Oral Cancers by Dr Qurat-Ul-Ain (Assistant Professor/ Community Dentistry Deparment) HBS Dental College, Islamabad

1. Oral Cancer
Dr Qurat-Ul-Ain
Assistant Professor
Community Dentistry
HBS Medical & Dental College

2. Learning Objectives
1. What is cancer
2. Definition of oral cancer
3. Types of oral cancer
4. Symptoms of oral cancers
5. Diagnosis
6. Staging
7. Etiology of oral cancer- epidemiological triad
8. Prevention of oral cancer

3. What is Cancer?
• Abnormal cell growth
• Ability to attack adjacent tissue & even distant
organs
• Death lead by this disease in case of
untreated patient
• Cancer can cure if diagnoses made in early
stages

4. Oral Cancer
Def :
“ OC described as an indurated, ulcerated
lump or sore that may or may not be painful
and is often associated with cervical lymph
adenopathy”

5. Pathological Types of Oral Cancer
1. Squamous cell Carcinomas and its
variants including:
• Basaloid squamous cell carcinoma
• Verrucous carcinoma
• Sarcomatoid carcinoma
2. Adenocarcinoma
3. Ameloblastoma
4. Melanoma
5. Lymphoma
6. Kaposi’s sarcoma

6. Oral cancers Site
• Carcinoma of lip
• Carcinoma of buccal mucosa
• Carcinoma of tongue
• Carcinoma of the floor of the mouth
• Carcinoma of the palate
• Carcinoma of gingiva

10. Kaposi’s Sarcoma

11. Potentially Malignant Lesions
1. Leukoplakia
2. Erythroplakia
3. Erosive lichen planus
4. Submucosal fibrosis

16. Sign & Symptoms
Oral cancer symptoms include:
• White or red spots inside the mouth
• A sore in the mouth that won’t heal
• Bleeding in the mouth
• Falling teeth
• Swallowing problems or pain
• A lump in the neck
• Sore ear/ an ear ache

17. Sign & Symptoms
Additional symptoms that may be
associated with this disease are:
• Abnormal taste in the mouth
• Mouth ulcer
• Difficulty swallowing
• Language problems

18. Staging
TNM System
Each letter in TNM has specific meaning
1. T= the size of the primary TUMOR
2. N= the status of the cervical lymph NODES
3. M= the presence or absence cancer in sites
other than the primary tumor (METASTASIS)

19. Staging
• Staging is define through physical
examination, diagnostic tests and
biopsies

20. Diagnosis of Oral Cancer
1. Complete medical history & clinical
examination
2. Biopsy ( tissue sample from lesion &
examine microscopically)
3. Computed tomography scan – CT Scan
4. Ultrasound
5. Magnetic resonance imaging -MRI

21. Epidemiological Triad of Oral Cancer
• Agent
• Host
• Environment

22. Epidemiological Triad of Oral Cancer
AGENT FACTOR
1. Biological: virus {i-e HIV} Fungus (i-e candida),
2. Chemical:
• Dyes,
• Nickel,
• Aromatic Amines,
• Chromium,
• Carcinogenic Constituents Of Tobacco,
• Alcohol & Alcohol Based Mouth Wash
3. Mechanical; sharp objects- i-e ill fitting dentures

23. Epidemiological Triad of Oral Cancer
HOST FACTORS
1. Age (incidence increases with age/-50 & above)
2. Race
3. Gender (male r more prone)
4. Genetic factors
5. Occupation
6. Immunity (kaposis sarcoma –AIDs Pt)
7. Social class (low income group)
8. Habits (smoking, Alcohol, unhealthy eating)

24. Epidemiological Triad of Oral Cancer
ENVIRONMENTAL FACTORS
1. Water pollution; i-e chloroform
2. Air Pollution i-e ground-level ozone, particle pollution
(or particulate matter), carbon monoxide, sulfur dioxide,
and nitrogen dioxide.
3. Geographic variations (Canada Eskimos-
salivary gland cancer)
4. Solar heat
5. Industrialization

25. Prevention of OC
• Many oral cancers are discovered through
routine dental examination.
• Other tips
• Have dental problems corrected.
• Minimize or avoid alcohol consumption.
• Minimize or avoid smoking or other
tobacco use.
• Practice good oral hygiene.

26. Early diagnosis
• About half of people with oral cancer will live
more than five years after diagnosis and
treatment.
• If the cancer is caught early, before it has spread
to other tissues, the cure rate is almost 75%.
• Unfortunately, more than half of oral cancer
cases are at an advanced stage when they are
detected and most have spread to the throat or
neck.
• Approximately 25% of people with oral cancer
die from delay in diagnosis. and treatment.