Woman: When I went to my new dentist after relocating to Aspen, I was surprised when he began his exam by checking my neck, cheeks and lips. I always thought that the dentist just examined my gums and my teeth. I had never had that done before.
Eric T. Stoopler, D.M.D., University of Pennsylvania School of Dental Medicine: A head and neck exam is something I do every time someone comes in for a checkup. It's a simple procedure and it doesn't take long. Most of the time there aren't any problems, or the problems turn out to be something minor.
Narrator: Regular checkups that include an examination of the entire head, mouth and neck can detect precancerous conditions or the early stages of oral cancer, which includes cancers in the mouth and part of the throat.
Cancer in the neck and mouth spreads quickly, and it often isn't found until it's so advanced that the outlook is poor and treatment options are limited. The way to catch it early is to learn how to check yourself, and to have regular exams by your dentist.
Dr. Stoopler: When we do a head and neck exam, we check a patient's face, neck area, lips and inside the mouth.
Cancer isn't the only thing we look for. We look for anything unusual such as swellings, sores, bumps or problems with their salivary glands.
Your mouth is like a mirror to the rest of your body and a good head and neck exam can detect other health issues. For example, if you have dry, cracked lips, it could mean you have a vitamin deficiency.
Narrator: Here's how a dentist does a head and neck exam.
First, the dentist will examine your face and neck for any changes in your skin or obvious growths or swellings.
He will feel the lymph nodes under your chin, in front of and behind your ears, and on both sides of your neck to see if they are enlarged.
Part of his examination will be checking your jaw joints — called the temporomandibular joints — to see if they move properly, if they make noises when you open and close your mouth and if they are tender.
The dentist will look at your lips to see if they are cracked, irritated or if you have any blisters.
Next, it's time to look inside your mouth. The dentist will examine the skin inside your bottom and top lips and inside both cheeks. He will feel for lumps or hardness by placing one finger inside your lips or cheeks and pressing gently.
Next he will examine your tongue. He will look at the top of your tongue and will use a piece of gauze to gently grab at the end of your tongue so he can look at both sides of your tongue. He will also raise it up to look underneath your tongue and the floor of your mouth.
He will ask you to tilt your head back, open your mouth wide and say, "Ah" so he can look at the top of your mouth, called your palate, and the back of your mouth near your tonsils.
He will then feel for lumps on the floor of your mouth by putting one finger on the floor of your mouth and one finger under your chin.
The complete exam only takes a few minutes and is painless.
Woman: My dentist found a red spot inside of my mouth that turned to be nothing serious, but I am so glad that he looks for things like that. I always have a mammogram and Pap smear, but I never thought about oral cancer.
Narrator: Your smile lights up your face and expresses your personality.
If you look closely, it also holds some important messages about your health.
By taking a few minutes once a month to look at your mouth inside and out, you can find clues that something is wrong before it gets too serious.
An oral self-exam is just as important as any other preventive health practice you do. By becoming familiar with what is normal for you, you will notice what might be abnormal or even cancerous.
To begin, stand in front of a mirror with good light.
You will be looking first and then feeling the different areas of your neck and mouth.
You should compare one side of your neck, face and mouth to the other. You will have normal differences from one side to the other, but once you know these, comparing both sides will help you notice unusual swellings, lumps and skin changes.
Gently feel both sides of your neck and under your jaw.
You're feeling for any lumps or swelling.
Now examine your lips. Look inside your lower lip and your upper lip.
Look inside both cheeks. The tissue inside your lips and cheeks should be firm and relatively smooth. There shouldn't be any spots or patches that are a different color or texture.
Oral cancer can start as a small, painless red or white patch or ulcer or a crusty area on your lip.
To show you an example of something that isnít normal, take a look at this photo. This red patch is on the roof of the mouth.
Here is another example of something that isnít normal. This white patch should be checked by a dentist.
Finally, look at this photo. This spot is suspicious because the tissue is scaly and redder than normal.
While you examine your mouth, you want to check for any swelling or lumps. Use your forefinger and thumb to feel your lips and cheeks. There are small salivary glands in this area, so it may feel slightly pebbly. This is normal.
Next, you should look at your gums, and all around your teeth. You should look for any swelling, ulcers or redness.
Use your forefinger to feel the area between your cheeks and teeth and all around your mouth. You're feeling for any lumps or swelling that weren't there before.
Now, look at the roof of your mouth. Check for the same things — color changes or unusual spots.
Then feel the roof of your mouth for lumps.
Now it's time to check your tongue. There are two ways to do this.
You can just stick out your tongue. Move it from side to side and look at both sides carefully. Then look at the top of your tongue. Finally, stick it up toward the roof of your mouth and look at the bottom of your tongue.
You can also use your fingers or a small piece of gauze or tissue to grab the end of your tongue and pull it out. Some people find it easier to do it this way.
Your tongue normally should be reddish-pink and moist. One side shouldn't be larger than the other. The surface of your tongue has thousands of taste buds, so it normally looks a little rough, almost like fine sandpaper. A shiny, perfectly smooth spot would be abnormal. A bright red spot also would be unusual.
Here's an example of an abnormal area on a tongue. This turned out to be a cancer and had to be removed.
One last thing: Use your forefinger to check the floor of your mouth, under your tongue, for lumps.
OK. You're done.
If a spot or sore is just a minor injury or irritation, it should heal within two weeks. If you see something, check it again in two weeks and if it hasn't gone away, see your dentist. Any lump or swelling should always be checked.
If you have any questions, ask your dentist to show you how to do a self-exam.
By checking your neck and mouth yourself every month, you might discover oral cancer early when it's more treatable.
And you'll be able to keep smiling for years to come.