today IDEM Singapore 2014 05 April

science & practice10 IDEM Singapore 2014—5 April they often have not grown large enough to be visible to the naked eye. By the time one can see the lesion, however, the survival rate has already dropped to probably 22–25 per cent after five years. When one discovers it before it be- comesmalignant,thereisvirtually a 100 per cent chance of survival and, if one catches it in the early stages, there is still a survival rate ofabout80percent.Therefore,itis critical that dentists use whatever meanstheyhavetoseethroughthe tissueinordertodetectchangesoc- curring underneath. Oral cancer detection tech- nology is already available on the market. What is your evalu- ation of the clinical value of de- vices like the VELscope, which was developed in Canada? This device is probably the most cost-effective technology on the market that I am aware of. I recently discussed this with the manufacturer of the leading oral camera in North America and a dentist who did research on fluo- rescence visualisation. We could not understand why a dentist would not acquire this technol- ogy. It is so easy with the exami- nation taking only under 2 min- utes or so. The researcher under- stood that initially the cost of the device is quite high and I said that it is not so expensive and, with most dentists being able to charge for it and make an income, why would they not use it? One can look with the naked eye and the tissue might look normal un- til a lesion reaches the surface. And then the patient has a prob- lem and the survival rate is very low. I have only found a couple of them but that was enough to save lives. What changes would den- tistry have to undergo to have a positive impact on oral can- cer rates in the long run? I sometimes hear from den- tists that by looking at the tissue one could come up with false positives. This is a poor excuse because if one talks to people who have checked patients for years this rarely happens. And if it does, what does it matter? I am not an expert but I think dental education is the key. I can only hope that dental schools throughout the world are teach- ing oral cancer examinations like we do in the US and Canada. Oral cancer classes are not very sexy unfortunately. Most dentists would rather attend something on cosmetics or im- plants before taking an oral can- cer class. The explanation they give is that they do not have to deal with cancer very often but they do need to deal with im- plants. Maybe a better idea would be to increase public awareness, so that dental patients begin to ask their dentists for oral cancer screenings with adjunctive tech- nologies. There are successful ex- amples of this type of campaign, like the one for prostate-specific antigen tests. Viagra had a break- through in the same way. Do you think that oral can- cer examination will be stan- dard in dental practices soon? Icannotimaginethatitwillnot be standard. Actually, it should be standard already. We have the responsibilitytolookatthetissue in the mouth and need to know what is abnormal when we look at it with adjunctive technolo- gies. It only takes about two days of looking into the mouths of pa- tients to become aware of what tissue is normal and what is not under fluorescence. One does not need a PhD for that. If in doubt, one can always take photographs ofitandhavethembackinaweek ortwotobeabletodecideifsome- thing should be examined. Thank you very much for the interview. AD 7 page 08 “...itiscriticalthatdentistsusewhatevermeanstheyhavetosee throughthetissueinordertodetectchangesoccurringunderneath.” TDI0714_08-10_Freydberg 31.03.14 13:53 Seite 2