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LFQs: Laser-Focused Questions for Debra Zafiropoulos, RDH

During ALD 2018, Debbie will be exhibiting on behalf of the National Cancer Network. We recently had the opportunity to catch up with Debbie during a brief break in her busy lecture schedule.

LFQsLaser-FocusedQuestions Debra Zafiropoulos, RDH, “The Vigilant Hygienist,” is a cause-driven educator, passionate speaker and pioneer health crusader. Debbie’s live programs have received accolades and earned her recognition as an A-list KOL educator in the dental industry.

Widely known as “Debbie Z”, she is a highly-regarded author and has been published in many dental industry publications. Debbie is also the founder of the National Cancer Network, a non-profit with the mission of raising awareness to prevent late-stage diagnosis of all visible forms of cancers through the multiple platforms of prevention, protection, screening and referrals.

Debbie was also a recipient of the 2017 Sunstar Award of Distinction and the 2017 Dental Products Report’s Top 25 Women in Dentistry.

During ALD 2018, Debbie will be exhibiting on behalf of the National Cancer Network. We recently had the opportunity to catch up with Debbie during a brief break in her busy lecture schedule.

ALD: You’re widely regarded as one of the strongest voices for the early detection and treatment of oral cancer. When and how did your journey begin?

DZ: Thank you, it’s an honor to be part of the upcoming Academy of Laser Dentistry Meeting in Orlando. I want to commend the Academy for including cancer awareness in their program and for bringing together the world’s finest clinicians for this very progressive and informative meeting! Now to my journey…. I started in dentistry a very long time ago. It wasn’t until I was enrolled in Expanded Functions Dental Assisting program, that I realized the awesome opportunity I had to affect a patient’s health and well-being…it was also the same time I realized that the opportunity also came with huge responsibility.

The day is etched in my memory…I was taking radiographs on a new patient with the now antiquated XCP holder system. I was determined to do the best job and make sure the patient had a painless experience. I examined the patient for any abnormalities like tori and or frenum issues and did not see anything except a bright, deep and irritated spot of tissue on the soft palate of the patient.

Upon further questioning, the patient did not even know it was there as they had no complaints of pain, knowledge of trauma or how long it was there.

Selfishly, I did not want to be blamed for inadvertently traumatizing the area taking x-rays, so I decided to have my professor confirm my finding (note the pre-existing abnormality) and allow me to proceed without deductions. He did but not without teaching me a bigger lesson.

My professor told me that I was not using all my ‘faculties’ …I thought he did was meaning he would have preferred I interrupted a different instructor…what he really meant was that I should have realized by smelling the tobacco scent on the patient’s clothes that the red spot was a result of his smoking habits.

I was perplexed as I had examined other smokers and they did not have red abnormalities on their palates… so I went to the library and took out every pathology book I could find and tried to find a picture that resembled the abnormality I found.

What I found is that there are thousands and thousands of red lesions and not all are the same, look the same or possibly heal the same. It was then that I committed to never, ever let a spot of unknown or undetermined origin walk out the door.

It was also then that I committed to not rely on subjective opinions and antiquated systems to determine the outcome of a patient’s well-being - I swore to know the ‘why’ behind every opportunity to ‘do’ for a patient. BTW, the patient went for a biopsy at my insistence and was diagnosed with T1, N0, M0… A stage 1 oral cancer tumor, that was caught early enough so that no cancer cells were present in nearby structures, lymph nodes, or distant sites.

ALD: Oral cancer mortality rates have not improved over the past few years, in, fact some forms of head and neck cancer have increased. Why do you think this is?

DZ: Great question, unfortunately, my answer is not so great. I believe the mortality and morbidity rates are escalating for a few reasons. First, we are relying on what we learned in school to be the ‘standard’ for evaluating oral abnormalities. And in my experience and or opinion, the industry is too varied in its ‘standards’. We need systems of synchronization to effect change in abnormality screenings.

