North Texas Dentistry Volume 8 Issue 1 NTD 2018 ISSUE 1 DE | Page 7

both oral and maxillofacial surgery and head and neck oncologic
and microvascular reconstructive surgery, and one of a very
small number of doctors in North Texas who consistently treat
oral cancer.
According to Dr. Kang, the way a dentist responds when a suspi-
cious lesion is detected has a dramatic impact on the patient’s
chance for survival. “Often, many dentists would, not incorrectly,
recommend watchful waiting because many benign soft tissue
abnormalities such as herpes simplex u lcerations or aphthous
ulcerations closely resemble oral cancer but resolve in 10-14
days. Unfortunately, some of these are later found to be squa-
mous cell carcinomas that were steadily advancing during the
watchful waiting period. Sometimes, oral cancer is misdiagnosed
as an infection and a round or two of antibiotics is prescribed. If
the lesion doesn’t go away, the patient might be referred to an
oral surgeon or periodontist for biopsy, and some additional time
elapses before the initial consultation for surgery. These are
precious days lost, because as the cancer grows, more tissue must
be removed to successfully treat the tumor. Our goal is to treat
the cancer within two weeks of consultation.”
The treatment path for oral cancer has evolved over recent years.
Oral cancer surgery performed by oral and maxillofacial
surgeons (OMS) declined in the 20 th century as interest in
orthognathic surgery bloomed. 2 Until the 1960s, most oral
cancer patients were treated by a general surgeon. In the 1970s,
doctors began commonly referring patients suspected of having
oral cancer to an otolaryngologist (ENT), who has specialized
knowledge of the ear, nose and throat, for diagnosis and treat-
ment. In the late 1980s and 1990s, dual degree residency
programs grew in the United States, and there was renewed
interest by oral and maxillofacial surgeons, who are specially
trained in disorders of the oral cavity, to begin providing surgical
treatment for patients with cancers of the head and neck. Until
2017, Dr. Kang was the only such specialist in Dallas, and the
only surgeon in North Texas focusing his practice solely on the
treatment of head and neck cancer and reconstructive surgery.
Dr. Kang focuses his practice on head and neck cancer with a
special interest in the treatment of oral cancer, salivary gland
cancers, thyroid cancers, and other malignancies of the head
and neck. He is one of an elite few surgeons dually trained in
Many dentists are comfortable with the biopsy of suspicious
lesions, which potentially can save several weeks of wasted time
before definitive treatment if the lesion proves to be malignant.
They must examine the lesion well and be careful to biopsy a
large enough area of representative tissue. In this case, the
patient can bring the pathology report to Dr. Kang for treatment.
Alternatively, dentists can send patients directly to Dr. Kang,
who typically sees them and performs a biopsy the same day
they are referred. “Prompt diagnosis and treatment is impera-
tive, to optimize survival for our patients. The patients under
Dr. Kang’s care essentially receive personal concierge service.
The patient will receive Dr. Kang’s personal cell phone number,
and is free to call and text anytime before and after surgery.
Often, if possible, we exchange cell phone numbers with the
referring doctor so they can receive immediate text updates as
diagnosis and treatments progress.” Dr. Kang sends updates to
the referring doctor regarding diagnosis, staging, treatment
plan, and timeline, and notes after follow-up appointments,
which continue for the life of the patient.
Because three out of four cases of patients over 50 diag-
nosed with oral cancer are closely tied to the development
of smoking and alcohol use, increased screening of these
patients is warranted.
Dr. Kang points out that, in the case of oral cancer, serious
missteps are possible and not uncommon. “A doctor who is less
familiar with the characteristics of oral cancer might prescribe
a steroid, which suppresses the immune system, allowing the
tumor to grow unchecked. A well-meaning general dentist might
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