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Oral cancer (OC) occurs when DNA mutations develop in the cells lining the lips and the mouth cavity. It commonly affects the tongue, floor of mouth, buccal mucosa, lips, palate, gum etc all. Mostly, oral cancers are squamous cell carcinomas that begin in the squamous cells lining the lips and the inside of mouth.
Type: of oral cancer are as enumerated below -
Gender: affects the male populace predominantly. But, it can affect both male and female. It’s the commonest cancer in India currently, and accounts for a significant percentage of the total cancer mortality.
Etiology: consumption of “khaini” (tobacco & lime mix), betel nut, areca nut, slaked lime, chronic irritation due to irregular teeth, smoking, alcohol consumption, oral infection with Herpes Simplex Virus (HSV) / Human Papilloma virus (HPV), nutritional deficiencies, chronic infections & poor dental/ oral hygiene are the common risk factors that can trigger oral carcinogenesis. It is noteworthy that the local effects of tobacco and alcohol are both dose-dependent and synergistic.
Features: the various presentations (of signs & symptoms) of Oral cancer are as given below –
Cheek cancer - hard and painless thickening, with an ulcer sometimes that does not heal for weeks together.
Lip cancer - white patch on the inner lining of the lip on which a hard mass slowly develops.
Palate cancer- persistent sore on the hard palate that may ulcerate.
Tongue cancer - ulcer on the side of the tongue that bleeds occasionally and does not heal.
Screening: is generally recommended for asymptomatic populations goal of which, as usual, is to be able to detect & diagnose oral cancer at an early stage which is potentially curable. Visual screening by healthcare personnel including dentists, general practitioners, oncologists, surgeons etc all is crucial to detect not only early asymptomatic oral cancers but also the oral pre-cancerous lesions including oral submucous fibrosis (OSMF), oral leukoplakia, erythroplakia et al which carry a high risk of malignant transformation to in-situ and invasive cancers.
Diagnosis: a complete physical exam of the local parts basis the features mentioned above arouses suspicion that prompts diagnosis -
Biopsy (punch or removal of mass of tissue (excision) for cytology) clinches the diagnosis of oral cancer. Should there be a neck mass that arises suspicion of a regional metastatic disease, a fine needle biopsy (FNB) can be attempted.
Initial staging workup includes CT, MRI scans etc all. PET CT scan though frequently employed, is not usually used for the initial workup.
A triple endoscopy that includes laryngoscopy, esophagoscopy and bronchoscopy can help definitive staging of the disease. Biopsies obtained during this procedure help confirm the primary diagnosis, define the extent to which the primary site disease has spread, and identify additional pre-malignant lesions and metastasis, if any.
Treatment / Prognosis: preventive measures, earlier diagnosis and right early treatment is key for better prognostication and efficient/ effective therapeutic management of oral cancer. Conventional treatment includes surgery, radiotherapy, chemotherapy as deems appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical endpoints and facilitate recovery as would be feasible contextually. As seen with other cancers, the site, stage, histopathological grading etc all determine the treatment outlook. The number of micronucleated oral mucosal cells can be a useful biomarker for predicting course of oral pre-cancerous lesions and prognosis thereof.
Prevention: rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an increased focus on protective factors and avoidance of the risk factors can be of help. Especially, abstaining from use of tobacco/ products, alcohol, regularly maintaining oral health and hygiene and daily intake of fresh seasonal fruits and vegetables can help prevent a vast majority of oral cancers. Also, timely screening/ detection of the pre-cancerous lesions of the oral cavity and prompt treatment thereof is crucial to preventing a malignant transformation of the same. If you wish to discuss about any specific problem, you can ask a free question.
Hi, I am doctor Ayush Sharma. I am a specialist in orthodontics and in facial orthopaedics. I deal basically in braces in young children and adults as well.
Most of the eager children must be noticing that their children have got crooked teeth. The reason for this is evolutionary changes, the jaw size is decreasing, the number of teeth are still the same, the dietary changes. All these are causing the teeth to become more and more crowded. The reason is that of the jaw size and the tooth size relationship. It is not matching anymore. This is why you must be observing that the milk teeth are not falling at the right time whereas the permanent teeth are getting more and more delayed. The solution for this is we need to have regular check ups for our children so that this problem can be solved at an earlier stage. If the child comes to us at an earlier stage, we have more treatment options and the bone is less mature so we can perform better procedures such as braces and other orthopaedic appliances which help in enhancing the jaw growth so that all the teeth can be accommodated well and your child can have a perfect smile.
In earlier days, we only had the option of getting metallic braces done but with the advancement and the recent technologies that has resulted in tooth coloured braces, invisible braces, lingual braces and more and more advancements which make the treatment very comfortable for your child and this does not limit you to a child treatment as well, but it has enhanced and even adults can get their crooked teeth corrected by us which results in better smiles, healthier teeth and longevity of the teeth as well.
If you have any queries regarding your crooked smile, irregularly placed teeth or you are not happy with your chewing ability, you can definitely contact me through liberate or contact me via my phone number, via my email or message me.
Tobacco prematurely ages the mouth and leads to mouth cancers. Smoking tobacco stains teeth and interrupts calcium absorption in your body.