Second, we don't take time to interview, examine and evaluate the patient, we are quick to get to drilling and filling, or pick and polishing. Three, and perhaps most importantly, we fall short in understanding the current cancer risks and integrating technology, communicating its value and expanding our referral sources. This is particularly alarming to me as the rates of late stage HPV-related cancers are escalating and our profession is lagging in positioning ourselves as preventionists.

ALD: Do you think dentists equipped with soft tissue lasers have an advantage when it comes to taking biopsies and obtaining pathology reports more quickly?

DZ: Absolutely! I love the fact that there are so many proactive dentists in the industry that are investing in technology that will not only expedite patient’s treatment but also do so in a way that can more accurately cut a suspicious area and efficiently coagulate the soft tissue at the same time with less pain and more convenient healing.

ALD: About a year ago, you founded the National Cancer Network. What is its mission and how does it compliment the efforts of other oral cancer-related non-profits?

DZ: The mission of the NationalCancerNetwork.org is three-fold:

  1. Raise awareness of prevention through communication and education.
  2. Accelerate progress by promoting protocols that integrate adjunctive and increase screening by teaching dental professionals synchronized screening systems and effective patient communication.
  3. Encourage and increase referrals by identifying qualified specialists to refer abnormalities to for an expedited diagnosis.
Our overall goal is to have a marked effect on decreasing the mortality and morbidity rate of late-stage cancer and to provide support to those who have received a cancer diagnosis.

ALD: One of the innovations of the NCN is a new screening protocol that puts dental professionals on the front lines of the early detection of visible abnormalities whether they be in the patient’s oral cavity or on exposed areas of their skin. Could you provide the details?

DZ: Ever since I have been in the healthcare industry, I have always been on the hunt for cutting-edge products, systems and tools. I realized over time that oral evaluations and diagnosis were subjective and often undervalued. When it came to looking at epithelial abnormalities in my operatory, I adopted a very strict protocol which involved asking the patient open-ended questions and the utilization of the latest tools to effectively assess the abnormality for the doctor to evaluate. This screening protocol is called SOSA™. (Screening for Skin & Oral Abnormalities).

Well, early in my career, my employer did not embrace my diligence or my SOSA™ system and my concerns were often dismissed because he thought I was ‘spot a phobic’…. you know what I mean? He thought that every abnormality that I saw didn't mean that HE had to see it. Until one day, a patient that he determined didn't have anything wrong and was told that it just looked like trauma went to another dentist for a second opinion and was diagnosed with tongue cancer.

ALD: Is screening for skin abnormalities within the dental professional’s scope of practice?

DZ: That question is hard to answer as our scope of practice varies for every state. What I will say is, and I say it in my programs all the time is “If you see something, Say Something!” It’s like being the TSA Agent at the airport but applying it to everyday life. Not too long ago there was a news story about a nurse watching a certain home renovation program where she saw something abnormal about the host’s neck and throat.

Well, she cared enough that when she saw something she said something by calling the producer and explaining her concern. It later came out that the abnormality she saw was diagnosed as a cancerous thyroid tumor and that the individual underwent surgery because of her action.

It may not be a ‘scope of practice’ line item, but I do think that it is our responsibility to educate the patient on what our concerns are when we see something abnormal.

ALD: One of your most popular lectures is “See Spot? Don’t Run!” Is this for the entire dental team?

DZ: Definitely! ” See Spot Don’t Run” was designed out of an industry need to have a simple system of identifying abnormalities that the WHOLE TEAM can get behind. In summary, the goal is for the team to train together. A team that trains together learns together and succeeds together. There is an accountability to each other and to the patients. We also intend for the team to realize that the words we use often opt patients out of care and not into health, so during this lecture, I share some key systems for that and lastly, our objective is to integrate SOSA™ screening for every patient every visit and empower the patient to evaluate any epithelial changes in-between visits and inform us if they have any concerns so that we may alleviate any anxiety with care, expedited systems and understanding. I’m very excited about exhibiting at ALD 2018 along with my NationalCancerNetwork.org team and look forward to a very long-lasting affiliation with the Academy of Laser Dentistry!


ALD Staff 2018-04-13
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ALD 2018