Oral cancer

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oral cancer

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Oral cancer

  1. 1. M.Aqeel Maqsood Roll# 146
  2. 2. Epidemiology , Etiology and Prevention of Oral cancer
  3. 3. What is Cancer?
  4. 4. Defined as:_ • An uncontrolled, uncoordinated, excessive and abnormal growth of cells is called cancer.
  5. 5. Benign Vs. Malignant • Does not spread • Rarely life threatening • Can be removed • Spreads to other parts of the body • Life threatening • Can be removed, but it may grow back
  6. 6. Types of Cancer • Benign • Malignant – Carcinoma • epithelial origin • E.g. squamous cell carcinoma – Sarcoma • Mesenchymal origin
  7. 7. Oral cancer • Defined as:_ Indurated, ulcerated lump or sore that may or may not be painful and is often associated cervical lymph adenopathy.
  8. 8. Why is it such an important public health issue? • Closely associated with tobacco and alcohol. • 2nd most common cause of death • In 2003-according to world health report 7.1 million deaths were reported. • Estimated 50% increase in death rate in next 20 years. • In Bangladesh, Sirilanka and Pakistan most common type of cancer. • And 1/3rd of all the cancers.
  9. 9. Signs and Symptoms • Sores that do not heal within 14 days • Bleeding in mouth • Lump in neck • Earache • Loose teeth • Dentures will not fit well • Pain or numbness in mouth • Difficulty chewing or swallowing • Bad breath • Patches on the lip or in the mouth that are red, white, or a mixture of both
  10. 10. Epidemiology of oral cancer
  11. 11. Host factors 1. Age – Incidence increases with age. – 98% cases in the west are over 40yrs old. – More than 50% of cases include ages above 50yrs. 2. Gender – Incidence is more in • Men • Industrial areas – Women have more incidence of lip carcinoma – Men have high incidence of buccal carcinoma 3. Occupation – Textile workers and leather industries have high incidence of buccal cavity and larynx carcinoma.
  12. 12. Host Factors 4. Immunity – AIDS patients are prone to Kaposi carcinoma. 5. Social Class 6. Custom and habits 7. Race
  13. 13. Agent Factors • Biological – HIV – Candida • Chemical – Arsenic,dyes,nickel,chromium • Mechanical – Ill fitting dentures – Sores from jagged teeth
  14. 14. Agent factors • Nutritional – – – – – Precarcinogens in food Increase consumption of fat Deficiency in folic acid Deficiency of proteins Increase in red chili
  15. 15. Environmental factors • Water contamination • Air pollution • Geographic variation – Netherland buccal mucosa – Switzerland lip and tongue – Canadian Eskimos salivary glands • Solar heat – Prolonged exposure causes melanoma
  16. 16. Etiology • Due to – – – – – – – Tobacco Unhealthy diet Alcohol Physical inactivity Infection Nutrients Physical irritants
  17. 17. Risk Factors • Tobacco is the main culprit – Mainly chewing tobacco – 75% of those diagnosed are tobacco users. • Alcohol 2nd largest risk factor • Combination of alcohol and tobacco use – 15x greater risk for oral cancer • Excessive sun exposure – Lip cancer 1/24/2014 Oral Cancer 19
  18. 18. Risk Factors • X-rays – Cumulative exposure • Other biological factors – Viruses and fungus – HPV 16 • Main agent in cervical cancer • Now has been linked to oral cancer 1/24/2014 Oral Cancer 20
  19. 19. Tobacco • Its an important risk factor of oral cancer. • 90% of cancers are caused by tobacco • Tobacco can be broadly classified into smokeless and smoking forms.
  20. 20. Bidi • Most popular form of tobacco • Estimated nictinic content is 1.7-3mg
  21. 21. Cigar • Cured tobacco wrapped in dried tobacco leaves.
  22. 22. Chilum • Conical clay pipe for smoking tobacco • Filed with coarsely cut tobacco pieces • Glowing charcoal is kept on top of tobacco
  23. 23. Hookah • Indinan origin • Also known as water pipe.
  24. 24. Cigerrete • 1gram tobacco cured by sunlight is coverred by paper. • 1-1.4mg Nicotinic content. • More common in urban areas
  25. 25. Paan • Most common habit of smokeles tobacco. • May also include • • • • • Cardamom Cocnut Clove Sugar Tobacco wraped in beetle leave
  26. 26. Snuff • Finely powdered air cured and fire cured tobacco leaves.
  27. 27. Mishri • Prepared by roasting tobacco on hot metal plate then powdered • Also used to clean the teeth
  28. 28. Khaini • Powdered sundried tobacco. • Simply placed in mouth and chewed
  29. 29. Mainpuri Tobacco • Ingredients include • • • • Tobacco Slaked lime Camphor cloves
  30. 30. Primary Program to educate adolescence Program for tobacco users Regular check up good oral hygiene
  31. 31. Secondary Screening Referral Early detection
  32. 32. Tertiary • Surgery • Chemotherapy – Cytotoxic drugs • Radiotherapy
  33. 33. What you can do: • • • • • Make yourself aware or your mouth Stop smoking and drinking excessively Be informed Have a good diet and stay healthy Behavioural modification
  34. 34. Prevention as a dentist • Regular check up • Suspected patients be thoroughly checked • Patient should be educated about the preventive aspects of oral cancers including – Behavioral – Physical – community

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