Tissue fluorescence has been used as an aid in visualization of oral mucosal abnormalities, such as oral cancer and pre-cancer. Fluorescence technology has been used in the medical field for many years, and in the dental field it has successfully screened more than 25 million patients in the past decade.
Saini et al. published a paper using OralID as a screening tool in visualizing oral premalignant lesions. In a high risk population, a conventional oral exam and OralID was compared to only a conventional oral exam.
Biopsies were taken of suspicious lesions in both groups. Sensitivity and specificity both improved; 8.1% and 11.4%, respectively; when clinicians utilized the OralID.
The Conclusion from the study was: “Results from this study suggests that OralID is a true adjunct to conventional oral examination in [visualizing] potential malignant changes in subjects visiting for regular dental check-up.”
Saini et al. Efficacy of Fluorescence Technology vs Conventional Oral Examination for the Early Detection of Oral Pre-Malignant Lesions. A Clinical Comparative Study. Endocr Metab Immune Disord Drug Targets. 2019. (In Print)
"Adding [fluorescence] as an adjunctive procedure improved the quality and outcome of the examination process."
Laronde et al. describe incorporating a clinical risk assessment in combination with fluorescence to predict lesion persistence. Unsurprisingly, " [t]he most predictive model for lesion persistence included both [fluorescence] status and lesion risk assessment."
"A protocol for screening (assess risk, reassess, and refer) is recommended for the screening of abnormal intraoral lesions. Integrating [fluorescence] into a process of assessing and reassessing lesions significantly improved this model."
"For those clinicians in general practice without the experience and expertise of a specialist, an imaging device to aid in the decision to refer would be very helpful. At the community level, the critical decision is not whether or not the lesion is cancer but whether or not the lesion should be referred for further investigation. Reassessment at a 3-week follow-up appointment is critical to improving the specificity of the FV autofluorescence imaging device."
“It is a good idea to use autofluorescence on an annual basis as a screening tool in the dental office.”
"Subclinical premalignant and malignant lesions that are not visible on routine white light oral examination become noticeable with direct autofluorescence visualization.”
“Autofluorescence imaging can be used to find lesions that are not or not easily noticed by visual inspection.”
”Autofluorescence imaging might be appropriate as an easy-to-use, sensitive and inexpensive method..."
This scientific article from the International Journal of Biomedical and Advanced Research explains why oral cancer screening in the dental set up is important. Below are a few statements taken from the journal article:
“…light-tissue interactions can be exploited to improve the visualization of neoplastic lesions.In particular, tissue autofluorescence has recently shown promise as an adjunctive diagnostic tool."
“Oral cancer and pre cancer display a loss of autofluorescence across a broad range of UV and visible excitation wavelengths."
“The incorporation of OralID in the first-line practice settings, such as dental offices and primary health care settings, may be a boon to population for regular check up for pre malignant lesions.”
“There is an enormous amount of advantage of this cost effective device (OralID) in the developing countries where financial liability is the main hindrance during oral cancer screening for the mass population."