Chairside Oral Cancer

guide for Prevention and patient management

Up to 70% of oral cancers are preceded by premalignant oral lesions, such as persistent red or white patches in the mouth.
This chairside guide focuses on the most common sites of oral cancer: the tongue, the insides of the cheeks, and the floor of the mouth.
ACCO FACTS
RccoFACTS
use Types of tobacco use Effects of tobacco on oral health

800 million men smoke.

cancer
Smoking
Risk factors
Smokeless Increases risk of:
Profile of those at highest risk
200 million women smoke.
50%
,000 individuals die each
MAIN RISK FACTORS
cigarettes
year from Cigarette smoking
snuff, dry
and is
• oral cancer
the most • smoker’s palateA typical high-risk profile for oral cancer
moist
OTHER RISK FACTORS
ar survival
ndhand smoke: 156,000 men, common form of tobacco is a man, over age 40, who uses tobacco
use, • periodontal disease
ith women
000 oral and 166,000 children.
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Effects of tobacco
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ast
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he Challenge of Oral Disease – A call for globaltobacco
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ease – A call for globaltobacco
action by FDI World Dental Federation.
ditions 2015
es • staining
ease – A call for global action by FDI World Dental Federation.
of Oral
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Disease – A call for global action
2015
by FDI
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(bad breath)
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PATIENT MANAGEMENT
ave a
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ction by FDI World Dental Federation.
BEFORE CANCER TREATMENT DURING CANCER TREATMENT AFTER CANCER TREATMENT
ld Dental Federation.
Prepare patients Minimize the side effects of Monitor the healing process and
before cancer treatment radiotherapy possible recurrence of oral cancer

STEP 1 Eliminate oral infectious focus • Use local antiseptic, anaesthetic gel and • Follow-up and recall at least twice a year.
STEP 2 Conduct non-invasive treatment non-alcoholic alkaline rinses in case of • Use antibiotic therapy in case
post radiotherapy mucositis. of traumatic dental procedures
STEP 3 Apply fluoride dental tray
• Prevent caries by recommending brushing after radiotherapy.
STEP 4 Recommend maxillofacial twice daily with a soft toothbrush and
prosthesis if indicated • Conduct non-traumatic prosthetics for
fluoride toothpaste between 2800ppm rehabilitation within 6 to 12 months.
and 5000ppm and/or apply fluoride
dental tray.
• Recommend sugar-free chewing gum and
salivary substitutes in case of xerostomia.
 STEP 1 STEP 2 STEP 3 STEP 4
Oral screening
Oral health professionals are well-placed to Examine the Examine the Examine the floor Examine the
screen high-risk patients for early signs of inner cheek lateral border of of the mouth palate
oral cancer. Survival rates can be improved the tongue
with early detection and timely referral to
multi-disciplinary treatment centres.
STEP 5

Diagnosis
WHITE LESIONS UNIQUE ULCERATION

It is
recommended
SCREENING BY PALPATION
Ask patient if he/she is a smoker to use two mirrors SCREENING BY PALPATION
and to palpate oral
mucosa in all oral
INFECTION LESIONS
REMOVABLE NON-REMOVABLE screening steps TRAUMATIC (tuberculosis, HIV, syphilis, etc.)
APHTHOSIS

Lichen planus, Tobacco Idiopathic Eliminate all traumatic factors Biopsy and timely Local or systemic
SWAB TEST
pemphigus Leukoplakia Leukoplakia and conduct two week follow-up referral treatment

Homogenous Non-homogenous
(smooth and (thick, white with red
translucent) spots, rugous) Biopsy to confirm if
If no candidiosis,
If candidiosis, oral cell carcinoma and
consultation
anti-fungal timely referral
needed regarding
treatment
oral hygiene
is needed
(plaque bacteria)

Stop tobacco
Stop tobacco
Biopsy: OIN, Dysplasia, SCC
and regular follow-up DISCLAIMER Please note that in this document ‘oral cancer’ refers to squamous cell carcinoma.
(Squamous Cell Carcinoma) NOTE Please consult national guidelines and recommendations on oral cancer management and prevention.

FDI World Dental Federation This chairside guide was

Avenue Louis-Casaï 51 • 1216 Genève • Switzerland
T +41 22 560 81 50 • info@fdiworlddental.org
www.fdiworlddental.org/oral-cancer made possible through an
unrestricted grant from
©2018 FDI World Dental Federation