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PHONE: (828) 754-1600
PHOURS OF OPERATION:
Monday - Thursday
8AM to 5PM
Friday
Business Office Hrs 8AM to 4PM
OFFICE LOCATION:
614 Hospital Ave NW
Lenoir, NC 28645
D. Wayne Hollar, Jr. DDS Practice Featured in Dental Economics Magazine

Oral Cancer Screening

VELscope Completely PAINLESS Oral Cancer Screening

AS SEEN ON Dr. OZ!

VELscope examination. The clinician shines the blue excitation light into the patient's oral cavity and looks through the Handpiece.

VELscope's fluorescence technology aids in the early visualization of mucosal diseases and enhances effective oral mucosal screening

VELscope is a revolutionary hand-held device that offers Dentists, Hygienists, and other oral health-care providers an easy-to-use adjunctive screening instrument for early detection. Its technology platform is based on the direct visualization of tissue fluorescence and the changes in fluorescence that result when abnormal tissue is present.

The VELscope Handpiece emits a safe blue light into the oral cavity, which excites the tissue beneath and at the surface and causes it to fluoresce. By utilizing special optical filters in the Handpiece, the clinician is able to immediately view the different fluorescence responses of healthy vs. abnormal oral tissue. The healthy oral mucosal tissue will appear bright green while suspicious regions are identified by a loss of fluorescence, and will thus appear dark.

VELscope provides a more effective oral cancer screening protocol with immediate benefits for the patient and clinician.

When used in combination with traditional oral cancer examination procedures, VELscope facilitates the discovery and visualization of mucosal abnormalities prior to surface exposure. In less than 5 minutes, the VELscope screening procedure helps oral healthcare professionals assure their patients that the best standard for oral cancer screening has been utilized. As an adjunctive tool in the annual oral mucosal tissue exam, VELscope combines minimal per-patient costs with more effective screening.

Normal tongue and...
normal "light green" VELscope image.
Normal "appearing" oropharynx and...
abnormal "dark" appearance with VELscope.
Obvious lesion under tongue and ...
abnormal "dark" appearance with VELscope.

Oral Cancer

Statistical Information

Every hour of every day in America someone dies of Oral Cancer. Oral Cancer is the sixth most common diagnosed form of cancer in the United States. Presently 30,000 patients are diagnosed annually with oral cancer. The 5-year survival rate is only 50%, accounting for 8,000 deaths each year. Oral Cancer risk factors include tobacco use, frequent and/or excessive alcohol consumption, a compromised immune system, past history of cancer, and the presence of the HPV virus. Recently however 25% of all newly diagnosed cases have been in patients under the age of forty with none of the known risk factors. Oral Cancer is one of the few cancers whose survival rate has not improved in the past 50 years. This is due primarily to the fact that during this time we have not changed the way we screen for this disease (a visual and manual examination of the oral cavity, head, and neck).

Oral Squamous Cell Carcinomas (OSCC) make up over 90% of all oral cancers, and because of its appearance it has been difficult to differentiate from the other relatively benign lesions of the oral cavity. Early OSCC and potentially malignant lesions can appear as a white patch (leukoplakia, or as a reddened area (erythroplakia), or as a red and white (erythroleukoplakia) mucosal change under standard white light examination. However, these cellular changes are often non-detectable to the human eye (even with magnification eyewear) under standard lighting conditions. Often, when the lesion becomes visible, it has advanced to invasive stages. The high mortality rate is directly related to the lack of early detection of potentially malignant lesions. When diagnosis and treatment are performed at or before a Stage 1 carcinoma level, the survival rate is more than 90%.

The cancers which have seen a major decline in the mortality rate have included colon, cervical, and prostate cancer and the primary reason is early detection and screening.

We can make a difference in the oral cancer mortality rate.

Early screening, diagnosis, and treatment planning saves lives.

Last updated by LED Dental, Inc. 05/23/2006.

