India has one of the highest incidence of Oral cancer in the world. The high incidence of oral cancer and oral pre-cancerous lesions in India has long been linked with the habit of betel quid chewing incorporating tobacco.Oral cancer ranks number one among men and number three among women in India. Oral cancer constitutes 12% of all cancers in men and 8% of all cancers among women.
Tobacco use has many negative effects on a person’s oral health. People who smoke or use smokeless tobacco are particularly at risk of developing oral cancer or periodontal (gum) disease. Tooth decay, badbreathtooth loss, bad breath (halitosis) and stains on the teeth are additional oral health conditions associated with tobacco use.Oral cancer is perhaps the most significant threat to a smoker.Tooth decay is damage to teeth caused when food and bacteria interact to form plaque and tartar.Each year, physicians diagnose new cases of cancer of the oral cavity and pharynx (upper throat at the back of the removal of the lower jawmouth). The five-year survival rate for oral cancers is 50 percent, and treatment methods can significantly alter facial appearance.
In Peninsula Malaysia, Indian is the predominant ethnic group for oral cancer .According to the National Cancer Registry (NCR) of Malaysia, mouth cancer is ranked as the 7th and 3rd most common cancers for the Indian males and females respectively. Oral cancer among the Indian males and females accounts for 4.5% and 6.5% respectively of all cancers (NCR report, 2003-2005). Hospital based data from different hospitals in Malaysia from 2003-2005 has shown that oral cancer was reported to be the highest among ethnic Indians, followed by Malays and Chinese.
nosmoking signAbout 90 percent of people with mouth cancer and some types of throat cancer have used tobacco, according to the American Cancer Society. All forms of tobacco are dangerous, including cigars, pipes, cigarettes, hookahs and other, more exotic forms. Smokers are six times more likely than nonsmokers to develop oral cancer. Using smokeless tobacco increases the risk of developing cancers of the cheek, gums, or inner surface of the lips by nearly 50 times.hookah_student
Smoking can cause cancer to develop anywhere in the mouth or pharynx. Pipe smoking also has an added risk of causing cancer in the area of the lips that comes into contact with the pipe. Smokeless or chewing tobacco is associated with cancers of the tongue, cheek, gums, and inner surface of the lips. This cancer can begin within a few years of regular use of smokeless tobacco and tends to spread quickly. Unless it is detected early, major surgery is often needed to remove parts of the mouth, jaw and tongue.
Smoking is among the leading risk factors for developing gum disease, a bacterial infection that erodes tissue that supports the teeth.People who smoke and have gum disease are likely to suffer from failed dental restorations and dental surgeries. Associated problems include :
* Other problems.
Use of tobacco products causes oral cancer because tobacco contains carcinogenic toxins, including nitrosamines. These chemicals damage cells in the lining of the mouth, pharynx (upper throat at the back of the mouth) and larynx (voice box). Damage to these cells may cause them to malfunction and to rapidly multiply as cancer cells. Many of the chemicals found in tobacco also damage DNA. When functional, DNA tells the cells how to grow and repair the damage.
Signs and symptoms
People who develop periodontal (gum) disease as a result of using tobacco products may experience symptoms such as swollen, red or sensitive gums. They also may experience gum pain or gums that bleed when brushing or flossing teeth.
Other symptoms associated with gum disease include:
* Bad breath (halitosis)
*An abscess or pus on the gums
Lip cancers may be detected earlier than other oral cancers because of their highly visible location. Many oral cancers are not detected until the symptoms become more advanced. When detected early, many oral cancers can be successfully treated. Some conditions that may indicate early signs of oral cancer include:
* Leukoplakia causes lesions that look like thick, white patches of tissue in the mouth or throat.
*Erythroplakia. It is a condition that causes raised red lesions in the mouth or throat.
* Dysplasia is a precancerous condition in the mouth or throat that may be preceded by leukoplakia
The most common signs and symptoms of oral cancer include:
*Sore in the mouth or on the lips that does not heal or bleeds easily.
*Pain in the mouth that does not go away.
*Lump or thickening in the cheek or on the lip.
*Red or white patch on the gums, tongue or lining of the mouth.
*Persistent bad breath.
Symptoms of more advanced oral cancer include:
*Difficulties chewing and swallowing.
*Problems moving the tongue or jaw.
*Loosening of the teeth or pain around teeth and jaw.
*Numbness around tongue or other areas of the mouth.
Patients who have concerns about their oral health should visit a dentist /physician. In either case, an examination of the patient’s head, neck and mouth will likely be performed and a thorough medical history obtained, including any family history of periodontal (gum) disease, cancer or other illnesses. The dentist/physician also will likely ask about tobacco use that may be related to the patient’s symptoms. New dental products like Vizilite and Oral Advance can help us in accurate diagnosis of oral cancerous lesions in Dental Operatory itself.
Various tests (e.g. CAT scan, PET scan) may be used to diagnose oral cancers and to examine for possible spread of the cancer to the head and neck area. If a patient is diagnosed with cancer, the physician will need to learn the stage of the cancer. Staging is based on the dimensions of the cancer, whether ther is lymph node involvement and whether there is spread to distant organs. Cancer staging provides information as to the extent of the disease and helps with planning treatment.
Treatment will depend on the cause of the oral health problem. Typically, periodontal (gum) disease results in widespread infection of the gums that requires treatment by a dentist or periodontist. Examples of such treatments include use of antibiotics, scaling, root planing or gum surgery. Gum surgery may involve reflecting the gums away from the bone, cleaning diseased gum pockets and stitching them back into place, or grafting soft tissue from another area of the mouth to replace diseased gum tissue.
Treatment of gum disease in people who use tobacco can be difficult to perform successfully. It is crucial that patients avoid using tobacco while undergoing treatment. Failure to do so will impact the effectiveness of treatment. Gum disease often improves greatly after quitting smoking.
Treatment for oral cancer varies depending on a number of factors, including the general health of the patient and the location and stage of cancer. The patient’s age, family and peer support and the ability to tolerate certain medications or procedures also affect the treatment plan.
Treatment options for individuals with oral cancer include surgery, radiation therapy and chemotherapy. These methods may be used alone or in combination.
The best way to prevent tobacco-related oral health problems is to avoid using tobacco in the first place. People who use tobacco products often can significantly lower their risk of oral health problems by quitting tobacco use.
Patients who have concerns about their oral health should visit a dentist. In this case, an examination of the patient’s mouth, head and neck will likely be performed and a thorough medical history obtained, including any family history of cancer, gum disease or other illnesses. Patients may be asked about their tobacco use, and may have to undergo additional testing if cancer or gum disease is suspected.Treatment depends on the cause of the oral health problem. Treatment options for patients with gum disease include use of antibiotics, scaling, root planing, and gum surgery to clean diseased gum pockets. Treatment options for patients with oral cancer include surgery, radiation therapy and chemotherapy.
The best way to prevent tobacco-related oral health problems is to avoid using tobacco in the first place. People who use tobacco products often can significantly lower their risk of oral health problems by quitting tobacco use. Regular dental examinations also are crucial in detecting oral health conditions in their early stages, when they are most treatable.