I REMEMBER a colleague once told me that every time he polishes the teeth of a male smoker who is over 60 years old, he almost expects the patient’s visit to be the last one. He feels that such a patient may very well die from cancer sooner rather than later.
The distressing news for inveterate smokers is that in many respects they are no different from cocaine or marijuana users since it has been established that this practice is not a habit as has been formerly believed, but really an addiction complete with the inherent physical and psychological dependence. Among numerous hazards are oral cancer, rampant caries, gingivitis, stomatitis, (infection of the lining of the mouth) and the staining of the teeth. These stains are invariably permanent since the nicotine penetrates the pores on the surface of the teeth eventually becoming part of its structure.
Statistics show that only three per cent of all mouth cancers occur in persons who have never smoked while those who chew tobacco have the highest chance of dying from the disease. The tongue is by far the most common area affected. Most often, oral cancer appears as a chronic, painful sore or ulcer, which had developed, from a white patch. The deeper in the mouth it is found, the faster it may kill the victim. In other words, cancer on the soft palate is far more dangerous than one located on the lip.
The prevalence of mouth cancers increases with age with 98 per cent of cases being over 40 years old. Of particular interest is the fact that in combination with alcohol, there is a significant increase in the incidence. In fact, recent studies indicate that even beer and wine could cause oral cancer, especially when consumed by inveterate cigarette smokers.
Can oral cancer be prevented? To a great extent, yes. Regular mouth and throat examinations can detect the condition at its earliest, most curable stage. Survival rates are around 75% if detected then. On the other hand, without periodic examinations and tests by your dentist risks the increase and survival rates decrease. A diet rich in vitamins A and C, moderation or abstention from tobacco and alcohol constitute modes of prevention. Progressively decreasing the number of cigarettes smoked daily is the recommended method to get rid of the addiction.
In addition to over 300 other poisons, the smoke from the cigarette contains nicotine and condensate (tar), which deposit on the tooth’s surface leaving a dark brown to black over some time. Because the enamel has tiny pores, the nicotine eventually penetrates the tooth’s body thus virtually incorporating itself in the structure of the dentin. Polishing cannot even remove it and the teeth, therefore, become permanently stained.
The destabilisation of the integrity of the various tissues in the mouth as a result of the constantly pervading heat and chemical-laden tobacco smoke leads to many local and systemic inflammatory conditions. The destruction of the cilia, which function by sweeping dust particles down the gullet from nasal lining and throat result in the chronic smoker’s cough.
The awareness of tobacco issues by health care workers may vary from just mentioning to their patients that smoking cessation will contribute to the general state of good health, to routine offers of advice and written material on quitting the tobacco habit. More formal assistance may include delivery of cessation programmes in small groups, or on a one-to-one basis in a clinical setting. It is important to note that even less intensive interventions may have an important impact on public health.