Mendez, M. (2014). Mistaken identity. ​Dimensions of Dental Hygiene, ​12(12), 27-29.

Gingival or oral cancer can be hard to detect sometimes because it can be confused with

an abscess, trauma, or periodontal disease. The extra/intra oral exams are crucial parts of each

dental appointment. Dental hygienists are often the first to identify any variants of normal or

abnormal changes in the mouth. Understanding what cancer looks like is important because

early detection can increase survival rate.

The appearance of squamous cell carcinoma lesions vary from a white plaque-like

appearance to a red and white exophytic appearance. They typically are found on the tongue,

tonsils, oral pharynx, or on the floor of the mouth. These lesions can be difficult to detect in the

early stages of gingival inflammation. Thorough documentation of all lesions is recommended

for evaluation.

Another form of squamous cell carcinoma is oral verrucous carcinoma. The appearance

also varies. It can be seen as a white plaque-like lesion or a mixture of white-red with a pebbly,

wart-like appearance. It’s etiology is unknown. Oral verrucous carcinoma can be found on the

mandibular posterior alveolar ridge, the retromolar region, buccal mucosa, palate, floor of the

mouth, or the lips. If any lesions are still present after two weeks, patients should be referred to

oral surgeons.

The case study discussed in this article features an elderly woman who had inflammation

of the gums and a suspicious lesion. The oral surgeon thought the inflammation was from

subgingival calculus and plaque. The woman was reinstructed on oral hygiene home care and

was told to come back two weeks later. In those two weeks the lesion had changed drastically.
Patient was then referred for biopsy and the results had shown they misdiagnosed periodontitis.

She actually had gingival cancer.

This article was very eye-opening to me. It definitely motivates me to always make sure

I am doing thorough intra oral exams on each patient. I never want to be the reason that a

cancerous lesion goes unnoticed for a patient. It shows there is way more to our job than just

scaling teeth.

The case study discussed in this article demonstrates the importance of documentation of

everything that you find in the oral cavity and to keep track of any changes that may occur. I

agree with how important documentation is. I also agree that it is important to ask your patients

a lot of questions to assist in the diagnosis.

This article taught me that there can be significant changes of lesions in a short amount of

time so it is important to take pictures and record measurements of lesions. This will be helpful

to the referred oral surgeon or oral pathologist for biopsy. I also learned that the appearance of

carcinoma varies and that gingival cancer can easily be misdiagnosed for something else. It is

important to be meticulous during evaluation of gingival lesions.

The content in the article relates to how important it is for us to do thorough intra oral

exams in clinics with each patient. Our oral exam booklet is very helpful with documentation of

any clinical findings. It makes it easy to not bypass any significant lesions we may find on our

patient.