Mouth Cancer Action Month 2020 with Rachel Botrugno

November is Mouth Cancer Action Month! So let's hear from Rachel Botrugno, a DCT1 in Oral Medicine and Restorative at Cardiff Dental Hospital about Mouth Cancer and what we can all do this month to make a difference and raise awareness...
In this short blog I aim to draw your attention to Mouth Cancer Action month and the role we have to play as dentists in mouth cancer assessment and awareness (particularly within primary care). I would also like to get you all thinking about how we can adapt/improve our delivery of mouth cancer prevention to our patients in light of the Covid-19 ‘new normal’.

The Impact of COVID-19

As England enters their second lockdown due to COVID-19, we welcome the news that dental practices will remain open during this period. The closure of dental practices in March 2020 has thought to have caused delays for approximately 10 million routine appointments. One of England's biggest NHS Trusts found the number of suspected cancer referrals fell by 65%. These statistics are concerning regarding the impact of early cancer detection within routine dental appointments. From my own experience of telephone triaging, examining and treating patients at Cardiff Dental Hospital I have heard first hand of the difficulties faced in finding an NHS dental practice that are taking on new patients.

Another area impacted by COVID-19 is the HPV vaccination programme where school closures has led to pupils missing out on the vaccination programme. This vaccine was started in 2008 in hope to reduce the number of HPV cancers, one of these being mouth cancer, and has been delivered within schools to those between 11-12 years of age.

Mouth Cancer Action Month 2020

November marks Mouth Cancer Action month. The terminology ‘mouth cancer’ is now preferred to ‘oral cancer’ when discussing with patients as the meaning is clearer and less clinical.

November and Beyond

I believe Mouth Cancer Action month provides an ideal time to consider how to raise awareness and education on prevention if mouth cancer to your patients. My ideas on what to think about include…

  1. When was the last time you completed brief smoking cessation advice training? Could you benefit from an update in this?
  2. How are you going to phrase this advice to patients at risk? Do not be afraid to mention mouth cancer risks as a reason to why you ask certain questions in the dental setting such as typical alcohol intake.
  3. Take the opportunity to mention mouth cancer as you complete your extra-oral examination and highlight some of the signs of mouth cancer such as a non-healing ulcer to improve the public's knowledge.
  4. Do you know exactly how and where you are going to refer patients for smoking cessation in your local area? Do you know if these services are affected by COVID-19?
  5. Discuss with the patient their previous attempts to quit smoking such as the strategies and methods they tried. Most smokers take numerous attempts to quit before being successful, so it is important to remind them that each quitting attempt should not be deemed as a failure.
  6. As unregistered patients explore your practice website to determine if you are taking on new patients you could consider marking Mouth Cancer Action month on your website or the practice’s social media profile. This could help raise awareness to a cohort beyond your current list of registered patients. Another great step would be to include information on how patients can carry out their own self check and how to proceed if they are concerned. The Mouth Cancer Foundation website has a self-check leaflet your patients can refer to or you could be creative and make you own video.

It seems it will take a long time for dentistry to catch up with the time we have lost due to COVID-19, but it is clear we can adapt as a profession and Mouth Cancer Action month should be no exception to this. I hope this read has provided some food for thought and useful resources for many.

Useful Resources

The State of Mouth Cancer UK Report 2020/2021 is an interesting read I recommend. It discusses signs, symptoms, self-examination and risk factors. 

The BDA has an excellent resource, ‘Oral cancer recognition tool kit’ offering 3 hours of CPD which acts as a useful refresher on the topic. The head and neck examination video is particularly useful to act as a reminder on how to carry out an extra-oral examination.

This is the link to the self-check leaflet as mentioned previously.

Thanks Rachel for your guest post! Please leave any comments about oral cancer and what you are doing for Mouth Cancer Action Month in the comments below!

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