The reality of identifying early oral cancer in the general dental practice.

Oral cancer has a good prognosis when detected at an early stage yet half of patients diagnosed with oral cancer in the UK have advanced stage disease, for which prognosis is poor. Although most oral tumours are preceded by pre-malignant lesions, the asymptomatic nature of oral cancer, diagnostic delay, and the possibility of hidden tumours, limit the ease at which oral cancer is detected early. Furthermore, in the UK, oral cancer is a relatively rare disease and does not have mutually exclusive signs or symptoms. Responsibility for the early detection of oral cancer is currently placed on the general dental practitioner. However, the current recommendations to screen for oral cancer at every routine check-up is not practical and has not produced the intended results. Selective opportunistic screening may be a more realistic and effective solution and a simple alert system is proposed to assist its implementation.