Early Detection of Oral Cancer: Is Velscope Reliable?

velscope.jpgI have taken 2 courses in the early detection of oral cancer. In one of these courses, the lecturer made a strong case for using the VELscope to detect oral cancer at such an early stage that no other signs were apparent, other than the characteristic appearance under the VELscope. He presented numerous cases of early detection confirmed by biopsy. In another course, taught by an oral surgeon, the emphasis was on visual inspection and referral for biopsy when needed. He felt the VELscope was not reliable. What is the experience of the readers who are VELscope users? What about other technologies, such as OralCDx, for the early detection of oral cancer? Are these technologies reliable and useful? Thanks.

Editor’s Note:
According to the VELscope:

“VELscope is a revolutionary hand-held device that provides dentists and hygienists with an easy-to-use adjunctive mucosal examination system for the early detection of abnormal tissue. It is based on the direct visualization of tissue fluorescence and the changes in fluorescence that occur when abnormalities are present.

The VELscope Handpiece emits a safe blue light into the oral cavity, which excites the tissue from the surface of the epithelium through to the basement membrane (where premalignant changes typically start) and into the stroma beneath, causing it to fluoresce. The clinician is then able to immediately view the different fluorescence responses to help differentiate between normal and abnormal tissue. In fact, VELscope is the only non-invasive adjunctive device clinically proven to help discover occult oral disease.”

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Comments

4 Responses to “Early Detection of Oral Cancer: Is Velscope Reliable?”

  1. John Y. Kwan, DDS on July 3rd, 2008 4:01 pm

    As a periodontist who has done oral soft tissue exams for my entire career as a dentist I was skeptical when my friend, Dr. Ray Bertolotti loaned me his VELscope because he was going to be out of town. He felt that this should be the standard of care for all specialists. Well, I checked out the technology and started using it. I have found lesions that were confirmed oral cancer only 3 times in my entire 27 years as a dentist so I do not expect to see much with the VELscope either. BUT that said, I am more sure that things ARE negative now. AND that first week with Ray’s VELscope I saw several patients that had begnign lesions that we had been observing. I feel much better when they show up VELscope negative!! SO, I bought 2 of them and use them on all new patient exams and also on my annual or biannual check ups.

    Comparing to Visilite and Orascoptic DK, this technology is so easy to use! The upfront cost is steep but over time the VELscope ends up being more affordable as far as time and money. Oral CDx is great when you find something suspicious but with VELscope ruleouts you don’t need to do that as routinely.

    I personally don’t charge a separate fee for the VELscope because I don’t want cost to enter the patient’s decision as to whether or not to have the exam. I also feel that our practice should provide the highest level of care, incorporating the latest technology.

  2. Mike Heads on July 5th, 2008 3:45 am

    This is the best piece of equipment I have ever purchased. Patients love the reassurance it giveswhen we use it routinely. Our oral surgeons were initially sceptical and said a good visual check is all you need but Velscope finds things before you can see them with the naked eye and they are now trialing the Velscope. I personally think all dentists, general or specialists, should have one of these in their practice and use them regularly on all their patients as we do.

  3. Kevin D. Huff, DDS, MAGD on July 17th, 2008 8:20 am

    Thank you for raising this question. I am not sure if the gentleman asking this question attended one of my courses or not, but the course content sounds remarkably familiar. I was originally very skeptical about the VELscope because I was disappointed with the other systems for early detection that I had been using. My hygienist convinced me to purchase one. Now, I am sponsored by LED Dental (makers of VELscope) and HenrySchein to speak about early oral cancer detection.

    In my courses, I try to very hard to be very objective about these technologies, and I have permission from each company to discuss their products, which is unique. I would encourage anyone interested to come to the Ohio AGD MasterTrack course, held at the OSU College of Dentistry on October 3-4, 2008. (http://www.dent.osu.edu/ce/pages/show_course.php?course_id=09.04). One day will be an intensive review of early oral pathology with Dr. Michael Kahn, the chairman of Tufts Oral Pathology. The second day will be a thorough review of current early detection technologies, as well as hands-on biopsy techniques with pig tongues.

    Currently, a draft is being prepared for publication showing that the VELscope dramatically reduced the amount of false positives in my practice over 1 year compared to the previous year in which only a white light clinical exam was used. In a nutshell, I missed 10 dysplasias without the VELscope, all of which were considered by the pathologist to be “premalignancy potential uncertain.”

    I hope this information is helpful to you.

  4. Barry Shipman on August 1st, 2008 11:06 am

    So far I have only heard that the Velscope only makes the doctors and patients feel better. I would be interested in data that shows that it works. I do not doubt that it is easy to use but I am looking for data that shows that it works, Will it detect Ca in situ. It detects cell changes but will it indicate squamous dyplasia or atypia or melanocytic atypia and does it work on skin or just mucous membranes?

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