Integrated medical and dental care streamlines throat cancer treatment

When Edward Jones schedules his regular dental cleanings, he always asks to see Keets Nelson, a dental hygienist at Kaiser Permanente’s dental office on Grand Avenue in Portland, Oregon. “Keets is a really interesting person to talk to,” said Jones. “I’ve been seeing him for years.”

But one routine cleaning with Nelson in November 2024 would prove life-changing.

Jones, a retired judge and criminal defense attorney, had gone in for a quarterly cleaning. Just as Nelson was about to finish up, he noticed a tiny rough spot on one of Jones’ tonsils.

A connection between medical and dental teams

“We see a lot of lesions in people’s mouths that aren’t problems, but in my gut I thought, ‘That one doesn’t look OK,’” said Nelson. “And because I had seen Edward several times before, I could say with confidence that I had never seen that spot before.”

Nelson asked dentist Charles Row to take a look. However, since the lesion was so far back in Jones’ throat, he couldn’t get a clear picture. Nelson advised Jones to make an appointment with his primary care doctor for a closer look.

Later that day, still concerned, Nelson messaged Jones’ doctor through Kaiser Permanente’s secure messaging system to give her a heads-up. After discussing the situation, his doctor referred Jones to the head and neck specialists in the otolaryngology department.

“Before I even got in to see my primary care physician, I got a call from Head and Neck Surgery to schedule a scope,” said Jones. “The whole process was seamless from my perspective.”

A throat cancer diagnosis

A CT scan and biopsy confirmed that Jones had throat cancer. In January 2025, he underwent surgery to remove the tonsil and nearby lymph nodes. Thanks to Nelson’s close attention and the swift collaboration between teams, Jones was able to avoid radiation, and the cancer was removed before it spread beyond the tonsil.

With time to heal — and follow-up support from a speech therapist — his voice is back to normal, and he can eat and drink without any issues. Just a few months after surgery, he and his wife spent 2 weeks in London, and have since traveled to California to visit their grandchildren.

The importance of regular check-ups

Jones’ experience underscores the importance of regular dental check-ups. While dental hygienists primarily focus on cleaning teeth, they’re also trained to identify other health concerns — from gum disease and tooth decay to signs of diabetes, inflammatory conditions, and medication side effects that can increase the risk of gum disease.

“I think people don’t really understand how much poor oral health can affect their overall health,” said Nelson. “I really value having enough time with patients during routine visits because it allows me to make an impact on their health — and sometimes their life — when they need it most.”

Dental hygienists can also be the first to notice changes in a person’s mouth, as in Jones’ case, where his cancer might have gone undetected for months had he not come in for a routine cleaning.

Thanks to the close coordination of medical and dental care at Kaiser Permanente, those regular check-ups can have a life-changing impact for members.