Mouth cancer is the general term used to describe malignant tumours that develop in the mouth, most often the tongue, tonsils, lips, cheeks and throat. Although there are risk factors, anyone can develop mouth cancer, whether we have our own teeth or not. Oral cancer screening should be done as part of your routine check-up and for this reason, it is important to attend your dental appointments regularly, even if you have dentures.
That’s a lot to look for! However, it is important to remember: our mouths are prone to all sorts of trauma such as hot or sharp food; bleeding gums and loose teeth can be caused by gingival disease or periodontal disease; many people are susceptible to ulcers that usually resolve in less than 3 weeks; dentures become loose over time and should be assessed every 5 years for a possible reline; and pain is usually caused by toothache or an abscess.
This is why it is important to know your normal. If you regularly check your own soft tissues and notice something out of the ordinary, you should call your dentist for a second opinion.
The most recognised risk factors are smoking, alcohol and drug use. However lesser known risk factors are poor diet and the Human Papilloma Virus (HPV).
HPV is the name given to a group of very common viruses. They affect the skin, have more than 100 different types and are easily transmitted from person to person. The reason that HPV is a risk factor for mouth cancer is because certain types of HPV can affect the mouth and throat and potentially cause cancer in these areas. HPV-16, the same virus associated with cervical cancer, is also linked to cancer in younger people in good health and with no history of either smoking or drinking. These HPV cancers are the fastest increasing type of mouth cancer. Fortunately, HPV-related cancers appear to be more responsive to treatment and the survival rate is much better than non-HPV mouth cancer.
HPV infections are successfully fought off by the body’s immune system and often resolve without treatment, even high-risk HPV infections.
Tobacco is still considered the main cause of mouth cancer. The World Health Organisation reported that up to 1/2 of all current smokers will die of a tobacco-related illness. Tobacco users are up to 6 times more likely to develop head and neck cancers as 75% of cancers occur in tobacco users. It is thought that approximately half (45%) of smokers do not know that smoking causes mouth cancer. Excessive alcohol consumption is believed to increase the risk by 4 times, as 3 in 4 people who have mouth cancer both smoke and drink alcohol. Poor diet is linked to 1/3 of all cases. It is also thought that HPV could overtake smoking and alcohol as the main risk factor.
Treatment of mouth cancer can often be very difficult. This is because it can affect vital structures in the mouth and throat such as the tongue for example. We use our tongues to eat, swallow and speak and therefore removal of part of it causes major issues with all of its functions which can be incredibly debilitating and stressful. Early diagnosis is absolutely crucial in treatment and survival rates of mouth cancer.
Prevention of mouth cancer is best done by avoiding the risk factors where possible and being aware of the associated signs and symptoms. Policy has also played a role in reducing mouth cancer such as: the 2007 smoking ban which reduced smoking levels from 22% to 14% and continues to reduce; plain packaging on cigarettes; a ban on tobacco sports advertising; smoking in cars with children was made illegal in 2015 which has reduced levels of passive smoking; the HPV vaccination for girls in 2007 and boys in 2019 which will protect 800,000 children a year from HPV-related cancers and diseases; and minimum pricing on alcohol in Scotland (2nd higest levels in the UK behind Wales).