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Susan Cotten, RDH

What Makes The Cotten Method™ of Oral Cancer Screening Different?

Oct 14, 2025

The Cotten Method™ of Screening is a comprehensive, four-pillar approach that goes beyond “going through the motions” of oral cancer screening. Rooted in science, it equips dental professionals with a deep understanding of cancer causes, expanded risk factors, and early signs and symptoms — plus advanced, extra-oral and intra-oral (EOIO) techniques. With ready-to-use patient and team communication tools, coding guidance, and the compassion of the Aloha spirit, The Cotten Method™ builds the knowledge, skills, and confidence to elevate early detection, protect patients, and reduce professional liability.

What Makes The Cotten Method™ Stand Out

The Cotten Method™ of Screening for Oral and Oropharyngeal Cancer is more than a “how-to” for hands-on screening — it’s a comprehensive, science-based system that empowers dental professionals with the knowledge, skills, and confidence to save lives. The creator of the modality, Susan Cotten, BSDH, RDH, OMT, developed it while working as a clinical hygienist, based on what she felt was missing in the screening system she was taught. She set out to create cancer screening best practices (above and beyond the existing standard of care) with a goal of saving more lives through early detection.

Unlike other approaches that focus primarily on the mechanical steps of screening, The Cotten Method™ is built on Four Science-Based Pillars:

  1. Solid Knowledge of Etiologies
    A deep understanding of all known causes of oral and oropharyngeal cancer — including, but not limited to, HPV — so screenings are informed by the why, not just the how.
  2. Expanded Risk Factor Awareness
    Insight into risk factors beyond tobacco, alcohol, and HPV, enabling clinicians to better evaluate each patient’s individual risk profile.
  3. Recognition of Early Signs and Symptoms
    Training to identify subtle symptoms that may appear before a visible lesion, allowing for earlier referrals and intervention.
  4. Comprehensive EOIO (Extraoral & Intraoral) Screening Mastery
    A detailed, step-by-step approach that goes beyond “checking the boxes” — from precise thyroid location and palpation to advanced evaluation of the oropharynx, tongue, and floor of mouth. Includes strategies for screening structures with limited visibility, understanding tonsil grading, and best practices for patient positioning and documentation.

How It’s Different

  • Depth of Knowledge + Clinical Skill
    Most training covers what to do. The Cotten Method™ integrates why it matters, creating a stronger clinical foundation.
  • Refined Techniques from Years of Clinical Application
    Susan developed this method over years of real-world clinical hygiene practice, referrals for suspicious areas, and lives saved as a result. 
  • Ready-to-use verbiage for:
    • Explaining a comprehensive screening to patients who have never experienced one.
    • Professionally addressing disagreements about referring suspicious findings.
    • Helping dentists and hygienists align on consistent screening standards.
  • Strategies to Reduce the Risk of Liability
    Guidance on proper documentation, insurance coding, and the liability implications of incomplete screenings.
  • Screen with Aloha
    Grounded in compassion, connection, and respect, The Cotten Method™ blends clinical excellence with the Aloha spirit — where Aloha means “the presence of breath” and “breath of life.” Every screening is an act of care and humanity.
Clinician's who learn from Susan always reach out to tell her about the lives they are impacting, and saving:

Not long after taking Susan’s workshop, I identified a slight asymmetry in the thyroid of a 28-year-old male patient. It was subtle, but he could see it. A month or so later, his mom came in for a dental appointment...with tears in her eyes, she gave me a big hug and said, “You saved my son’s life!” He had been diagnosed with thyroid cancer. She said the doctors were amazed that it was caught because it was so small. 

Stephanie Shada, BS, RDH

In short:
Performing a thorough screening is essential — but without the knowledge foundation, patient communication skills, and refined clinical techniques taught in The Cotten Method™, you’re missing the opportunity to elevate early detection, patient trust, and professional confidence to their highest level.

Enroll in The Cotten Method Online Certificate Course HERE 

Sleep better knowing you are providing the highest level of care available, and that as science advances, you'll have access to all future revisions of the course and modality. Enroll as an office and display your certificates proudly!

 

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