Lesser-Known Causes of Oral Cancer 

29 Apr, 2023

More than 1,35,000 new cases of oral cancer are reported in India every year. Many reports suggest that oral cancer is responsible for nearly 30% of all cancer-related deaths in the country. While it is no news that the consumption of tobacco and alcohol are the main reasons for oral cancer, there are other lesser-known factors that contribute to an increased risk of oral cancer.  

Today well explore some of the surprising and lesser-known causes of oral cancer that you should be aware of to protect yourself and your loved ones. Dr. Yash Mathur who is a head and neck surgical oncologist associated with HCG Mumbai, says that off late, there is an increase in cases of oral cancer with non-tobacco aetiology.  

Human Papillomavirus (HPV) 

Chronic HPV infection, which is caused by the Human papillomavirus (HPV), has been found to increase the risk of oropharyngeal cancer. 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 cells of the mouth and throat, which can in turn make them divide abnormally and form a tumour.  

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 vaccination should be taken between the ages of 11 and 14, ideally. It can be taken earlier or later, i.e., from 9 years up to 26 years of age.  

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) in addition to 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 vaccine called Cervavac, which is a quadrivalent vaccine. 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 programme to prevent HPV infection in females from the age group of 9 to 14 years.  

Poor Oral Hygiene 

Poor oral hygiene is another lesser-known cause of oral cancer. Paying less attention to oral hygiene can lead to bacterial build-up in the mouth and cause inflammation. This inflammation can damage your mouth and throat cells, leading to cancer.  

Prevention includes brushing your teeth twice a day, flossing once a day, and visiting your dentist for regular check-ups.  

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 the presence of a lump in the throat region or swelling in the neck due to lymph node enlargement. You should consult an oral cancer specialist if something suspicious is observed.   

Chronic Inflammation  

Chronic inflammation has been recognised as a risk factor for several types of cancer, 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.   

Chronic inflammation in the oral cavity can be caused by several factors, including poor oral hygiene, gum disease like gingivitis, and periodontitis. 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, limiting 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.  

Ill-fitting dentures 

Dr. Yash says that in his clinical practice, one of the most common causes of oral cancer in teetotallers is an instance where an ill-fitting denture or prosthesis may cause chronic irritation to normal gums, cheeks, or tongue, gradually leading to a non-healing ulcer and eventually causing oral cancer. 

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 left untreated.  

More effective ways to prevent oral cancer in such people include opting for regular health check-ups and abstaining from habits that increase the oral cancer risk. Visiting your dentist regularly and taking good care of your dentures, getting the ill-fitting dentures, and broken, sharp teeth removed can help you in reducing your oral cancer risk. A head and neck oncologist should be consulted in cases of ulcers that persist for more than 2 weeks. 

Sun Exposure 

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, it is important to protect your skin and lips from excessive sun exposure. This can be done by wearing a hat, using a lip balm with SPF protection, and avoiding prolonged exposure to the sun, especially during peak hours (11 am – 3 pm).  

Occupational Exposure 

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.  


For oral cancer to be effectively managed, it needs to be detected in its early stages. While smoking and alcohol consumption are well-known causes of oral cancer, there are also lesser-known causes that people should be aware of.  

Along with awareness of the lesser-known factors, it is important to know about various measures that can help reduce your oral cancer risk. Practising good oral hygiene habits, living a healthy lifestyle, protecting yourself from the sun, and following safety guidelines when working with hazardous substances, along with regular visits to a dentist, are a few measures that can help you reduce your oral cancer risk. 

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