Journal of Oral Hygiene & Health
Open Access

Cancer outcomes; Chemotherapy; Epidemiology; Head and neck tumours; Oral cancer; Radiotherapy; Surgery

Introduction

The lining of the lips, mouth, or upper throat can develop cancer, which is known as oral cancer or mouth cancer. In the mouth, it typically begins as a painless white area that thickens, turns red in spots, develops into an ulcer, and keeps getting worse. It typically appears on the lips as a slow-growing, persistent crusting ulcer that does not heal. Additional signs and symptoms could be swallowing that is unpleasant or difficult, new lumps or bumps in the neck, a mouth swelling, or numbness in the lips or mouth. Alcohol and cigarette usage are risk factors. The risk of oral cancer is 15 times higher in those who use both alcohol and cigarettes than in people who do not. Infection with HPV, chewing paan, and sun exposure on the lower lip are additional risk factors. A subtype of head and neck malignancies is oral cancer. A biopsy of the problematic area is used to make the diagnosis, which is then followed by a CT scan, MRI, PET scan, and inspection to see if it has spread to other parts of the body [1-5].

Avoiding cigarette products, limiting alcohol use, using lip sunscreen, getting the HPV vaccine, and avoiding paan are all ways to prevent oral cancer. Combinations of surgery (to remove the tumour and local lymph nodes), radiation therapy, chemotherapy, and targeted therapy may be utilised as treatments for oral cancer. The types of therapies will be determined by the extent, distribution, and size of the cancer as well as the patient’s general condition.

Discussion

All malignancies (neoplastic transformations) are known to be caused by alterations (mutations) in the genes that regulate cell activity. A cell with mutated genes may grow and multiply uncontrollably, be unable to repair DNA damage internally, or refuse to self-destruct or die (apoptosis). For a cell to become malignant, many mutations are required. A neoplastic cell is created when specific classes of genes are repeatedly altered, and it then develops uncontrollably. When a cell mutates to this degree, it has the capacity to convey the mutations to its entire offspring when it divides. Every day, when our bodies replace billions of cells, random genetic mistakes occur. In addition to these chance events, genetic mistakes can also be passed down through families, be brought on by viruses, or arise as a result of exposure to toxins or radiation. Our bodies often have systems in place to eliminate these aberrant cells. We are now learning some of the reasons why this doesn’t happen and cancer develops.

Depending on where the tumour is located, oral cancer symptoms and signs might vary, but typically involve thin, erratic white patches in the mouth. Red and white patches may also be seen (mixed red and white patches are much more likely to be cancerous when biopsied). A raised border with an ulcer and a continuous rough spot that is just mildly unpleasant are the traditional warning signs. The ulcer is more frequently crusting and dry on the lip and more frequently a mass in the pharynx. Moreover, a white patch, loose teeth, bleeding gums, a recurring earache, numbness in the lip and chin, or swelling may be related to it. When cancer spreads to the throat, additional symptoms may include pain when swallowing, altered voice, and trouble swallowing (often caused by HPV16+ malignancy at the base of the tongue). The lesions often cause relatively little discomfort until they grow larger, at which point a burning sensation develops. A painless, hard mass will form as the lesion progresses to the neck’s lymph nodes. General pains may arise if it spreads to other parts of the body, most frequently as a result of bone metastases [6-10].

Treatment may start once a cancer diagnosis has been made with certainty and has been staged. Surgery, radiation oncologists, chemotherapy oncologists, dental professionals, dietitians, and rehabilitation and restorative specialists should all work together to treat oral malignancies. The true curative treatment techniques typically involve concomitant radiation and chemotherapy, occasionally in addition to surgery. Although it can kill cancer cells on its own, chemotherapy is not routinely utilised as a monotherapy for oral malignancies. It is a potent component of treatment when used to lower the risk of metastasis, make the cancerous cells more sensitive to radiation, shrink any tumour before surgery, or for patients who have established distant metastases of the disease.

Conclusion

Every oral cancer patient needs ongoing monitoring. However, there is also frequently significant post-treatment morbidity that necessitates additional rehabilitation and treatment, including but not limited to speech and swallow rehabilitation, the preservation of the remaining dentition and restoration of missing dentition, and the management of xerostomia. Clinical and/or radiologic surveillance for new and recurrent cancers is crucial. Not to be ignored and to be addressed are the psychologic and social morbidities of cancer diagnosis and treatment. Dentists and dental experts are essential to patient care at every stage since oral cavity cancer is a difficult disease with a high fatality rate. The dental professional plays a variety of roles in the management of oral cancer, including prevention through education about quitting smoking and responsible alcohol use, early detection and referral of premalignant lesions and oral cancers, ongoing surveillance, follow-up, and oral health preservation. All oral cancer patients should be treated by a multidisciplinary team with expertise in the treatment of head and neck tumours, and any worrisome lesions should be promptly referred to an oral and maxillofacial surgeon or an oral medicine specialist.

1. Kuroda S, Sakai Y, Tamamura N, Deguchi T, Takano-Yamamoto T (2007) Treatment of severe anterior open bite with skeletal anchorage in adults: Comparison with orthognathic surgery outcomes.Am J Orthod Dentofac Orthop132: 599–605.

Google Scholar, Crossref, Indexed at

2. Melsen B, Agerbaek N, Eriksen J, Terp S (1988) New attachment through periodontal treatment and orthodontic intrusion.Am J Orthod Dentofac Orthop94: 104–116.

Google Scholar, Crossref, Indexed at

3. Cohen-Levy J, Cohen N (2011) Computerized analysis of occlusal contacts after lingual orthodontic treatment in adultsInt Orthod9: 410–431.

Google Scholar, CrossrefIndexed at

4. Magdaleno F, Ginestal E (2010) Side effects of stabilization occlusal splints: A report of three cases and literature review.CRANIO28: 128–135.

Google Scholar, Crossref, Indexed at

5. Crawford SD (1999) Condylar axis position, as determined by the occlusion and measured by the CPI instrument, and signs and symptoms of temporomandibular dysfunction.Angle Orthod69: 103–115.

Google Scholar, Crossref, Indexed at

6. Alexander SR, Moore RN, DuBois LM (1993) Mandibular condyle position: Comparison of articulator mountings and magnetic resonance imaging.Am J Orthod Dentofac Orthop104: 230–239.

Google Scholar, Crossref, Indexed at

7. Armijo‐Olivo S, Rappoport K, Fuentes J, Gadotti IC, Major PW, et al. (2011)Head and cervical posture in patients with temporomandibular disorders.J Orofac Pain 25: 199–209.

Google Scholar, Indexed at

8. Hilgenberg PB, Saldanha AD, Cunha CO, Rubo JH, Conti PC (2012)Temporomandibular disorders, otologic symptoms and depression levels in tinnitus patients.J Oral Rehabil 39: 239–244.

Google Scholar, Crossref, Indexed at

9. Forssell H, Kalso E, Koskela P, Vehmanen R, Puukka P, et al. (1999) Occlusal treatments in temporomandibular disorders: a qualitative systematic review of randomized controlled trials.Pain 83: 549–560.

Google Scholar, Crossref, Indexed at

10. Fujii T, Torisu T, Nakamura S (2005) A change of occlusal conditions after splint therapy for bruxers with and without pain in the masticatory muscles.Cranio23: 113–118.

Google Scholar, Crossref, Indexed at