting oral cancer is higher than if you smoke!

Because this issue is so important to me, I’ll be spending the next few weeks presenting information about oral cancer — including interviews from oncologists as well as oral cancer survivors.

I’m doing this because no one in the mainstream media seems to be doing it — despite my sending out press releases, emails, story pitches, and other information regarding this important health issue.

If you’re a sexually active young women, please do not ignore this message. Call your dentist today and ask to be tested for oral cancer and/or HPV. Many dentists across the US (myself included) now have access to tests such as ViziLite, which is a simple wash that takes 90 seconds and can help save your life.

You can learn more about oral cancer by visiting my Squidoo page and by viewing the ViziLite demo below:

According to an AOL Health News article, a study conducted in Japan indicates that coffee may help lower the risk of developing cancer in the mouth and throat.

According the study, “among more than 38,000 study participants aged 40 to 64 years with no prior history of cancer, 157 cases of cancer of the mouth, pharynx and esophagus occurred during 13 years of follow up.”

The article notes that “compared with people who did not drink coffee, those who drank one or more cups per day had half the risk of developing these cancers.”

The Japanese researchers were quite surprised by the results. While their study indicates that fewer high-risk participants (those who smoked and drank alcohol) developed cancers, the researchers pointed out that not smoking and drinking is the best way to lower your risk — but if you do continue these behaviors, drinking coffee may help.

I’ve become pretty passionate about the increase in oral cancer in young women and the reasons why young women should get tested for this deadly cancer when they visit their dentist.

According to the Oral Cancer Foundation, each day 100 individuals are diagnosed with oral cancer — and that’s just in the US!

In addition, one person dies of oral cancer every hour of every day.

States the Oral Cancer Foundation:

When found early, oral cancers have an 80 to 90 % survival rate. Unfortunately at this time, the majority are found as late stage cancers, and this accounts for the very high death rate of about 45% at five years from diagnosis, and high treatment related morbidity in survivors.

Late stage diagnosis is not occurring because these cancers are hard to discover, it is because of a lack of public awareness coupled with the lack of a national program for opportunistic screenings which would yield early discovery by medical and dental professionals.

As an FYI, I have alerted the local media to this story but not one has followed up with me. Very disconcerting — and frightening. You would think that informing consumers about oral cancer would be a public service announcement.

Which is why I’m very happy that SheKnows, a Website for women, interviewed me about this topic. Thank you, Michele!