Are you interfering with your screening for infection, cysts and oral cancer?
The truth is you probably didn’t even realize that your Dentist screens for infection, cysts and cancer during your routine dental appointments.
At Westmount Dental, we visually assess every patient. Most patients do not realize that x-ray radiographs are an important component of our overall examination and screening process.
The two greatest challenges every dentist faces with a screening is (1) are we able to see enough and (2) will the patient allow us to do what we need to do.
The answer to the first question is, for now, yes. The techniques and tools used today in the screening process are limited by technological abilities. As technology continues to evolve I am certain Dentists will be able to see more, detect conditions earlier and, therefore save more lives.
Addressing the issue of patients who interfere with their own care is where the challenge lies.
In dentistry, screening includes touching the skin, muscle and bone in and around the mouth. A visual inspection is critical to the process and it includes x-ray radiographs of the teeth and supporting jaw bone. Screening methods are completely ineffective when the patient refuses care, more specifically; declining to have x-ray radiographs taken of their mouth. This directly inhibits the dentist’s ability to provide the care patients have come to expect from their health care provider.
The most popular excuse for refusing radiographs I hear from my patients is the unsubstantiated fear that the radiation exposure from dental radiographs cause oral cancer. The best example that comes to mind relates to my experience with “Ruth” a few years ago.
Ruth had routinely declined x-ray radiographs at each of her hygiene maintenance appointments for fear of the radiation exposure.
I had explained that radiographs were a vital component of the examination as they allow me to detect decay, bone loss, infection, and tumours. I also explained that our office has taken steps to minimize our patients’ exposure by using lead aprons, lead lining of every treatment room wall and cabinet, and most importantly, our digital system exposes patients to significantly less radiation than conventional X-rays.
Ruth still refused.
At a subsequent appointment I had asked if we could take the necessary images needed to examine her. This time she did not express her customary, borderline reflexive, refusal and instead permitted me to take the appropriate radiographs – but I could tell she wasn’t happy saying it. In all sincerity, I thought, and anyone in a similar position may as well, “I hope I find something of relevance, or else she will refuse radiographs for the rest of her life!”
And there they were. Large, dark regions near her lower wisdom teeth. The lesions had displaced the teeth so far down that any non-dentist would have thought that these teeth were growing out from under her jaw.
Following an immediate referral to an Oral Surgeon, he had surgically removed both growths and sent them for biopsy to the Pathologist . Thankfully, they were not metastatic cancerous lesions however they were locally-invasive benign tumours that caused significant damage to her jaw.
In a recent article in the Journal of the Canadian Dental Association, it states that “there isn’t enough evidence to definitively say whether oral cancer screening is effective or not.”
The CDA and the College’s position on this issue remains unwavering – despite inconclusive evidence, dentists should remain vigilant for tissue irregularities and signs of pre-cancerous or cancerous lesions in all patients during routine follow-up and new patient oral examinations.
I am certain that the countless number of patients in whom I have detected infections, cysts and tumours are all very grateful that I performed a screening for them. I will continue to do the same for everyone in my practice because not performing a screening is an alternative I do not want to consider.
Lastly, to my patients who routinely decline having x-rays, I sincerely hope that one day you will realize that the benefits of radiography far outweigh the unproven dangers, and moreover, trusting my professional judgment may save your life.
Our dentists provide a full range of treatment including dental implants, root canal therapy, wisdom tooth surgery, sedation, Invisalign orthodontics, and cosmetic treatments. most importantly, our preventive dental care program aims to reduce the risk of you and your family requiring more invasive and costly treatment.
Our office is located in the heart of Thornhill in Vaughan. Call today to schedule your appointment. 905-881-8284