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The Intraoral and Extraoral Exam

Course Number: 337

Radiographs and Oral Photography

Radiographs and oral photography are important adjuncts which can be utilized to compare changes in tissue. Photography is especially beneficial in cases where severe inflammation is present. Some of the adjunct devices can identify inflammation in the soft tissues but they cannot differentiate between inflammation caused by, for example, cheek biting or lichen planus. At the same time, because inflammation is a constant in some cases, frequent biopsy may not be appropriate since constant biopsies are not the optimal form of patient management. Often tissue specimens return with a “non-specific ulcerative tissue” diagnosis and crucial areas may be missed due to excessive inflammation. Being able to compare digital images of the lesion provides the practitioner the added benefit of actually seeing the progression or extension of the lesion. An added benefit is being able to show the patient how the lesion has progressed over time when suggesting they need to have a biopsy. Oral photography is highly beneficial as a key part of the patient’s permanent record as well. Radiographs can be used to determine if a lesion seen on the surface of the oral tissues actually extends into the bone or other hard structures adding another dimension to the diagnostic process. Radiographs are also important in assessing both hard and soft tissue lesions within the oral cavity that may not be visible during the standard oral cancer exam. Periodic radiographs may find pathology and lesions at a much earlier existence when treatment may be far less invasive for a patient. The American Cancer Society provides an extensive review of the current staging of oral lesions that have been detected with information about the spread of oral cancer or the recurrence.60

STATICYTE (Proteocyte AI)

The early diagnosis of oral squamous cell carcinoma (OSCC) is the ultimate goal in dentistry today. Mouth cancer affects an estimated 450+ individuals worldwide each year. The deaths resulting from oral epithelial dysplasia which reach the OSCC classification present the patient with major surgery and even death. STRATICYTE has developed a new method assessing a protein called S100A7. This biomarker is linked to the risk of developing oral cancer and may provide an objective way to assess whether the OED might result in cancer. This method allows the patient to understand their own risks and assists in making decisions going forward about their treatment.61 See STATICYTE