Minimally invasive methods of oral cancer detection can aid in early diagnosis and prompt treatment planning. Here are two methods which are minimal or non-invasive methods of oral cancer detection.

Chemiluminescent Illumination - A minimally invasive method

• The term "chemiluminescence" refers to the emission of light from a chemical reaction.  
• A nontoxic blue-white chemiluminescent light is shone into mouth and tissue reflectance is observed. 
• Improve the identification of mucosal abnormalities with respect to the use of normal incandescent light. 
• Devices working based on this principle: Vizilite, Microlux DL unit

Vizilite 

• Is an oral lesion identification and marking system 
• Used as an adjunct to the conventional head and neck examination
• Comprised of a chemiluminescent light source (ViziLite) to improve the identification of lesions and a blue phenothiazine dye to mark those lesions identified by ViziLite 
• Has outer flexible plastic capsule containing aspirin or acetyl salicylic acid- inner fragile glass vial containing hydrogen peroxide 
• These chemicals react to produce light of blue-white color (430-580 nm) which lasts for 10 min 
• Normal epithelium will absorb light and appear dark 
• Hyperkeratinized or dysplastic lesions appear white 

Contraindications : 

• For those who might have difficulties understanding instructions and for who have physical impairments. 

Microlux DL 

• Painless, non-invasive test, takes less than three minutes 
• Acetic acid dehydrates the cytoplasm of acetowhite lesions and the lesion's refractive properties are changed 
• The irregular cells take on a whitish hue which contrasts with surrounding tissue, helping to identify abnormalities which require further testing 

Oral Brush Biopsy 

• Introduced in 1999 
• It utilizes a stiff brush to collect the sample cells from the basal layer cells non invasively and assess the dysplasia by computer assisted neural network. 
• Is a rapidly conducted chair side procedure 
• Results in minimal bleeding, requires no topical or local anesthetic, and results in a collection of a complete transepithelial tissue sample 
• The cutting edge of the brush  is placed against the lesion and while maintaining firm pressure, rotated in a clockwise fashion 
• The brush is repeatedly rotated about 5-15 times 
• Red lesions and  ulcerations generally require little pressure and few rotations. 
• White lesions, lesions on the palate and gingiva which are typically covered with keratin, require more pressure and more rotations to reach the basement membrane 
• After obtaining the sample - the cellular material on the brush - transferred  and rotated on the glass slide from one end to another  
• The high accuracy of OralCDx is due to the fact that analyses of oral brush biopsies are accomplished with the assistance of sophisticated computers and advances in image recognition 

Indication:

• Small or tiny, nonsuspicious, common, unexplained red or white spots. 

Contraindication:

• Lesions that are highly suspicious and require immediate scalpel biopsy. 
• Lesions with an intact epithelium - submucosal masses, pigmented lesions, fibromas and mucoceles should be biopsied with a scalpel when indicated.

 Article by Dr. Siri P.B.