Oral cancer frequently progresses without causing any pain or discomfort and is particularly dangerous because in its early stage, it cannot be felt by the patient. Often oral cancer is discovered when it has spread to other locations of the body. The most common cause is the chewable tobacco which is affordable and easily available at all paan, beedi shops.
Further, its popularity among the labourers and daily wage workers stems from the fact that it curbs hunger and gives a kind of well-being feeling in addition to being addictive. Hence the danger of this disease is immense.
In a 2014 interview, Dr Ashok Dhoble, Indian Dental Association General Secretary, noted that India has witnessed a steep growth in oral cancer patients because of the widespread use of cigarettes and chewable tobacco products. Roughly 30 per cent of India’s adult population – 15 years and older – uses some form of tobacco, according to “Tobacco use in India: An evil with many faces,” a report compiled by the American Cancer Society under the India Cancer Initiative. “Many faces” refers to the various types of smoked and smokeless tobacco products consumed in India, which include beedis, cigarettes, chillum, hookah, chutta, khaini, gutkha, paan with tobacco and paan masala.
Steps taken to curb the use of tobacco products are definitely in the right direction. But further efforts are required, not just in the obvious area of addressing addiction in tobacco products, but in creating employment opportunities for those currently working in this industry.
In India, the highest incidence of oral cancer is in the region of the tongue, followed by lips and then the salivary glands. Oral lesions can be benign or malignant and the confirmatory test is biopsy from the site. Non-invasive tests are also available to remove the doubt from a suspicious looking lesion with the dentists in the form of dyes which have reasonable accuracy to exclude the disease.
Oral cancer starts typically as a non-healing ulcer or a white or red patch in the mouth. The warning signs include change of colour, burning sensation, limited mouth opening, presence of swelling or nodules, inability to swallow, and thickening of the oral mucosa.
A regular check-up by a dental surgeon is the best way to monitor your oral health. However, self-diagnosis is also useful and can be done by examining your mouth in good daylight. Any non-healing ulcer of more than three months duration must ring the warning bell and immediately seen by a dental surgeon.
Hookah is the most common form of tobacco smoking in villages because it is cheap and generally you find hookah in village panchayats where it is passed from one person to another and another. Unfortunately, this habit is fast picking up in modern bars where hookahs are placed.
Between the smoking tobacco’s, beedis are most harmful, followed by hookah and cigarettes. However there is no doubt that they are all bad. The severity may differ.
It is also the type of tobacco used in the hookah which is most important. In India, of the total tobacco users, 48 per cent are using chewable tobacco in the form of gutkha, khaini, or zarda and 42 per cent are on smoking tobaccos with 38 per cent on beedis and 14 per cent on cigarette smoking.
As government bodies’ move toward curbing the use of tobacco products, those who use them should be constantly mindful of the dangers present. A dental visit is a good first step, as the dentist is most skilled in identifying even the most subtle signs of trouble.
(The writer is chief clinical officer, Clove Dental)
