Oral health and hygiene have not yet received enough attention in the routine health check regimen of Indians. Many cases of oral cancer can be detected early if dental visits are regular.
The incidence of oral cancer in India is alarming – the country sees around one lakh new cases every year, according to an ICMR study. More than 90% of these cases of oral cancer are attributed to tobacco, alcohol and betel nut (supari/pan masala) consumption.
However, another cause — contributing to less than 5% of oral cancer cases — has been observed recently: sharp teeth. This is a problem observed in patients with none of the contributing factors, but which has become a cause for increasing concern in the recent past.
To cite an example, a 36-year-old man with a white patch on the right side of his tongue approached us, uncomfortably. He was a non-smoker and had no other risky habits either. The patch measured approximately 2 cm. He had a medical history of repeated injuries to the tongue of adjacent teeth and had had a dental filling. When he came for consultation, we suggested that he do a frozen section biopsy, which revealed a diagnosis of tongue cancer. He immediately began treatment where he underwent laser removal of the patch and partial removal of the tongue with plastic surgery and robotic neck dissection.
The most common sites for oral cancers are the tongue, jaw or inside of the cheek. Factors such as broken teeth, decayed teeth, filled teeth, and ill-fitting dentures – which fall under the category of sharp teeth – predispose a person to chronic mucosal trauma. Rarely, implants are also a cause. These long-term factors have been shown to directly or indirectly cause
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BE ALERT FOR SIGNALS
One should be vigilant and identify if any of the above mentioned reasons are causing discomfort, irritation, pain or ulcers, and consult a dentist without delay and have the same checked. The most common risk areas in the mouth are the inner cheek (oral mucosa/gutter) and the tongue.
An increased risk has been observed in users of mouthwashes containing alcohol. However, these data still lack strong evidence and are currently under investigation.
ORAL HYGIENE IS CRUCIAL
Oral hygiene has been shown to be an independent risk factor for oral cancer in several studies. Generally, it is not the food we eat, but the lack of dental hygiene, such as regular brushing and cleaning, that leads to poor oral hygiene. Thus, it is important to maintain dental hygiene with regular rinsing and brushing. With a good preventive strategy, one can reduce the risk of sharp teeth and therefore of oral cancer because of it.
—The author is Consultant-Head & Neck Oncology, HCG Cancer Hospital, Bengaluru.