Dentistry and Dental Materials

Oral cancer awareness by the public is essential to addressing the need for routine screenings. Th e risk factors for oral cancer have expanded. Human Papilloma Virus (16 and 18) must now be included with the usual concerns of tobacco use and alcohol abuse. Th e gold standard for cancer diagnosis is the histopathological analysis of a suspected lesion. However, a lesion must fi rst be detected. Oral cancer screening is a pillar of comprehensive and periodic oral evaluations and early detection reduces the morbidity and mortality. Th e goal of early detection may be more easily achievable with the use of autofl uorescence technology. If a clinician can visualize a potentially harmful lesion easier, then this earlier detection may lead to improved prognosis. When oral tissue is exposed to a blue wavelength of light, the endogenous fl uorophores are excited to emit a green wavelength. With the appropriate fi lter, the healthcare provider can visualize the resulting autofl uorescence. Normal tissue appears varying shades of green and abnormal tissue typically appears dark. Since premalignant dysplasia may not be readily apparent to the naked eye, this technology can be useful in detection of oral mucosal abnormalities. However, it must be noted that vascular lesions, pigmented lesions, and amalgam tattoos have decreased fl uorescence. Diascopy, applying pressure to evaluate if the lesion blanches, can assist the clinician in determining whether a lesion is vascular/infl ammatory or nonvascular. Physiologic pigmentation and amalgam stain do not blanch. Th ere are several types of devices available. Th ese will be presented.