Oral Manifestations of Prostate Cancer

Q: I was recently diagnosed with prostate cancer. My urologist told me to make sure I keep seeing my dentist and never to refuse X-rays. Why the concern?

A: You know the old song: “The leg bone’s connected to the foot bone, the foot bone’s connected to the ankle bone, etc. etc.”? Well, the prostate is somewhat connected to the jaw bone. I kid you not.

There is a classic dental board exam question that shows a dental X-ray and the patient’s medical history. The X-ray shows areas of bone loss in a semi-circular pattern, surrounding the teeth. This could be confused with abscesses and trick the dentist (or the test-taker) into recommending root canals! WRONG.

We do a vitality test on the teeth; if they test “vital”, meaning the nerve has not died; then no abscess and the lesions in the bone would have to be some type of tumor. Prostate cancer is known to spread to the bones and the jaw bone could easily be missed by MD’s.

Among the bone metastases affecting the oral cavity, adenocarcinoma is the most frequent histological type of spreading tumor. The main clinical manifestations may include pain, swelling, tooth loss, bleeding, trismus (difficulty in opening your mouth), paresthesia sensation (partial numbness) and epistaxis (nose bleeds.)

Make sure you see a dentist before, during and after cancer treatment in order to make comparisons on the x-rays to avoid missing crucial issues.

Editor’s Note: Don’t miss my colleague, Diego Rubinowicz MD speak on a similar topic: Free Men’s Health Seminar: Enlarged Prostate (Benign Prostatic Hyperplasia) at the Fairfield Inn and Suites by Marriott at 10616 Forrest Hill Blvd, Wellington FL 33414 on Tuesday February 4th, 2020 at 6:15pm. Call us; seating is limited. (All prostates welcome!)