by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine
When the average person hears “dentist,” the word “activism” doesn’t usually come to mind. However, there are many dentists who stand up for the changes they want to see. For instance, dentists changed oral health forever when they rallied to fluoridate water. They took action and won, case by case, community by community. We need that same kind of dedication for a different matter now: oral cancer.
In the United States, a person dies every hour from oral cancer, and many of those people could have been saved if they’d had a screening or an earlier screening for oral cancer.1 Let’s face it—actually getting reimbursed for a screening would help. We have 150,000 dentists in this country and we don’t even get paid by the largest dental insurance companies in the world for an oral-cancer exam?
Another lifesaver: the vaccine for human papillomavirus (HPV). If more people got the HPV vaccine, fewer people would get oral cancer. It’s that simple, but dentists aren’t even allowed to administer the vaccine.
It’s worse than that, though: most of us don’t give HPV advice or talk about HPV at all. How many people have to die before the physicians of the mouth start asking parents, “Has your child been vaccinated for HPV?” The fact that HPV is linked to cervical cancer is becoming well known, but the average person is not aware that HPV is also linked to oral cancers.
Dentists could be an amazing ally in spreading this information, and I believe we should be able to give the vaccine. I would like to, but as a dentist I’m not allowed to, and even if I did give it, I wouldn’t get reimbursed for it. A registered nurse can give the vaccine, but I can’t.
After almost a decade of advanced education I don’t have the legal right to give a vaccine, yet I go to Walgreens or CVS and I can get a flu shot.
Dentists, we have to take our ground back.
All the data I see says that the average American sees a dentist twice for every time he or she sees a physician. This frequency of visit gives us tremendous power, and that power is not being used adequately. Dentistry is a sleeping giant in terms of overall health. We do a lot, but we could do more, and we should be reimbursed for it. Should we screen patients for lung cancer or brain tumors? No. But preventing oral cancer is a cause we should take up.
There has long been a resistance to helping people regarding oral cancer and I think it has to do with past prejudice. When I got out of school in 1987, a lot of clinicians weren’t much into oral-cancer screening, and it’s probably because they were judgmental. Public perception was that everyone who had oral cancer did “bad” things such as drinking and smoking, and brought the illness on themselves. Some people still may have those beliefs regarding oral cancer and HPV, when sexual activity plays a role.
We’ve had some brave famous people go public about their oral cancer (such as actor Michael Douglas, who was diagnosed with throat cancer) and this is helping to remove the stigma. There’s a lot more that can be done to educate the public, though, and we are just the people to take the lead. We’ve taken the lead before…
I am very proud of our efforts for community fluoridation, which started in the 1940s in Grand Rapids, Michigan. Right now about 74 percent of Americans drink fluoridated water, and the research shows that we have about a 40-percent reduction in decay in those communities. But why stop there? One in four Americans still doesn’t have water fluoridation. Maybe it’s time for the American Dental Association (ADA) to get involved. The ADA has an amazing president, Dr. Maxine Feinberg, whom I love and adore, and the president-elect is Dr. Carol Summerhays, whom I also very much admire. Maybe if we start talking with these two legendary dentists and the ADA about this topic, water fluoridation can become a piece of national legislation. By the way, check out the podcast I did with Maxine Feinberg and Carol Summerhays at Dentaltown.com/ADApodcast. You can also find it in the blogs/podcasts section.
We have national legislation to put vitamin D in milk; we have national legislation to put chlorine in water. We don’t let every community decide if they put vitamin D in milk, or chlorine in the water to prevent cholera, or iodine in the salt to prevent goiter. Can you imagine if one in four communities didn’t have iodine in the salt and people had goiters? Or if communities didn’t have vitamin D in their milk and had rickets? This is crazy. It’s time to close the water-fluoridation deal and have one piece of national legislation.
I’d like to go farther than that, though, and take on oral cancer. I want to see legislation for this and I want people to accept that dentists have eight years of college and are doctors. They should be able to do anything in any state that a pharmacist at Walgreens and CVS can do, such as give a flu shot if they want to, and they sure should be able to give an HPV vaccine.
Legislation or not, we all need to start talking to patients about HPV and oral cancer, because someone is dying of oral cancer every hour.
You’re a doctor and your patients are counting on you. Man up. Woman up. Let’s band together to standardize fluoridation nationwide and to reduce oral-cancer deaths.
Oral Cancer Facts
Nearly 45,750 Americans will be diagnosed with oral or pharyngeal cancer this year.
It will cause more than 8,650 deaths, killing roughly one person per hour, 24 hours per day.
Historically, the death rate associated with this cancer is particularly high not because the cancer is hard to discover or diagnose, but because the cancer is routinely discovered late in its development.
Of those 45,750 newly diagnosed individuals, only slightly more than half—approximately 57 percent—will be alive in five years.
One of the real dangers of this cancer is that in its early stages, it can go unnoticed. The good news is that in many cases, a physician or dentist can see or feel the precursor tissue changes, or the actual cancer while it is still very small or in its earliest stages.
Worldwide the problem is much greater, with more than 450,000 new cases diagnosed each year. Note that the world incidence numbers from the World Health Organization, while the best available, are estimates that users should consider with caveats.
The human papilloma virus (HPV) is now confirmed to cause oral cancer in a younger age group. Transmitted via sexual contact, HPV (particularly version 16) is conclusively implicated in the increasing incidence of young, non-smoking oral-cancer patients. This is the same virus that—along with its other versions—causes more than 90 percent of all cervical cancers in women. The foundation believes, based on recent peer-reviewed published data, that HPV16 may be replacing tobacco as the primary causative agent in the initiation of the disease process in people under the age of 50.
Information from Oralcancerfoundation.org – See more at: http://www.dentaltown.com/Dentaltown/Article.aspx?i=393&aid=5412#sthash.ahl8vFaJ.dpuf