Spotting Skin Cancer in the Dental Chair: Melanoma, Dermoscopy & AI | Dr. Alexander Witkowski

Your patients see you twice a year, and a lot of skin cancer shows up from the neck up, so the dental office may be the first place a melanoma gets noticed. Dermatologist Dr. Alexander Witkowski, who holds the Guinness World Record for the smallest skin cancer ever detected, explains how dental teams can bring up a suspicious spot without overstepping, how dermoscopy and AI can triage a lesion in seconds, and why a biopsy can miss the cancer that's really there. In this episode: - Why the dental chair is a great place to catch skin cancer early - How to bring up a spot on a patient's face without overstepping your scope - Why it can take a year to see a dermatologist, and why that matters for melanoma - Dermoscopy and the three-point checklist: green, orange or red - AI that reads a skin lesion in five seconds - Why only about 5% of a lesion gets seen by the pathologist, and AI heat maps that show where to biopsy - Could the same tools work for oral lesions? - Insurance denials for "poor prognosis," and the words that win appeals 📰 Plus dental news from spring 2024: bills to end EFT fees on insurance payments, the FBI's cybersecurity warning for oral surgeons, and the Department of Labor's new overtime rules for salaried staff. Dr. Alexander Witkowski, MD, is a dermatologist and assistant professor of dermatology at Oregon Health & Science University, where he co-directs the skin imaging and technology center. He chairs the American Academy of Dermatology's cutaneous imaging expert resource group and is the founder and CEO of Sklip, a digital dermoscopy tool for skin cancer triage. He trained in medicine in Poland and in dermatology in Italy, and holds the Guinness World Record for the smallest skin cancer detected, a 0.65 mm melanoma in situ. His views are his own and not those of OHSU. Chapters: 0:00 Intro 1:17 Insurance denials for "poor prognosis" 5:59 Chad's tips for winning insurance appeals 8:02 The words claims reviewers look for 9:35 Only 6% of patients use their max 10:40 News 11:04 News: bills to end EFT fees 12:47 News: FBI cyber warning for oral surgeons 14:34 News: new overtime pay rules 16:43 Why target oral surgeons? 18:38 Meet Dr. Alexander Witkowski 23:08 How he met Chad at the Hinman 27:43 Why a dermatologist goes to dental meetings 28:30 From medical school in Poland to dermatology 30:41 Italy, confocal microscopy and a world record 32:42 Building Sklip 35:08 Waiting a year to see a dermatologist 36:36 AI that reads a skin lesion in five seconds 37:48 Why dental offices matter for skin cancer 39:12 What would you say about a spot on a patient's cheek? 40:30 Extraoral skin checks and scope of practice 41:54 Being a health care advocate 44:38 Starting the conversation with patients 46:42 Building trust and word of mouth 48:16 Could this work inside the mouth? 50:07 Green, yellow or red for oral lesions 53:22 Do screening tools improve outcomes? 55:26 Why dentists embrace new tools 56:40 Green, orange, red: the three-point checklist 59:06 When the biopsy misses the cancer 1:01:30 Only 5% of a lesion gets read 1:03:12 AI heat maps that show where to biopsy 1:05:40 A discount for DINKs 1:06:56 Chad's spot after Cancun 1:08:41 Closing: physicians of the oral cavity 1:11:33 Modena, Ferrari and dermoscopy 🎧 Listen to the podcast: Apple Podcasts: https://podcasts.apple.com/us/podcast/dentists-in-the-know/id1543254763 Spotify: https://open.spotify.com/show/2Elfj6LX0hCUyp0AgdTsij 📺 Make sure you subscribe to catch new episodes live every Wednesday at 8pm ET! https://www.youtube.com/@dentistsintheknow 🌐 Check out our brand new website: https://dentistsintheknow.com 🌟 Stay up to date on all the latest dental trends when you follow the DINKs: https://fanflet.com/dinks/social-2