19 Jul, 2024
19 Jul, 2024
This article is medically reviewed by Dr. Yash Mathur, Consultant – Surgical Oncology, HCG Cancer Centre, Borivali.
Most of the patients visiting for regular oral checkups ask about the reasons for oral cancer.
Beyond well-known factors like tobacco and alcohol, lesser-known causes of oral cancer include human papillomavirus (HPV) infection, particularly HPV-16, prolonged sun exposure leading to lip cancer, and chronic irritation from poorly fitted dentures or rough teeth.
Poor oral hygiene and a diet lacking in fruits and vegetables may also contribute to the development of oral cancer. Awareness of these factors can help in devising prevention strategies and detecting oral cancer in its early stages.
Individuals ask various questions from the doctor, such as what causes oral cancer and risk factors for oral cancer. Some of the causes of oral cancer are:
Chronic HPV infection, caused by the human papillomavirus (HPV), has been found to increase the risk of oropharyngeal cancer and may be one of the potential causes of oral cancer in non-smokers and smokers.
This infection is sexually transmitted, and the virus spreads through oral sexual practices and infects the mouth and throat.
HPV can lead to mutations in the mouth and throat cells, which can make them divide abnormally and form a tumor. It is especially associated with tongue and tonsil cancer.
While tobacco and alcohol are well-known causes of oral cancer, there are certain lesser-known risk
factors that play a significant role in oral cancer development.
Human papillomavirus (HPV) infections, poor oral hygiene, and chronic irritation from ill-fitting
dentures can increase risk.
Additionally, diets low in fruits and vegetables and excessive sun exposure are important contributors.
Dr. Yash Mathur
While not all cases of oral cancer are caused by HPV, it is important to be aware of the risks associated with the virus.
The best way to reduce the risk of HPV infection and, thereby, HPV-related oral cancer is to adopt healthy sexual practices, avoid unnatural sexual habits, and opt for HPV vaccination.
The HPV vaccine is recommended for both males and females aged between 9 and 26 years. Ideally, this vaccine is recommended between the ages of 11 and 14. However, it can be given earlier or later, i.e., from 9 to 26 years of age.
In recent years, doctors have been recommending HPV vaccines for adults between the ages of 27 and 45, depending on their sexual history.
There are currently three HPV vaccines available, including Gardasil, Cervarix, and Gardasil 9. While both Gardasil and Cervarix protect against HPV types 16 and 18, Gardasil also provides protection against types 6 and 11, which are responsible for 90% of anogenital warts. Cervarix may offer some cross-protection against other HPV types.
Gardasil 9 provides even more comprehensive protection, covering seven oncogenic types (HPV 16, 18, 31, 33, 45, 52, and 58) and types 6 and 11. In total, Gardasil 9 protects against almost 90% of HPV types that have the potential to cause cancer.
As of September 2022, the Serum Institute of India has developed a new quadrivalent vaccine called Cervavac. The vaccine protects against four different strains of the human papillomavirus (HPV 6, 11, 16, and 18). The government of India has launched a vaccination program to prevent HPV infection in females from the age group of 9 to 14.
Poor oral hygiene is another lesser-known cause of oral cancer. Paying less attention to oral hygiene can lead to bacterial buildup in the mouth and inflammation. This inflammation can damage your mouth and throat cells, leading to cancer.
During your dental check-ups, your dentist will examine your gums, palates, soft tissue, and tongue for lesions, ulcers, white or red patches, bleeding, and a lump in the throat region or swelling in the neck due to lymph node enlargement.
If something suspicious is observed, you should consult an oral cancer specialist.
Chronic inflammation has been recognized as a risk factor for several cancer types, including oral cancer.
Inflammation is your immune system’s way of responding to injuries. In general circumstances, inflammation drives healing; however, when it becomes chronic, it can lead to further injury and cause damage to healthy tissue. In some cases, this can lead to cancer.
Several factors, including poor oral hygiene, gum disease like gingivitis, and periodontitis, can cause chronic inflammation in the oral cavity.
Nutritional deficiencies, smoking, and alcohol consumption are also associated with an increased risk of chronic inflammation leading to malignancy. Over time, this inflammation can lead to changes in the cells of the mouth and throat, increasing the risk of oral cancer.
Some of the most effective ways to reduce the risk of chronic inflammation-related oral cancer include maintaining good oral hygiene, quitting smoking, stopping alcohol consumption, and eating a balanced diet that comprises the right amounts of vegetables and fruits.
Regular dental check-ups can also help detect any early signs of oral cancer and prevent its progression.
This type of cancer is more often associated with people who are addicted to areca nuts (supari) and suffer from reduced mouth opening.
Reduced mouth opening due to supari is called oral submucous fibrosis, which is classified as a potentially malignant disorder. People suffering from this have a very high chance of developing oral cancer in their lifetime if this condition is left unmanaged. This disease is most commonly found in the Indian subcontinent.
Of the many potential causes of oral cancer among teetotalers, one of the shocking ones is the usage of ill-fitting dentures.
