Oral Cancer, Lesions and Growths
What are the risk factors for oral cancer?
The risk factors for oral cancer include: tobacco and alcohol use, exposer to sunlight (especially for lip cancer), age (incidence of oral cancer rises steadily with age), gender (men are twice as likely as women to get oral cancer), and race (African Americans are twice as likely as Caucasians to get oral cancer). Note, of all the rick factor tobacco is the primary cause of oral cancer, which accounts for 90% of all cases. Smokers are 6 times more likely to develop oral cancers than nonsmokers.
How can you lower your risk for oral cancer?
Most oral cancer is preventable. Approximately 75% of oral cancers are related to the use of tobacco and alcohol. If you are among those using both, you risk becomes much greater than if you were using each substance alone. In order to decrease your risk, you should avoid the use of any tobacco products (including cigarettes, chews, pipes, cigars and snuff), minimize the amounts of alcohol you consume, use an SPF lip balm to protect yourself from sun exposure and eat plenty of fruits and vegetables to help reduce your risks.
What can be done to detect oral cancers?
With oral cancers, the earlier the detection the greater the prognosis. Oral cancer is known to spread fairly quickly, with only half of those diagnosed surviving more than 5 years. Your dentist should incorporate or request your permission to perform an oral cancer screening exam each year as part of the office protocol. If the don’t offer the exam to you or perform this task, you should request the exam or seek care elsewhere. The exam should include an overall evaluation of the face, lips, head and neck, with a thorough inspection of the inside of the upper and lower lips, the gums, the inside of the cheeks, the floor of the mouth. Newer types of oral cancer exams include tests that use fluorescent lights and special rinses and dyes (such as Toluidine Blue) to help dentists spot abnormal changes in the mucous membranes that line the inside of the mouth.
What are some of the benign (non-cancerous) ulcerative lesions that we may find in the mouth?
Among the most common, benign uncreative lesions are:
- Aphothous Stomatitis (also known as the common) – is the most common type of oral ulceration that affects about 20% of the general population, with 50% prevalence in those individuals experiencing some form of psychological stress. These lesions begin as reddish areas that develop intone a whitish-yellow area with a red halo. The number of lesions may vary from one to hundreds, and can be quite painful for 10-14 days. Treatment includes topical antibiotics, antiseptic rinses, and dietary supplements. Sometimes topical corticosteroids are required to help resolve the symptoms and limit their recurrence.
- Traumatic Ulcers – as the name suggests, are ulcers that are caused by some form of trauma to the superficial layers of the soft tissues in the mouth. They can arise from dental injections, biting the cheek, tongue or lip, or getting poked by a sharp crust of bread or chip, etc. They are usually seen on the tongue lips or inside of the cheeks. They can present as a painful, single lesion with a reddish border and a yellow, puss-like center. This area will heal on its own, but can be made to feel more comfortable by using topical numbing agents or rinses.
- Herpes Simplex – There are two strains of the herpes simplex virus. Type I (HSV-1) and Type II (HSV-2). HSV-1 is the type that is associated with the lips moth and face and transmitted via saliva, while HSV-2 is usually sexually transmitted. HSV-1 is the most common type of herpes virus and many people develop the related sores (lesions) inside the mouth, such as cold sores (fever blisters). HSV is never eliminated from the body, but stays dormant and can reactivated, causing symptoms. When the virus is active, painful ulcerations can develop, but the main indicator of a primary infection is a diffuse, reddish and painful gum inflammation. Multiple pinhead reddish ulcers tend to cluster and join together over several days. It is normal to experience fever and enlarged lymph nodes during this time. Diagnosis is usually made by lab tests of the cells and tissue. Treatment of the primary infection includes fever reducing medications and fluid management. Antiviral medications such as acyclovir will help to lessen the duration and severity of the lesions. There is no known cure for HSV infection, but treatments can reduce the likelihood of the virus spreading and manifesting itself.
- Acute Necrotizing Ulcerative Gingivitis (ANUG) – This disorder, also known as “trench mouth”, was common among the soldiers during World War I. ANUG is most often brought about by stress and a diminished resistance. Other factors that cause NUG include: smoking, poor oral hygiene and inadequate nutrition. It is a painful infection with crater-like ulcerations, swelling, sloughing off of dead tissue from the mouth, and accompanied by a bad odor from the area. Fever, enlarged lymph glands and malaise (general discomfort or uneasiness) are sometimes present, too. Treatment includes cleaning out the bad tissue, followed by an antibacterial rinse such as chlorhexidine or diluted hydrogen peroxide. Rest, proper diet, nutritional supplements and proper home care, as well as abstaining from smoking, alcohol and spicy foods, will also speed the healing process.
- Lichen Planus – Oral lichen planus is a chronic autoimmune inflammatory condition that can affect the lining of your mouth, and usually manifests as scattered, white, pinhead elevation that are interconnected by white lines to appear like lacy white patches. Oral lichen planus occurs most often on the inside of your cheeks but also can affect your gums, tongue, lipsand other parts of your mouth. Sometimes oral lichen planus can involve your throat or esophagus. An initial episode of oral lichen planus may last for weeks or months, but it is usually a chronic condition that can last for many years. Although there’s no cure at this time, this condition can be managed with medications and home remedies.