The DDU issued the advice as it revealed that it was notified of 63 cases in the five year period 2008 -2012 relating to oral cancer. In 53 of those cases, it was alleged that the dental professional failed to check the patient for oral cancer during their examination, didn't diagnose a suspicious lesion that was present, or there was a delay in referring the patient to a specialist. In at least four cases the patient died from the disease.
Latest statistics suggest there has been a 50 per cent rise in mouth cancer between 2000 and 2011 and the GDC now recommends all registrants complete continuing professional development in early detection of oral cancer.
John Makin, DDU dento-legal adviser said:
"With November being Mouth Cancer Action Month, it's an important opportunity to raise the profile of this devastating disease, especially because, worryingly, rates of oral cancer continue to increase.
"Dental professionals are in an ideal position to spot suspicious lesions or ulcers but the aggressive nature of the disease means that missing one opportunity to make an early diagnosis or prompt referral can have serious consequences for the patient’s prognosis.
"Most dental professionals do not to see many cases of oral cancer during their career but with the disease becoming more common it is important they know how to spot the possible signs and respond appropriately."
Of the 63 cases notified to the DDU, 29 were compensation claims of which four have been settled, 12 have been closed with no payment and 13 discontinued. Of the settled claims, the largest damages payment of £40,000 plus legal costs was to a family of an elderly patient who died from oral cancer after a delay in diagnosis.
In addition to the compensation claims, there were 31 complaints and six dental professionals were investigated by the GDC.
The DDU's advice to dental professionals to help reduce the risk of delayed diagnosis includes:
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Ensure that your skills are in line with current teaching and practice. The GDC now recommends all registrants complete continuing professional development in the early detection of oral cancer.
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Consider asking the patient about their lifestyle so you can assess their risk of oral cancer, but if the patient doesn't want to respond, don't insist.
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It's advisable to have a low threshold of suspicion when it comes to any lesion or swelling, particularly when the patient is in a high risk group. Be prepared to seek a second opinion and investigate further if necessary.
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Record your examination findings, even if negative, in the clinical notes, making a careful note of suspicious lesions or swellings along with your treatment plan and advice. The use of mouth maps and photographs may be helpful.
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If you suspect an abnormality might be cancerous you should make an immediate referral to an appropriate specialist for further investigation, in line with the referral guidelines produced by NICE or SIGN.Your practice should have a protocol in place to ensure referrals are made efficiently and consistently.
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Explain to the patient what you have found and what happens next. It’s a good idea to tell them how long they can expect to wait before receiving an appointment and advise them to call if there is any delay.
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Chase up oral cancer referrals to ensure they have been received and that the patient has been sent a consultation appointment.