Dental Tribune U.S. Edition

Publisher & Chairman Torsten Oemus t.oemus@dental-tribune.com Chief OPerating OffiCer Eric Seid e.seid@dental-tribune.com grOuP editOr Robin Goodman r.goodman@dental-tribune.com editOr in Chief dental tribune Dr. David L. Hoexter feedback@dental-tribune.com managing editOr u.s. and Canada editiOns Robert Selleck r.selleck@dental-tribune.com managing editOr Fred Michmershuizen f.michmershuizen@dental-tribune.com managing editOr Sierra Rendon s.rendon@dental-tribune.com managing editOr shOw dailies Kristine Colker k.colker@dental-tribune.com PrOduCt & aCCOunt manager Mark Eisen m.eisen@dental-tribune.com marketing manager Anna Kataoka-Wlodarczyk a.wlodarczyk@dental-tribune.com sales & marketing assistant Lorrie Young l.young@dental-tribune.com C.e. direCtOr Christiane Ferret c.ferret@dtstudyclub.com Dental Tribune America, LLC 116 West 23rd St., Ste. #500 New York, N.Y. 10011 (212) 244-7181 Published by Dental Tribune America © 2012 Dental Tribune America, LLC All rights reserved. Dental Tribune strives to maintain the utmost accu- racy in its news and clinical reports. If you find a fac- tual error or content that requires clarification, please contact Managing Editor Robert Selleck at r.selleck@ dental-tribune.com. Dental Tribune cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not assume responsibility for product names or statements made by advertisers. Opinions expressed by authors are their own and may not reflect those of Dental Tribune America. editOrial bOard Dr. Joel Berg Dr. L. Stephen Buchanan Dr. Arnaldo Castellucci Dr. Gorden Christensen Dr. Rella Christensen Dr. William Dickerson Hugh Doherty Dr. James Doundoulakis Dr. David Garber Dr. Fay Goldstep Dr. Howard Glazer Dr. Harold Heymann Dr. Karl Leinfelder Dr. Roger Levin Dr. Carl E. Misch Dr. Dan Nathanson Dr. Chester Redhead Dr. Irwin Smigel Dr. Jon Suzuki Dr. Dennis Tartakow Dr. Dan Ward Tell us what you think! Do you have general comments or criti- cism you would like to share? Is there a particular topic you would like to see articles about in Dental Tribune? Let us know by e-mailing feedback@dental- tribune.com. We look forward to hear- ing from you! If you would like to make any change to your subscription (name, address or to opt out) please send us an e-mail at database@dental-tribune.com and be sure to include which publica- tion you are referring to. Also, please note that subscription changes can take up to six weeks to process. DENTAL TRIBUNE The World’s Dental Newspaper · US Edition Oral radiotherapy technique targets only cancerous tissue Researchers at the University of Grana- da and the Virgen de las Nieves University Hospital in Granada, Spain, have devel- oped a new radiotherapy technique that is less toxic than traditional methods be- cause it targets only cancerous tissue. The new protocol provides a less inva- sive but equally efficient postoperative treatment for cases of cancer of the oral cavity and pharynx. The initial study — conducted between 2005 and 2008 — included 80 patients diagnosed with epidermoid cancer of the oral cavity and pharynx, who had under- gone lymph node removal. The affected nodes were located by the surgeon during the intervention and classified into dif- ferent risk levels. Classification enabled physicians to target the areas at a higher risk of recurrence. This way, neck areas at a lower risk of containing residual cancer cells were not irradiated. Researchers conducted the study with the intent of minimizing side effects of radiotherapy, reducing treatment discon- tinuation and thus improving overall ef- fectiveness of such therapy. More than 70 percent of oral and pharynx cancers treat- ed with surgery require supplementary treatment with radiotherapy or chemo- therapy to reduce the risk of recurrence and spreading to the lymph nodes. Ra- diotherapy and chemotherapy are highly toxic, mainly because of ulceration of the mucous membranes lining the oral cav- ity; toxicity leads may patients to stop the treatment, which significantly reduces the chances of cure. By using the risk map obtained with the collaboration of the surgeon and the pathologist, an individualized treatment was designed and adapted to the specific risk level of recurrence in each neck area. The volume of tissue irradiated was sig- nificantly smaller than that usually irra- diated with traditional