When it comes to oral cancer, early identification and diagnosis can save lives, and dentists are on the front lines of that struggle. To help clinicians win this battle, the ADA has released an evidence-based, online clinical practice guideline for evaluating potentially malignant disorders in the oral cavity. It includes one good practice statement and 6 clinical recommendations for oral health professionals.
“This guideline is the result of a collaborative effort between ADA staff and experts in oral cancer for the expressed use and benefit of the ADA membership and, most importantly, the patients we are charged with caring for,” said Mark Lingen, PhD, chair of the expert panel that drafted the guideline and an oral and maxillofacial pathologist and professor of pathology at the University of Chicago Pritzker School of Medicine.
The panel urges clinicians to obtain an updated medical, social, and dental history of each adult patient and perform an intraoral and extraoral conventional visual and tactile examination for every visit. During this exam, dentists should distinguish between mouths with no lesions, mouths with seemingly innocuous lesions, and mouths with lesions suspected to be potentially malignant or that are malignant.
No further action is recommended when there are no clinically evident lesions or symptoms. When there is a clinically evident but seemingly innocuous lesion, periodic follow-up with the patient is recommended to determine the need for further evaluation. When there is a clinically evident and suspicious lesion, suspected to be a potentially malignant disorder or a malignant disorder, the dentist should perform a biopsy or immediately refer the patient to a specialist.
The panel does not recommend autofluorescence, tissue reflectance, or vital staining adjuncts for evaluating potentially malignant disorders among patients with clinically evident but seemingly innocuous or suspicious lesions. Also, commercially available salivary adjuncts are not recommended for evaluating potentially malignant disorders with or without clinically evident, seemingly innocuous, or suspicious lesions.
The study, “Evidence-Based Clinical Practice Guideline for the Evaluation of Potentially Malignant Disorders in the Oral Cavity,” was published by JADA. An online chairside guide also is available. In addition, Lingen will present the panel’s recommendations on the ADA Science Institute Stage during the ADA 2017 national meeting in Atlanta in October.