Skin cancer – should dental teams start checking their patients?

skin cancer – dentist checking patientSkin cancer is the fifth most common cancer in the UK. Annette Matthews explores whether dental teams should start inspecting more than the mouth.

For most the world is a little different now with COVID-19 playing a big role in how we conduct our clinics and appointment schedules.

Time is a huge constraint, which furthermore encourages the optimum use of skill mix and the team approach to avoid missing things.

COVID-19 hasn’t stopped other health concerns that our appointments can also help to detect.

With access to healthcare at an all-time critical point, would utilising our eyes for more additional concerns be too much to ask?

Checking for skin cancer

We know all too well, and indeed see the list growing rapidly in the systemic conditions that manifest themselves orally.

We inspect extra orally amongst many other vital points at any oral assessment. As well as noting down any abnormalities, taking into consideration the risk factors and referring when necessary. It is what we are trained to do.

But how many of us take a long hard look at one of the largest organs in the body?

I do now, but I didn’t use to. Tunnel vision is very real in any industry. We have a lot to cover and I am under no impression that any of us are superhuman. The answer here is skill mix.

In fact, it’s not just me looking – my team are all trained to spot the early signs of skin cancer and melanoma using a tool from the Karen Clifford Skin charity (SKCIN).

Is it really my remit? To detect and protect – of course it is.

Did you wash your face this morning and apply a broad spectrum SPF? Right after you brushed and interdentally cleaned your teeth.

That conversation could easily flow in your surgeries.

The point of sale of good quality broad spectrum sun/skin protection in our waiting rooms can run alongside the oral health sundries.

Subliminal preventative education – most of us are incredibly good at this.

Preventative practice

I need not remind you that the majority of what we deal with in dentistry is more often than not preventative.

This point then might shock you, but up to 90% of skin cancers and melanoma are indeed preventable too.

Early detection in any skin cancer is essential to improve the possible outcome. With melanoma it is a matter of life and death.

Melanoma is one of the only cancers we can physically see developing. If left it can metastasise and spread to vital organs, leaving an incredibly poor outcome.

How many of us can see the top of our own heads, behind our ears or our necks?

Our patients, those who live alone, who may lead busy lives and those who don’t know what to look for, are unable to spot those areas we naturally have access to as the chair is tipping back.

This is a window of opportunity the dental team has to spot these early onset abnormalities.

My own clinical practice has uncovered more than 20 confirmed skin cancers and melanomas. Three of which were highlighted by my supporting team – when I was busy in ‘my treatment zone’.

Not only do we have a realistic window, but we have a regular one from regular oral health screenings to periodontal maintenance and treatments. Effectively more eyes to potentially save lives.

Using the dental team

The use of skill mix is imperative.

Ensuring all team members are up to speed with preventative aspects on health concerns and systemic manifestations within our team’s skill set is one we should all aim for.

The MASCED accreditation by the SKCIN charity will help with exactly this and should be part of any annual core PDP.

To learn more about the SKCIN accreditation for you and your team visit www.skcin.org.


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