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Early Detection of Gingival Cancer

While rare, gingival cancer can be deadly, and patients’ first line of defense is in the hands of their oral health professional. Frequently mistaken for periodontal disease or local tissue trauma, gingival cancer is thought to arise from a preexisting leukoplakia or erythroplakia found on the gingiva. Are you prepared to catch the signs and symptoms of gingival cancer?

Early Detection of Gingival Cancer

While rare, gingival cancer can be deadly, and patients’ first line of defense is in the hands of their oral health professional. Frequently mistaken for periodontal disease or local tissue trauma, gingival cancer is thought to arise from a preexisting leukoplakia or erythroplakia found on the gingiva. Are you prepared to catch the signs and symptoms of gingival cancer?

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Age

The average age of the patient at initial presentation of gingival squamous cell carcinoma (SCC) is between 60 and 70.

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Low Risk 

SCC often develops in individuals considered at low risk for oral cancer, including nonsmokers and individuals who consume little or no alcohol.

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Signs and Symptoms

The signs and symptoms of SCC include red/white lesions, ulceration, loose teeth, swelling, pain, or a nonhealing extraction socket, but these may all be indicative of another oral health problem, making early detection challenging.

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Lesions

Tumors at more advanced stages will present with a mass or lower lip paresthesia, especially if the inferior alveolar nerve is involved. As a rule, any gingival lesion presenting with the previously described signs and symptoms that has not resolved within 3 weeks to 4 weeks should be biopsied.

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Imaging

Computed tomography and magnetic resonance imaging are considered first-line imaging modalities in the preoperative management of gingival SCC.

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Tumor Staging

Initial tumor staging requires a thorough clinical and radiographic examination. Tumors are typically staged using the designated tumor, node, metastasis  American Joint Committee on Cancer staging system.13 Difficulty with this classification occurs in relationship to advanced size (T4) and the specific gingival subsite.

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Extractions

If a loose tooth is identified within a gingival mass, it is best not to extract the associated tooth, as this will allow the treating surgeon to assess not only for true bone invasion, but also evaluate the extent of the tumor in the surrounding soft tissue.

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