Adjunctive diagnostic aids in oral cancer screening: an update

During the past decade, several adjunctive aids have been introduced to the marketplace with the promoted goal of improving the dental practitioner's ability to screen for and identify oral premalignant and malignant lesions (OPMLs). These products include the OralCDx Brush Test, ViziLite Plus with TBlue, Microlux, VELscope Vx, Sapphire Plus, Identafi, and the DOE Oral Exam System. They are all marketed as aids for the clinician to use in addition to, not in lieu of, the accomplishment of a conventional oral examination (COE). Studies addressing the efficacy of these products when used in the general practice setting to screen for OPMLs are limited and conflicting. The ability to discriminate between truly dangerous OPML against the milieu of benign mucosal lesions remains a concern and further research is necessary to determine the true value of these products as marketed to the general practitioner. The attainment of a complete history and the accomplishment of a thorough and disciplined COE remains the foundation upon which the practitioner assesses the patient for OPMLs. Findings deemed suspicious or equivocal should be referred to an expert for further assessment or undergo immediate biopsy, while findings deemed innocuous should be re-evaluated within 2 weeks and referred to an expert for further assessment or undergo biopsy if still present.