Continued from Part 1
Tobacco and alcohol use are important risk factors for leukoplakia and oral cancer.
Drug-related pemphigoid and other bullous disorders
Drug-induced pemphigoid may be due to drugs acting as haptens or drug-induced immunological dysfunction.
Drugs most commonly implicated
Oral side effects caused by drugs are relatively uncommon but may be important. Some drugs almost invariably cause side effects in the mouth, for example dry mouth from many drugs, and oral ulcerswith some of the cytotoxic agents, while other drugs rarely cause oral complications. Some habits, such as the use of oral snuff (smokeless tobacco), can cause gum recession and leukoplakia (a precancerous white lesion) and possibly predispose to oral cancer whereas oral use of cocaine can cause gum ulceration or peeling of mouth tissues. Drugs that occasionally cause complications in the mouth are discussed below. Continue reading
Continued from Part 4
What are the principles of treatment for oral cancer?
Individuals with oral cancer often present too late for cure and some may not benefit from treatment. Three treatment options are possible:
- Attempted cure
- Active palliative care
- Supportive care only pending death
If cure is attempted, the highest chances of success are given by multimodality treatment – a combination of surgery, radiotherapy, and more rarely, chemotherapy. The most aggressive treatment that the individual is able to withstand will be recommended because if the first round of treatment fails, the chances of survival are much reduced. Continue reading
Continued from Part 3
What are the investigations needed for oral cancer?
Investigations are done to see the extent of cancer and to confirm the diagnosis. The following investigations may be indicated:
- Jaw radiography or x-ray
- Chest x-ray or computed tomography (CT). This is important as a pre-anesthetic check especially in individuals with known airways disease, and to demonstrate second primary tumors or spread to lungs or lymph nodes, ribs or vertebrae.
- Magnetic resonance imaging (MRI) or CT of the primary site, of the head and neck, and suspected sites of distant spread. MRI is particularly useful to determine tumor spread, soft tissue involvement and lymph nodes involvement.
- Blood test: full blood picture and hemoglobin, blood for grouping and cross-matching, urea and electrolytes, and liver function tests.
- Biopsy. Biopsy is a tissue sample taken for histopathological analysis and it gives confirmative diagnosis. Continue reading
Continued from Part 2
candidal leukoplakia in a person who smokes heavily © powerbasetx.org
Chronic candidal infection
This is often associated with speckled leukoplakias and such lesions are particularly prone to undergo cancerous transformation, though the role of candidal or yeast infection in malignant transformation must be regarded as uncertain. Continue reading
Continued from Part 1
Betel quid (paan) and other chewing habits
Paan chewing is one of the most widespread habits in the world and is practiced by over 200 million people worldwide. It is particularly common in South-East Asia and the Indian subcontinent and is also prevalent within these ethnic communities in parts of the USA. The composition of the quid varies but basically consists of betel nut and slaked lime wrapped in a betel leaf to which tobacco and various spices are often added. The quid is usually placed in the cheek pockets and is frequently kept in the mouth for a long time. As the quid is chewed, alkaloids are released from the nut and the tobacco which are said to aid digestion and to produce a slight euphoric effect. The habit is more common in women than in men, and although the frequency of use increases with age the habit often starts in childhood. Continue reading
Oral cancer is the sixth most common cancer reported worldwide. Oral cancer affects twice as many men as in women. For every 100,000 people, 6.3 males and 3.2 females are likely to develop mouth cancer. However this difference is less than it has been in the past, partly due to changes in smoking habits. Continue reading
Tooth extractions can be a bloody affair. Bleeding or the abnormal flow of blood is normally seen in tooth extraction but excessive bleeding can be caused by something as simple as taking aspirin to prevent heart attacks or because of some inherited blood disorders. Continue reading
Continued from Part 1
Smoking Cessation and Recovery
Smoking cessation is an essential component for the successful treatment of periodontal disease as there is little rationale for treating periodontitis without eliminating one of the major causes of the disease. Thus, there is also the question of whether periodontal surgical treatment is indicated without a commitment by the patient to quit smoking. As with other smoking diseases, cessation is only the first step of a long healing process where the smoker often does not approach the lower risk of the nonsmoker for 10 to 20 years.
Smoking is a major hazard to health and promotes many diseases. In addition to nicotine (one of the most heavily used addictive drugs), cigarette smoke is composed of dozen gases (mainly carbon monoxide) and tar as well as almost 4000 other compounds which causes cancer are present. The ingredients of tobacco products affect not only our body directly, but also the people around us indirectly. Many of our organs succumb to the side effects of smoking, including our gums. Continue reading