Oral Cancer Screening: Application of Vital Stains as Adjuncts to Clinical Examination

An essential first line of investigation in oral oncology is clinical examination of high-risk oral sites. Given the elevated DNA content in cancers, vital dyes such as toluidine blue, methylene blue, Lugol’s iodine, and rose bengal, which have an inherent chemical capacity to bind to DNA, have been studied for their clinical utility in screening malignant changes in the oral cavity. In this chapter, we cover the basics of clinical examination and review the literature on the use of vital stains as adjunct diagnostic aids in patients with clinically suspicious oral lesions such as leukoplakia and erythroplakia. The goal of this chapter is to provide the reader with an overview of the vital stains available on the market and their potential for clinical application. A discussion of their strengths, limitations, and the rationale for development of new screening methods, has also been provided.