Hi, I have heard of this, but I was reading my Feb Issue of Ladies Home Journal and there is a blurb about it. Said alot of insurance companies are paying for it.
Has anyone had it done yet? Dan sees his dentist at the end of the month and wondered if this was worth the money? Dans cancer was tonsil, so I am thinking this would not find it there? Are there many false positives?
Just curious, Thanks
Sherrie

Sherrie,

Vizilite is an early oral cancer detection screening test that is based on the same technique (chemiluminescense) that has been use to make pap smears more accurate for several years. The tissue of the cervix and the oral mucosa are just about identical histologically. The test is completed by having the patient rinse with what is basically a dilute vinegar solution for about one minute. This removes the thin layer of glycoproteins that occurs naturally from saliva and coats all of the surfaces in your mouth. Then your mouth is examined with a special light by your dental hygienist and your doctor and any areas where there are atypical cells will glow white. The tissue glows white because the light penetrates the top layers of cells and is reflected back by the enlarged nucleii of any cells that may changing from normal to abnormal. Removing the glycoprotein layer allows the light to penetrate the cells.

Is it worth the money? I believe that it is because right now it is the only tool besides our naked eye to help identify early tissue changes that could be oral cancers. Are there false positives? It is a screening -- it is not diagnostic. All it is saying is to get something checked out. Usually the next step following a positive Vizilite screening would be a brush biopsy, which is a non-invasive biopsy, like a pap-smear, that is diagnostic.

I am an oral cancer survivor and a dental hygienist who speaks to dental practices on implementing an early oral cancer screening program that includes a through visual oral cancer exam, a Vizilite screening, followed by a brush biopsy if necessary. My goal is to have evry dental practice in the country following these three steps. Just so you know, I am not employed by, nor do I receive any compensentaion from Zila Pharmaceuticals, the manufacturer of Vizilite or OralCDx Labs, Inc, the manufacturer of brush biopsies. I am just trying to make a difference in the rates of early diagnosis. I know that Vizilite is not perfect and I know that some dentists won't use it properly, but right now it is the best tool that we have and so it should be used. When something better comes along, then we'll use that.

Bobb, Thank you so much for the information. Dans dentist is great but he has never brought this up, so I am having him bring it to his attention this much.

Thanks again.
Sherrie

Bobb,
This is an extremely interesting and sounds to me like a valuable test. When I was diagnosed with SCC in 1997 with met to 1 node in neck and no known primary, the surgeon took all sorts of biopsies in my mouth in an attempt to find the primary. All came back negative, however, this meant I was going into radiation with many unhealed sores in my mouth which caused many more problems. I will have to mention this test to my dentist the next time I see him. Thank you for the info.

Eileen

Sherrie and Eileen,

You're welcome. Please share the information with your dentists and refer them to this web site for more information on Vizilite. Eileen, I am close enough to meet with your dentist if he is interested in information on implementing a comprehensive early oral cancer detection program in his practice. By the way, we are being treated by the same doctor at Penn.

Barb

Hi Bob,
Small World. Both my prosthodontist(Princeton & MD Anderson trained) and my periodontist (lawrencville abd associated with HUP) do oral cancer screening on all patients, but do not use this vitilize. Is this something brand new? If it is I will give you name of both drs and and can call and say I thought they would be interested. If it is not brand new, I have an appt with prosthodontist on the 24th and will try to remember to mention to him. If I forget, knock me over the head and I will email you his name and number and you can call him. Remind me to get back to you on this.

Take care,
Eileen

PS. If you ever need a great PT, I also have one of those in Lawrencville. Specializes in Trismus, but got to practice on me for two neck disections.

Just a note: The Visilite finds ANY abnormality in the mouth, that means the 97 +% of them that are benign like a canker sore, a pizza burn on your tongue, a cheek bite, and on and on and on. (The ratio of non maliganant to malignant abnormalities is extraordinary) Please note that this device is a discovery device not a diagnostic device. But its shortcoming is that it finds anything....... As to insurance companies paying for the exam, in the world of dental insurance it so far is only being covered in a very limited area (great lakes region) by one company, Delta Dental. If it makes dentists more interested in doing the exams, it gets my vote, but as a device that truly is some kind of major break through, it is not. The main objection by the dental community in the last three years of Zila trying to market the disposable light has been that the cost per patient is too high, it is not covered by insurance, and many think that it does not offer significant advantages over a normal visual exam. The issue is to get this group of individuals to just do any kind of proper exam, special light or not. The hygiene community is rapidly identifying itself as the group most likely to be the ones that find