Early Detection

Historically, it has been difficult to determine which abnormal tissues in the mouth are worthy of concern. The fact is, the average person routinely has conditions existing in their mouths that mimic the appearance of pre-cancerous changes, and very early cancers of the soft tissues. One study determined that the average dentist sees 3-5 patients a day who exhibit soft tissue abnormalities, most of which are benign in nature. Even the simplest things, such as a canker sore (herpes simplex), the wound left by accidentally biting the inside of your cheek, or sore spots from a poorly fitting prosthetic appliance or denture, all at first examination, share similarities with dangerous lesions. Some of these conditions cause physical discomfort, others are painless. The question is which ones deserve action, and which ones bear watching and waiting?

There has been a tendency to watch these areas over an extended period to determine if they are dangerous or not. Unfortunately, this philosophy leads to a situation in which a dangerous lesion may continue to prosper and grow into a later stage, hard to cure cancer. Any sore, discoloration, induration, prominent tissue, irritation, hoarseness, which does not resolve within a two week period on its own, with or without treatment, should be considered suspect and worthy of further examination or referral. Besides a routine visit to the dental office for regular examinations, it is the patient's responsibility to be aware of changes in their oral environment. When these changes occur, they need to be brought to the attention of a qualified dental professional for examination. The dental professional needs to be current in the knowledge base necessary to make a proper diagnosis, and be competent in the proper screening procedures to identify oral cancer.

How to know if you have had a proper oral cancer screening

There are two separate issues, discovery and diagnosis. Discovery is the result of a thorough visual and manual examination. A protocol for a comprehensive oral cancer screening appears elsewhere in this section of the web site. It includes a systematic visual examination of all the soft tissues of the mouth, including manual extension of the tongue to examine its base, a bi-manual palpation of the floor of the mouth, and a digital examination of the borders of the tongue, and the lymph nodes surrounding the oral cavity and in the neck. New diagnostic aids, including lights, dyes, and other techniques are beginning to appear on the marketplace. While making the discovery process more effective, it is still possible to do a comprehensive examination through a proper visual and tactile process.

Once suspect tissues have been detected, the only way a definitive diagnosis of oral cancer may be made is through biopsy. Given the large number of tissue abnormalities a dentist sees every day, it is not logical, nor practical, that each one of these be biopsied. The first question which may help in the determination of which abnormality bears closer examination, is how long has the suspect condition been present? Any condition that has existed for 14 days or more without resolution should be considered suspect and worthy of further diagnostic procedures or referral. Certainly, it is common knowledge that two of the most prevalent lesions that mimic oral cancer, are the herpes simplex ulceration, and aphthous ulcerations, each resolving of their own accord in approximately 10-14 days. Perhaps that sentence should be underlined, since one of the most common diagnoses received with referred patients to a major university cancer pathology department is "an atypical herpetic/aphthous lesion" These all too frequently turn out to be squamous cell carcinomas, which have been under observation.... for several months.

Still, it would seem impractical at these early timelines to engage in biopsy. A oral biopsy brush is available that makes this decision to get an early diagnosis through biopsy easier to make. Simple, painless, and accurate diagnosis of soft tissue abnormalities can be obtained through its use.

Note that this system is not designed to provide the kind of information, specifically cellular architecture, that would be obtained through a punch or incisional biopsy. But it will provide an answer to the question of whether malignancy exists or not, through a quick, minimally invasive, and inexpensive procedure. Should positive results be returned through this system, the brush biopsy must be followed by a conventional biopsy procedure for confirmation. The strong argument for the brush biopsy is that it eliminates the waiting and watching of a suspicious lesion, while it develops from a highly treatable and curable, early stage localized cancer, into a life threatening late stage malignancy. Positive identification of oral cancers at the earliest stages, result in the best prognosis for cure and long-term survivability.

Creating awareness, discovery, diagnosis, and referral. When it comes to oral cancer and saving lives, these are the primary responsibilities of the dental community. The most important step in reducing the death rate from oral cancer is early discovery. No group has a better opportunity to have an impact than members of the dental community.

Last updated by LED Dental, Inc. 05/23/2006.

The copyrighted information was obtained by permission from LED Dental, Inc. and is protected by the copyrights of LED Dental, Inc.