When ill-fitting dentures or prosthetic devices are used for a long time, they may cause chronic irritation to healthy gums, cheeks, and tongue. Gradually, they trap carcinogens, accumulate bacteria, and cause chronic inflammation, which can increase the risk of oral cancer development.
Dr. Yash Mathur
Some of the effective ways to prevent oral cancer in such people include opting for regular health check-ups and abstaining from habits that increase the risk of cancer development.
Visiting your dentist regularly and taking good care of your dentures, promptly addressing the issues of ill-fitting dentures and broken or sharp teeth, can help reduce your oral cancer risk.
A head and neck oncologist should be consulted in the case of ulcers that persist for over two weeks.
There is a growing body of evidence suggesting that excessive sun exposure may increase the risk of certain types of oral cancer. Ultraviolet (UV) radiation from the sun can damage the DNA in cells, leading to mutations that can eventually lead to cancer.
One of the studies published in the International Journal of Cancer reported that individuals who had a history of frequent sunburns and high levels of sun exposure had a higher risk of getting diagnosed with oral cancer.
Another study published in the Journal of Investigative Dermatology found that individuals who had a history of significant sun exposure had an increased risk of developing lip cancer.
Therefore, protecting your skin and lips from excessive sun exposure is important. You can do this by wearing a hat, using lip balm with SPF protection, and avoiding prolonged exposure to the sun, especially during peak hours (11 a.m.–3 p.m.).
Occupational exposure is another lesser-known risk factor for oral cancer. Prolonged exposure to hazardous chemicals, which is common at certain workplaces, is found to increase the oral cancer risk.
People who work in industries such as construction, manufacturing, and chemical production may be at higher risk of developing oral cancer due to exposure to hazardous substances.
A family history of oral cancer significantly raises an individual's risk for the disease. Exposure to the same environmental factors and similar lifestyle habits, such as tobacco and alcohol use—basic risk factors—are usually shared by family members. Such shared behaviors may enhance the genetic risk and increase the incidence of the disease in the family.
Those individuals who have a positive family history of oral cancer without a relevant history of tobacco and alcohol consumption should consider early screening and genetic counseling for early detection.
A poor diet may also increase the risk of oral cancer. Diets low in essential nutrients, mainly fruits and vegetables, can make one more susceptible to oral cancer.
Fruits and vegetables are rich in antioxidants, vitamins, and minerals. These ingredients protect cells from damage and support immune function.
Moreover, diets containing significant amounts of processed foods can lead to chronic inflammation and obesity. These two factors also increase the risk of oral cancer. Alcohol use, combined with poor dietary intake, further increases the risk of oral cancer.
A balanced diet rich in plenty of fruits and vegetables may help reduce the risk of oral cancer.
Excessive alcohol use is a significant risk factor for oral cancer. It acts as a solvent and allows carcinogens to enter the cells that line the oral cavity. It is metabolized into acetaldehyde, a toxic compound that can potentially damage the DNA and proteins related to the development of cancer. It forms DNA adducts, which can lead to damage to the DNA in the oral mucosa.
Long-term alcohol consumption may irritate and inflame the oral mucosa, thus providing a favorable environment for malignant changes.
This risk is significantly increased when alcohol is consumed with tobacco. Additionally, heavy drinking is associated with nutritional deficiencies, which reduce the body's ability to repair damaged tissues.
The risk of oral cancer may be reduced by limiting alcohol consumption and avoiding tobacco use.
As a dedicated single-specialty cancer hospital in India, HCG offers comprehensive care for different types of oral cancer. Through its unique approaches of multidisciplinary care, personalization, and patient-centricity, HCG helps oral cancer patients receive better quality care and support.
Through our state-of-the-art diagnostic and treatment facilities and new-age oral cancer treatment approaches, we aim to deliver holistic care that has a positive impact not just on survival rates but also on the quality of life.
Lesser-known causes of oral cancer in India include HPV infection, prolonged sun exposure, and chronic irritation from poorly fitted dentures or rough teeth. Poor oral hygiene and a diet lacking fruits and vegetables also contribute to oral cancer.
Chronic inflammation from gum disease, family history, and occupational exposure to hazardous chemicals are additional risk factors. Excessive alcohol consumption, especially when combined with tobacco use, further increases the risk.
Awareness of these factors helps in the early detection and development of prevention strategies.
Author Bio : Dr. Yash Mathur
Consultant – Surgical Oncology
MDS (OMFS), FHNS (Head & Neck Oncosurgery)
Dr. Yash Mathur is a seasoned head and neck cancer specialist and robotic oncosurgeon with extensive training in the management of advanced oral, oropharyngeal, and salivary gland malignancies. He is known for doing trans axillary neck dissection (RABIT). Dr. Yash is skilled at performing minimal-access resections for advanced oral cancers and complex primary surgeries, especially on the tongue, cheek, and lips. Through specialized training, Dr. Yash has acquired a mastery of head and neck surgery and reconstruction for post-surgery oral and craniofacial defects.
To book an appointment with Dr. Yash Mathur, please click here.