Brian,

I promote Vizilite, not as the perfect answer, but as a screening device, something better than what we had before. I recommend that if something shows up, the doctors follow it up with a brush biopsy, which is diagnostic. I think anything that makes the doctors and hygienists take a second look is worth doing. I agree that the hygienists (being one myself) are the most likely team members to identify early tissue changes because they spend the most time with the patients, they see the same patients every six months (usually), and they are trained to identify subtle differences in tissue texture and color when evaluating periodontal health. The problem I find with referring patients up the food chain for biopsy is that too often they are told that what they have been referred for is "nothing". It happened to me and if not for my own professional knowledge and persistence I would never have been treated at Stage 1.

Barb

If the patient has had the problem for more than 14-21 days, and the dentist doesn't know what it is, I want that patient to have a referral to a dental medicine specialist (they are at most dental schools and are not just a regular dds), or I want that tissue looked at and biopsied by a periodontist, oral surgeon, or ent, who sends it out to a certified pathology lab. This is especially true if the patient comes into the practice and says day one that they have had it in their mouths for at least two weeks. This is not the time to mess around with lights and brushes if the DDS does not know difinatively what he is looking at. The problem with the biopsy brush is that it is designed (and the company states this) for early (under 14-21 days) determination if something is worth taking a more serious look at or not. That more serious look, is a biopsy done with a knife or a punch. While I'm in favor of the brushes use up to that time period, anything after three weeks that is still there needs something more than a brush biopsy. It also cannot be used on open sores, so there is another limitation to it that would not exist with a conventional biopsy. Even if the brush comes back positive (abnormal actually, since the brush provides no architecture because of its collection system it scrambles all the cells up and you do not know what level in the tissue they were at) they still have to go out for a regular biopsy (published cdx brush protocol). I'm with you, anything that will get people interested in doing a screening is OK with me. But just because the Visilite lights something up, that doesn't mean the dentist is going to do anything about it...in his mind the thing lights up things that are not malignant 95% of the time. I am afraid that this is going to put the dentist into a watch and wait mentality. And the brush is only good for those lesions that are not actually sores, but discolored tissue, so that is also limiting besides the early period when it's use is of optimum value. Remember it is used to prevent someone from going three weeks without a diagnosis and the dentist isn't sure. A punch or incisional biopsy takes 5 minutes. You get a finite definition of what's what from the pathology lab in less than 4 days. Done deal. These things are all helpful, but I want to know without ambiguity, and I want to know NOW. I do not think that it is in the realm of responsibility of a general DDS to diagnose cancer. I think they should be looking for suspect tissue and referring. Too many cases of watching and waiting have shown me that DDS are not even doing the most basic thing - referral. This is nothing less than treating the patient with watchful neglect in my book, and any one of them that does this should end up in court. In my lectures to dental students, I always tell them when you refer, you are covering your rear end, and you are potentially saving the patient's. Referral to someone more knowledgeable is also deferral of lawsuits, and it is in the patient's best interest.

Brian,

I am all in favor of referrals but here is something you need to know about the real world of dentistry. The very early kinds of tissue changes the signal stage I lesions look so innocent that when the patients are sent out for referral the most common response is for the oral surgeon, oral medicine, ent, periodontist, whomever to look at the lesion at say "it's nothing". At least with a brush biposy that shows an atypical result you may get some attention. When I showed my leukoplakia to an ENT, he literally laughed at me and asked why I was wasting anyone's time. The brush biopsy results normally take less that a week to get. Most patients do not know how long a lesion has been present in their mouths. Mine was present for about 4 months before someone took me seriously enough to do a brush biopsy. I know what all of the literature says but you have to apply all of that in the real world. These general dentists are not doing brush biopsies to diagnose cancer, they are doing them so that the doctor they refer the patient to for biopsy may take the lesion more seriously. Early detection saves lives has to be hammered into the heads of the oral surgeons, the ents, the oral medincine docs, the periodontists. It is not the general dentists who are watching and waiting. At least not the ones I educate.

Barb