All Rights Reserved, 2017 | D. Wayne Hollar, Jr. DDS - 614 Hospital Ave NW, Lenoir, NC 28645 | Master of The Academy of General Dentistry
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Phone: (828) 754-1600
Quick Visitor Information
PHONE: (828) 754-1600
HOURS OF OPERATION:
Monday - Thursday
8AM to 5PM
Friday
BUSINESS OFFICE HOURS - 8AM to 4PM
OFFICE LOCATION:
614 Hospital Ave NW
Lenoir, NC 28645
Oral Cancer Screening

VELscope Completely PAINLESS Oral Cancer Screening

AS SEEN ON Dr. OZ!

VELscope examination. The clinician shines the blue excitation light into the patient's oral cavity and looks through the Handpiece.

VELscope's fluorescence technology aids in the early visualization of mucosal diseases and enhances effective oral mucosal screening

VELscope is a revolutionary hand-held device that offers Dentists, Hygienists, and other oral health-care providers an easy-to-use adjunctive screening instrument for early detection. Its technology platform is based on the direct visualization of tissue fluorescence and the changes in fluorescence that result when abnormal tissue is present.

The VELscope Handpiece emits a safe blue light into the oral cavity, which excites the tissue beneath and at the surface and causes it to fluoresce. By utilizing special optical filters in the Handpiece, the clinician is able to immediately view the different fluorescence responses of healthy vs. abnormal oral tissue. The healthy oral mucosal tissue will appear bright green while suspicious regions are identified by a loss of fluorescence, and will thus appear dark.

VELscope provides a more effective oral cancer screening protocol with immediate benefits for the patient and clinician.

When used in combination with traditional oral cancer examination procedures, VELscope facilitates the discovery and visualization of mucosal abnormalities prior to surface exposure. In less than 5 minutes, the VELscope screening procedure helps oral healthcare professionals assure their patients that the best standard for oral cancer screening has been utilized. As an adjunctive tool in the annual oral mucosal tissue exam, VELscope combines minimal per-patient costs with more effective screening.

Normal tongue and... normal "light green" VELscope image. Normal "appearing" oropharynx and... abnormal "dark" appearance with VELscope. Obvious lesion under tongue and ... abnormal "dark" appearance with VELscope.

Oral Cancer

Statistical Information

Every hour of every day in America someone dies of Oral Cancer. Oral Cancer is the sixth most common diagnosed form of cancer in the United States. Presently 30,000 patients are diagnosed annually with oral cancer. The 5-year survival rate is only 50%, accounting for 8,000 deaths each year. Oral Cancer risk factors include tobacco use, frequent and/or excessive alcohol consumption, a compromised immune system, past history of cancer, and the presence of the HPV virus. Recently however 25% of all newly diagnosed cases have been in patients under the age of forty with none of the known risk factors. Oral Cancer is one of the few cancers whose survival rate has not improved in the past 50 years. This is due primarily to the fact that during this time we have not changed the way we screen for this disease (a visual and manual examination of the oral cavity, head, and neck).

Oral Squamous Cell Carcinomas (OSCC) make up over 90% of all oral cancers, and because of its appearance it has been difficult to differentiate from the other relatively benign lesions of the oral cavity. Early OSCC and potentially malignant lesions can appear as a white patch (leukoplakia, or as a reddened area (erythroplakia), or as a red and white (erythroleukoplakia) mucosal change under standard white light examination. However, these cellular changes are often non-detectable to the human eye (even with magnification eyewear) under standard lighting conditions. Often, when the lesion becomes visible, it has advanced to invasive stages. The high mortality rate is directly related to the lack of early detection of potentially malignant lesions. When diagnosis and treatment are performed at or before a Stage 1 carcinoma level, the survival rate is more than 90%.

The cancers which have seen a major decline in the mortality rate have included colon, cervical, and prostate cancer and the primary reason is early detection and screening.

We can make a difference in the oral cancer mortality rate.

Early screening, diagnosis, and treatment planning saves lives.

Last updated by LED Dental, Inc. 05/23/2006.

