Oral Disease Prevention

Oral Cancer

Oral cancer is cancer that occurs anywhere in the mouth and on the lips.

Risk Factors

Tobacco

90% of patients with oral cancer use tobacco.  The risk of developing oral cancer increases with the amount smoked or chewed and duration of the habit.  Smokers are 6 times more likely than non-smokers to develop oral cancer.  Tobacco smoke from cigarettes, cigars, or pipes can cause cancers anywhere in the oral cavity or pharynx, lips, larynx, lungs, esophagus, kidneys, bladder, and other organs.

Chewing (spit) tobacco is associated with cancers of the cheek, gums, and inner surface of the lips.  Chewing tobacco increases the risk of this cancer by about 50%.

Alcohol

Approximately 75% to 80% of all patients with oral cancer frequently consume alcohol.  This cancer is about 6 times more common in drinkers than in non-drinkers.

Gender

Men – Oral cancer is twice as common in men as in women.  This is because men are more likely to use tobacco and alcohol.

Women – The rate at which women are developing oral cancer is dramatically increasing.  This growth is likely due to the increase in the number of women smoking.
In 1950 the male to female ratio of oral cancer was approximately 6:1; by 1997 it was approximately 2:1.

Ultraviolet Light

More than 30% of patients with cancers of the lip have outdoor occupations associated with prolonged exposure to sunlight.

Lack of Fruits and Vegetables in Diet

Signs and Symptoms

• A sore in the mouth that does not heal (most common symptom)
• A lump or thickening in the cheek, a white or red patch on the gums, tongue, tonsil, or lining of the mouth
• A sore throat or a feeling that something is caught in the throat.
• Difficulty chewing or swallowing
• Difficulty moving the jaw or tongue
• Numbness of the tongue or other area of the mouth
• Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
• Loosening of the teeth or pain around the teeth or jaw
• Voice changes
• A lump or mass in the neck
• Weigh loss

Many of these signs and symptoms may be caused by less serious problems. It is important to see a medical doctor or dentist if any of these conditions lasts more than two weeks.

Preventing Oral Cancer

Tobacco and alcohol use are the greatest risk factors for developing oral cancers.  Never start smoking or chewing tobacco.  Quitting tobacco and alcohol use significantly lowers your risk of developing these cancers, even after years of use.

Exposure to ultraviolet radiation is an important and very avoidable risk factor for cancer of the lips and skin.  Avoid being outdoors in the middle of the day.  If you must be outdoors, minimize your exposure by wearing a wide-brimmed hat and using lip balm with SPF of 15 or greater.

Eat a healthy diet and take vitamin supplements if necessary.

Adults between the ages of 18 and 39 should have an oral cancer exam every three years.  Adults 40 years and older should have an oral cancer exam every year.

Oral Cancer resources for patients and providers

Healthcare providers play an important role in the early detection of cancerous lesions in the mouth and in the prevention of this disease by promoting tobacco cessation and alcohol intake reduction.  Dentists and dental hygienists are crucial to early detection of oral cancer, however, physicians, nurse practitioners, physician’s assistants, and nurses also play an important role in early detection.

By far, the oral cancer exam provides the most cost effective and efficient strategy for detecting oral cancer.  A key part of the strategy of the Office of Oral Health is to increase the number of all healthcare providers that routinely perform oral cancer exams for their patients.

Smoking Cessation

One of the most effective ways of helping patients prevent oral cancer is to promote smoking cessation. All health care providers, especially dentists and hygienists, have a unique opportunity to assist tobacco using patients in cessation. Office visits afford health care providers the chance to influence patient behavior in a brief period of time.  The following resources provide information specifically for assisting health care providers in promoting smoking cessation among patients.

For county specific contact information on tobacco cessation programs, please see Maryland Center for Health Promotion and Tobacco Use Prevention Tobacco Cessation Resource Directory.

For the most current tobacco and tobacco control research please see National Cancer Institute, Tobacco Control Research Branch and Society for Research on Nicotine and Tobacco.

For general guidance on treating tobacco dependence, please see the U.S. Surgeon General’s Treating Tobacco Use and Dependence: A Quick Reference Guide for Clinicians
Maryland Quitting Use and Initiation of Tobacco (MDQuit) is the resource center for tobacco use cessation and prevention for the State of Maryland.  This resource center assists providers and programs in reducing tobacco use among citizens across Maryland.

Conducting an Oral Cancer Exam

• For more details of conducting an Oral Cancer Examination, please see The Oral Cancer Examination, a detailed description of the oral cancer examination with photographs.