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      Recent trends in prevention of oral cancer

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          Oral cancers often occurs out of long standing potentially malignant lesions and conditions so called premalignant lesions and conditions. Oral precancer is a intermediate state with increased cancer rate which can be recognized and treated obviously with much better prognosis than a full blown malignancy. Oral cancer risk can be lowered or even prevented by simply understanding basic oral hygiene, different bacteria found in the mouth, and how diet influences oral cancers. Currently, research is being done on the relationship between diet and oral cancer. Oral cancer is a very serious disease that can be prevented. Practicing good oral hygiene is key to help keep the oral cavity clean. Limiting the use of tobacco and alcohol products is also important because these are the causes of most oral cancers. Lastly, eating a well balanced diet that has protective affects can reduce the risk of oral cancer. This includes a diet high in fruits, vegetables, and fish and low in high fat and cholesterol meats, rice, and refined grains.

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          Most cited references 28

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          Smokeless tobacco and health in India and South Asia.

          South Asia is a major producer and net exporter of tobacco. Over one-third of tobacco consumed regionally is smokeless. Traditional forms like betel quid, tobacco with lime and tobacco tooth powder are commonly used and the use of new products is increasing, not only among men but also among children, teenagers, women of reproductive age, medical and dental students and in the South Asian diaspora. Smokeless tobacco users studied prospectively in India had age-adjusted relative risks for premature mortality of 1.2-1.96 (men) and 1.3 (women). Current male chewers of betel quid with tobacco in case-control studies in India had relative risks of oral cancer varying between 1.8-5.8 and relative risks for oesophageal cancer of 2.1-3.2. Oral submucous fibrosis is increasing due to the use of processed areca nut products, many containing tobacco. Pregnant women in India who used smokeless tobacco have a threefold increased risk of stillbirth and a two- to threefold increased risk of having a low birthweight infant. In recent years, several states in India have banned the sale, manufacture and storage of gutka, a smokeless tobacco product containing areca nut. In May 2003 in India, the Tobacco Products Bill 2001 was enacted to regulate the promotion and sale of all tobacco products. In two large-scale educational interventions in India, sizable proportions of tobacco users quit during 5-10 years of follow-up and incidence rates of oral leukoplakia measured in one study fell in the intervention cohort. Tobacco education must be imparted through schools, existing government health programmes and hospital outreach programmes.
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            Hamsters chewing betel quid or areca nut directly show a decrease in body weight and survival rates with concomitant epithelial hyperplasia of cheek pouch.

            Betel quid (BQ) chewing is strongly associated with the occurrence of oral leukoplakia, oral submucous fibrosis, and oral cancer. There are about 200-600 million BQ chewers in the world. Previous animal studies support the potential carcinogenicity of BQ in different test systems. However, little animal experiment has let hamsters or rats to chew BQ directly, similar to that in humans. In the present study, we established a hamster model of chewing BQ or areca nut (AN). A total of 81 2-week-old hamsters were randomly divided into three groups: 25 for control group, 28 for BQ-chewing group, and 28 for AN-chewing group. These animals were fed with powdered diet with/without BQ or AN for 18 months. Although the consumption of BQ or AN showed some variations, hamsters fed with powdered diet could chew and grind AN or BQ into small pieces of coarse fibers during the entire experimental period. The survival rate of AN-chewing hamsters decreased significantly after 6 months of exposure. The mean survival time was 15.6 +/- 0.9 months for control animals, 13.6 +/- 0.98 months for AN-chewing animals, and 15.7 +/- 0.55 months for BQ-chewing animals. The body weight of BQ- or AN-chewing animals also decreased after 4-13 months. Hamsters fed with AN for 18 months showed hyperkeratosis in 80% and acanthosis in 50% of cheek pouches. Animals fed with BQ for 18 months also showed hyperkeratosis in 93% and acanthosis in 14% of cheek pouches. These results indicate that AN and BQ components may induce alterations in proliferation and differentiation of oral epithelial cells. Animal model of chewing BQ or AN can be useful for future tumor initiation, promotion and chemoprevention experiments simulating the condition of BQ chewing in humans.
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              Oral cancer: prevention and detection.

               Ingrid Joseph (2001)
              Researchers in oral cancer agree that the early diagnosis of oral carcinoma greatly increases the probability of cure with minimum impairment and deformity. Primary prevention which involves reducing the exposure to tobacco, alcohol and betel quid has been shown to be effective in reducing the incidence of oral cancer. Secondary prevention involves screening for the early detection of oral cancer. Oral cancer screening can take many forms. Clinical examination and biopsy allow the early detection of premalignant and early oral cancers. Screening can be made more efficient by inspecting high-risk sites--the floor of the mouth, the ventrolateral surface of the tongue and the soft palate. Due to the cost of population screening, it is advisable to initially target high-risk groups, those over 40 years of age, including smokers and heavy drinkers. It is recommended that dentists perform an annual visual oral cancer examination on all their patients and obtain a specialist opinion for suspicious oral lesions. Ora Test with toluidine blue may be used as an adjunct to soft tissue examination to highlight any invisible, asymptomatic lesions. Exfoliative cytology can detect early oral cancer and can be performed by dentally untrained personnel. It is rapid and relatively non-invasive and therefore may be useful in population-based oral cancer screening programmes. Recently, based on various studies, the oral CDx brush biopsy technique has been proposed as a highly accurate method of detecting oral precancerous and cancerous lesions. More frequent oral cancer examinations are recommended for treated oral cancer patients to monitor the development of secondary tumours. Family members of patients with oral cancer are also at high risk and therefore should be examined more frequently. Whatever screening method is used, a positive screening result must be confirmed by biopsy. A public awareness programme that stresses the importance of at least one annual dental examination, identification of warning signs of oral cancer and recognition of the hazards of tobacco and alcohol use is necessary to reverse the high morbidity and mortality rates associated with this disease. In the future, the identification of oncogene and tumour suppressor gene mutations in biopsy specimens may give a clearer indication of the likely behaviour of suspicious oral lesions.

                Author and article information

                J Int Soc Prev Community Dent
                J Int Soc Prev Community Dent
                Journal of International Society of Preventive & Community Dentistry
                Medknow Publications & Media Pvt Ltd (India )
                December 2014
                : 4
                : Suppl 3
                : S131-S138
                Department of Oral and Maxillofacial Surgery, Muslim Education Society Dental College, Kerala, India
                [1 ]Department of Pedodontics, Muslim Education Society Dental College, Kerala, India
                [2 ]Department of Orthodontics, Muslim Education Society Dental College, Kerala, India
                Author notes
                Corresponding author (email: < drmummar@ >) Dr. Ummar Mangalath, Department of Oral and Maxillofacial Surgery, Muslim Education Society Dental College, Perinthalmanna, Palachode, Malappuram - 679 338, Kerala, India
                Copyright: © Journal of International Society of Preventive and Community Dentistry

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                tobacco, dentist, smoking, oral cancer


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