Early Detection

Historically, it has been difficult to determine which abnormal tissues in the mouth are worthy of concern. The fact is, the average person routinely has conditions existing in their mouths that mimic the appearance of pre-cancerous changes, and very early cancers of the soft tissues. One study determined that the average dentist sees 3-5 patients a day who exhibit soft tissue abnormalities, most of which are benign in nature. Even the simplest things, such as a canker sore (herpes simplex), the wound left by accidentally biting the inside of your cheek, or sore spots from a poorly fitting prosthetic appliance or denture, all at first examination, share similarities with dangerous lesions. Some of these conditions cause physical discomfort, others are painless. The question is which ones deserve action, and which ones bear watching and waiting?

There has been a tendency to watch these areas over an extended period to determine if they are dangerous or not. Unfortunately, this philosophy leads to a situation in which a dangerous lesion may continue to prosper and grow into a later stage, hard to cure cancer. Any sore, discoloration, induration, prominent tissue, irritation, hoarseness, which does not resolve within a two week period on its own, with or without treatment, should be considered suspect and worthy of further examination or referral. Besides a routine visit to the dental office for regular examinations, it is the patient's responsibility to be aware of changes in their oral environment. When these changes occur, they need to be brought to the attention of a qualified dental professional for examination. The dental professional needs to be current in the knowledge base necessary to make a proper diagnosis, and be competent in the proper screening procedures to identify oral cancer.

How to know if you have had a proper oral cancer screening

There are two separate issues, discovery and diagnosis. Discovery is the result of a thorough visual and manual examination. A protocol for a comprehensive oral cancer screening appears elsewhere in this section of the web site. It includes a systematic visual examination of all the soft tissues of the mouth, including manual extension of the tongue to examine its base, a bi-manual palpation of the floor of the mouth, and a digital examination of the borders of the tongue, and the lymph nodes surrounding the oral cavity and in the neck. New diagnostic aids, including lights, dyes, and other techniques are beginning to appear on the marketplace. While making the discovery process more effective, it is still possible to do a comprehensive examination through a proper visual and tactile process.

Once suspect tissues have been detected, the only way a definitive diagnosis of oral cancer may be made is through biopsy. Given the large number of tissue abnormalities a dentist sees every day, it is not logical, nor practical, that each one of these be biopsied. The first question which may help in the determination of which abnormality bears closer examination, is how long has the suspect condition been present? Any condition that has existed for 14 days or more without resolution should be considered suspect and worthy of further diagnostic procedures or referral. Certainly, it is common knowledge that two of the most prevalent lesions that mimic oral cancer, are the herpes simplex ulceration, and aphthous ulcerations, each resolving of their own accord in approximately 10-14 days. Perhaps that sentence should be underlined, since one of the most common diagnoses received with referred patients to a major university cancer pathology department is "an atypical herpetic/aphthous lesion" These all too frequently turn out to be squamous cell carcinomas, which have been under observation.... for several months.

Still, it would seem impractical at these early timelines to engage in biopsy. A oral biopsy brush is available that makes this decision to get an early diagnosis through biopsy easier to make. Simple, painless, and accurate diagnosis of soft tissue abnormalities can be obtained through its use.

Note that this system is not designed to provide the kind of information, specifically cellular architecture, that would be obtained through a punch or incisional biopsy. But it will provide an answer to the question of whether malignancy exists or not, through a quick, minimally invasive, and inexpensive procedure. Should positive results be returned through this system, the brush biopsy must be followed by a conventional biopsy procedure for confirmation. The strong argument for the brush biopsy is that it eliminates the waiting and watching of a suspicious lesion, while it develops from a highly treatable and curable, early stage localized cancer, into a life threatening late stage malignancy. Positive identification of oral cancers at the earliest stages, result in the best prognosis for cure and long-term survivability.

Creating awareness, discovery, diagnosis, and referral. When it comes to oral cancer and saving lives, these are the primary responsibilities of the dental community. The most important step in reducing the death rate from oral cancer is early discovery. No group has a better opportunity to have an impact than members of the dental community.

Last updated by LED Dental, Inc. 05/23/2006.

The copyrighted information was obtained by permission from LED Dental, Inc. and is protected by the copyrights of LED Dental, Inc.



All Rights Reserved, 2017
D. Wayne Hollar, Jr. DDS
614 Hospital Ave NW, Lenoir, NC 28645
Master of The Academy of General Dentistry