techniques. The trial was led by the radiation on- cologist at the Virgen de las Nieves Hos- pital, Miguel Martínez Carrillo, and was conducted in collaboration with the hos- pital's department's of radiation oncol- ogy, medical physics, maxillofacial sur- gery and pathology and the University of Granada Department of Radiology and Physical Medicine A three-year follow up showed the vol- ume of irradiated tissue was reduced in 44 percent of patients. With the new tech- nique, irradiation of an average volume of 118 cc of tissue was avoided. A total of 95 percent of patients completed radio- therapy and presented significantly lower toxicity than patients treated with the traditional technique. Recurrence rates did not increase. This study was coordi- nated by University of Granada professors Rosario del Moral Ávila and José Mariano Ruiz de Almodóvar Rivera. The results of this study will be published in the journal "Radiation Oncology." (Source: University of Granada) “ SAGA, page A1 screening-awareness campaign, based at www.sixstepscreening.org. It’s been 13 years since Grayzel’s diag- nosis of squamous cell carcinoma and the radical treatment that took a third of her tongue, her entire left sternocleido- mastoid muscle, much of her saliva flow and nearly her life. But it’s her account of how the illness affected her relation- ship with her two young children that is perhaps the most transfixing. Today, she calls herself lucky, not just because she’s alive and cancer-free, but also because unlike so many late-stage survivors, she literally kept the tip of her tongue, physi- cally enabling her to clearly and passion- ately articulate her message. Grayzel spoke with Dental Tribune shortly before her appearance at the 2012 Yankee Dental Conference. Aren’t oral cancer screenings already part of a routine dental checkup? The American Dental Association’s guidelines say every checkup should include an oral cancer screening. But the guidelines do not say what an oral cancer screening entails, such as how many steps or how long it should take. As a result, some dentists might think they are doing oral cancer screenings, but they may be falling short. Did they pull out the tongue for lateral inspec- tion? Did they feel the palate to see if it was soft and hard in the right places? Did they ask the patient to say “Aah” so they could look at the symmetry of the back of the throat? Did they check the lymph nodes under the chin? Did they feel the neck for enlarged lymph nodes? Did they flip the lips out to look inside the lips and cheeks? That’s all a part of it. If patients don’t get that, they should personally demand it. With just 3 percent of cancers in the U.S. occurring in the oral cavity and pharynx, why are enhanced awareness and com- prehensive screenings by dental profes- sionals so critical? Oral cancer kills. It's critical that dentists serve their patients right by providing the best care possible. After I was diag- nosed, I wanted to know why the heck the dentists I had turned to didn’t know what was staring at them from my later- al tongue. You didn’t need a magnifying glass. You didn’t have to look way back. It was right there, a huge ulceration that was there for months. Dentists are not mandated to have any continuing education in the early detec- tion of oral cancer, which is dentistry’s deadliest disease. The state of New York is the only exception, requiring one two-hour course to maintain licensure. It's more than critical, it's criminal for dentists not to do screenings properly and thoroughly; to do that they need current education keeping up-to-date in detecting the early signs. The tagline for the Six-Step-Screening campaign is, “If you’re not getting it, ask for it!” If enough patients demand it, dentists will have to change what they know about oral can- cer to provide the best care for their pa- tients. Would mandated C.E. requirements in oral-cancer screening have made a differ- ence in your case? Late-stage-oral-cancer survivor and master storyteller Eva Grayzel speaks throughout the world, primarily to dental professionals, advocating for improved early detetection of oral cancers. She shares her survival success story, while also using fables and tales from around the globe to teach, empower and energize. Photo/Provided by Eva Grayzel ” See SAGA, page A6 Dental Tribune U.S. Edition | April 2012A4 NEWs