Recent advances in Northern Michigan dental care include spitting into a test tube. Traverse City dentist Dr. Peter Piché discusses oral cancer and a new saliva test that analyzes “biomarkers”—a test proven more accurate than blood testing, in this medical feature originally published in the Medical Insider within the November 2015 issue of Traverse, Northern Michigan’s Magazine.

For years, dentists have been screening patients for oral cancers during their regular checkups, but the screening process has been less than perfect. The dentist can feel a lesion only when it’s already well advanced, and attempts at early screening tests thus far—like flourescence rinse applied to the inside of the mouth—result in a high rate of false positive findings and unnecessary biopsies. But the need to have a good early screening test for oral cancer is undeniable: oral cancer has one of the highest mortality rates of all cancers, and part of the reason is the difficulty of detecting it early.

Coming soon, however, is a test that promises to make earlier and more accurate screening a reality. Bonus: the test is easy for both patient and dentist, because the patient just spits into a test tube.

“There are a number of different oral cancers,” says Dr. Peter Piché, a family dentist in Traverse City, “but the big one is squamous cell carcinoma, because of the one in 98 people who get oral cancer, 90 percent of them will have squamous cell carcinoma.” As with other cancers, the earlier the cancer can be detected, the less invasive the treatment can be and the less expensive it is to treat; and of course, earlier detection means fewer people will succumb to oral cancer.

The saliva analysis involves looking for messenger RNA and proteins—called “biomarkers”—that are associated with squamous cell carcinoma. If those markers appear, further investigation would ensue. The dentist might recommend seeing another specialist or might take a tissue sample for testing. If no lesions are found, a dentist might suggest testing a patient’s saliva on a regular basis. “The saliva test proved more accurate than blood testing and has 10 years of research behind it,” Piché says. Saliva appears to be such a good cancer screening medium that researchers are now looking to see if other cancers reveal themselves there.

The saliva test for squamous cell carcinoma is not yet widely available, but Piché expects dentists will begin folding it into their service offerings over the next year or two.

Northern Michigan Medical & Health

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