Oral health and hygiene is yet to gain enough attention in the routine health check-up regime of Indians. Many cases of oral cancer can be caught early if dentist visits are regular.
The incidence of oral cancer in India is alarming — the country sees about one lakh new cases every year, according to an ICMR study. More than 90% of these oral cancer cases are attributed to the usage of tobacco, alcohol and betel nut (supari/pan masala).
However, another cause — contributing to less than 5% of oral cancer cases — has been observed recently: sharp teeth. This is a problem noticed in patients with none of the contributory factors, yet has become a cause of rising concern in the recent past.
To cite an instance, a 36-year-old gentleman with a white patch over the right side of his tongue approached us facing discomfort. He was a non-smoker and did not have any other risky habits either. The patch measured about 2 cm. He had a medical history of repeated injury to the tongue from the adjacent teeth and undergoing a dental filling. When he came in for consultation, we suggested he undertake a frozen-section biopsy, which revealed diagnosis of tongue cancer. He was immediately started on treatment where he underwent laser removal of the patch and partial removal of the tongue with plastic surgery and robotic neck dissection.
Most common sites of oral cancers are the tongue, jaw or inner cheek. Factors like broken teeth, decayed teeth, filled teeth and ill-fitted dentures — which come under the bracket of sharp teeth — predispose a person to chronic mucosal trauma. Rarely, implants too are a cause. These factors in the long run have been shown to cause either direct or indirect
BE ALERT TO THE 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 get the same examined. The most common risk-prone areas in the mouth are the inner cheek (buccal mucosa/gutter) and tongue.
An increased risk has been observed among users of alcoholcontaining mouthwash. However, this data still lacks strong proof and is currently being studied.
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 that we eat, but lack of dental hygiene like 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 thus oral cancer due to this.
—The writer is Dr. Vishal Rao, Consultant-Head & Neck Oncology, HCG Cancer Hospital, Bengaluru.