Susan Cotten, BSDH, RDH, OMT

What I love most about being a dental hygienist is the relationships we form with patients and colleagues, and the impact those relationships can have in improved patient care and health outcomes.

Fifteen years ago, my patient who was an HPV oropharyngeal cancer and cervical cancer survivor, sat in my operatory crying. She was going to a good friend’s wedding that weekend and all she wanted was to be able to go to the wedding, smile and laugh out loud, just like everyone else, without the constant fear that someone would see what her teeth looked like. But she couldn’t, the fear was always there. Oral cancer and the treatments left her with teeth she was embarrassed to show and life-long oral side effects which were difficult to manage. As her dental hygienist, I saw the devastation to her mouth and teeth, but it wasn’t until that moment that I realized how this cancer affected her entire life.

It was that patient and an event I attended that weekend that gave me an extreme sliver of focus, purpose, and passion for earlier detection of oral and oropharyngeal cancers, and to ensure all dental professionals are confidently performing comprehensive screenings.  At that time, fifteen years ago, I was neither thorough nor completely confident performing a comprehensive screening. I always looked at the tongue, but I didn’t always perform the extraoral screening. I needed to change as a clinical dental hygienist and go back to what I was doing right out of dental hygiene school, a comprehensive extraoral and intraoral screening, every patient every time – so I did! It was working with mentors, specialists, and digging into research that gave me a renewed confidence in screening and understanding of each critical component of a comprehensive screening.

I saw a need to raise awareness in my community about HPV and all things oral cancer. As a result, I organized oral cancer walk/run events to support the work of the Oral Cancer Foundation, spoke at local dental and dental hygiene schools, organized and offered free oral cancer screenings at my office and community health fairs, including the Denver Broncos Health and Wellness Expo. I volunteered as a board member and oral cancer screening coordinator with Colorado Mission of Mercy, and with the Denver Homeless Head & Neck Cancer Screening and Care Group providing free screenings to the homeless, and worked as the Dental Lead for the Alliance for HPV Free Colorado.

From this extreme focus, The Cotten Method of Screening was developed. I saw a need for clinical calibration in dentistry and a science-based guide to the critical components of a comprehensive screening. Today, I have the extreme honor to share this life-saving information with dental colleagues at conferences through presentations and hands-on oral cancer screening workshops.

The dental community is not immune to oral cancer, and yet we too often do not receive comprehensive screenings or screenings at all. After hearing stories of dentists, dental hygienists, and other team members being diagnosed with oral, oropharyngeal, and other head and neck cancers, I teamed with the Rocky Mountain Dental Conference/RMDC last year to offer free screenings to attendees on the exhibit floor. After hearing my pitch about this new screening outreach, RMDC was completely on board! We also provided airway and myofunctional assessments, led by dental hygienist and myofunctional therapist, Kimmie Herrera – we were swamped providing screenings to colleagues! This couldn’t have been done without the dental hygienists who volunteered their time to help provide screenings. I’m thrilled to say we will be providing screenings again in 2026. Due to the success of our screenings last year, RMDC is offering additional health screenings and vaccines for attendees in 2026. “Together We Will Save Lives”!

Susan Cotten BSDH, RDH, OMT