Presentazione clinica e diagnosi = [Clinical presentation and diagnosis]

OBJECTIVES The aim of the present review is to update the dentist on the current knowledge regarding mouth cancer, in particular in terms of prevention, diagnosis and treatment. MATERIALS AND METHODS We queried he most important biomedical databases (PubMed, Embase) and Google Scholar in search of articles relevant to the objectives of the article. The full text of these articles were obtained. The information acquired was further integrated with texts and data already available to the authors. RESULTS Squamous cell carcinoma is a very common neoplasm in the oral cavity. It is an unknown condition event if it represents 90% of malignant tumours in the head and neck area. It is an epithelial tumour that originates from the superficial layer of the mucosa, in areas that can be easily inspected by the patient himself or during a normal dental check-up. Although this is a factor in favour of early diagnosis, mucosal changes that show pre-cancerous signs are not easily recognized. The diagnostic delay is therefore the factor that most of all is in direct correlation with the mortality linked to the disease. It is important to recognize all the clinical manifestations of the disease in order to quickly identify any pathological changes in the lining tissues. Attention to the oral health must not be only the responsibility of the dentist or oral pathologist but also of the patient himself. Even minimal alterations in the superficial tissues cannot be ignored, noting any evolution over time in a timely manner, fundamental data for an accurate diagnosis. In the same way, the dentist must make a differential diagnosis between the conditions that may be the consequence of a dental-periodontal problem and a specific pathology of the soft tissues. After a suspicion of malignancy, the diagnostic path necessary for the precise definition of the pathology is followed. It will therefore be essential to perform an incisional or excisional biopsy that enables the pathologist to identify the histological nature of the lesion. Among the professional figures involved in the diagnosis and treatment process of squamous cell carcinoma there is also the otolaryngologist. Through the use of endoessere scopes it is possible to deepen evaluation, treatment and follow-up, responding to the needs of a holistic management of patients with oral cancer. In fact, it is possible to comprehensively evaluate the upper aerodigestive passages during staging and follow-up, enhance the evaluation of patients with difficult horoscopy, evaluate resection margins and identify relapses early, also using innovative methods. No less important role in the patient care process is played by correct and effective communication. Even more, patient-centered communication strategies are indispensable for health professionals who find themselves having to disclose oncological diagnoses. The main functions of good communication between doctor and patient are: the promotion of health and the healing process, the correct response to the emotions of the patients, the management of the subject’s uncertainty and the possibility of making informed decisions by the patient and ultimately to better compliance and adherence to treatment. CONCLUSIONS In patients who present clinical signs of alteration of the mucous membranes of the oral cavity it is important to define with certainty the nature of the pathology. Early diagnosis is essential because it allows the reduction of the risk of mortality. The patient must be properly informed on the importance of the state of health of the oral cavity. Professionals operating within this district must be trained to recognize any pathological alteration. CLINICAL SIGNIFICANCE Oral cancer is a disease that the dental team must know and recognize, to be able to offer patients a sound information about the disease and allow for an adequate diagnosis and treatment process.