THE sad news for persistent smokers is that in many respects, they are no different from cocaine or marijuana smokers since it has been established that this practice is not a habit as has been previously believed, but really an addiction complete with inherent physical and psychological dependence.

For the past four consecutive years, the theme for Oral Cancer Month was “Check Your Mouth”. According to the Oral Cancer Foundation, every hour, 24 hours a day, 365 days a year, someone dies from oral or oropharyngeal cancer. The oropharyngeal area is located at the back of the oral cavity and upper throat.

Among numerous hazards related to oral cancer are: rampant caries, gingivitis, stomatitis (infection of the lining of the mouth) and the staining of the teeth. Statistics show that only three percent 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% 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? Largely, 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 increase, and survival rates decrease. A diet rich in vitamins A and C and 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 a period. Because the enamel has tiny pores, the nicotine eventually penetrates the tooth’s body, thus virtually incorporating itself into the structure of the dentin. Polishing cannot even remove it, and the teeth, therefore, become permanently stained.
Destabilisation of the integrity of the various tissues in the mouth because 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 the nasal lining and throat, results in the chronic smoker’s cough.

The awareness of tobacco issues by healthcare 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 the 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.