Health Desk

Long-lasting mouth wounds caused by sharp or broken teeth, combined with tobacco and alcohol consumption, are contributing to a rising risk of oral cancer in Bangladesh. Experts warn that untreated sores, premalignant lesions, and poor dental hygiene can silently develop into life-threatening conditions if not addressed promptly.

Dr. Shakhawat Hossain Sayantha, Dean of the Faculty of Dentistry and Associate Professor of Oral & Maxillofacial Surgery at Bangladesh Medical University (BMU), highlighted that many individuals consider minor mouth wounds insignificant. However, persistent irritation from sharp teeth on the tongue or cheek can, over time, lead to oral cancer.

Mouth ulcers occur for various reasons, the most common being aphthous ulcers, which, despite severe pain, are generally harmless and self-limiting. Stress, lack of sleep, hormonal changes, accidental biting, and deficiencies in vitamins or minerals often trigger these lesions. Typically, they heal within five to seven days and can be managed with mild pain relief or mouthwash.

However, not all ulcers are benign. Some can indicate underlying conditions such as tuberculosis, syphilis, or herpes simplex infections. Certain lesions, known as premalignant, represent early stages of cancer. Among these, leukoplakia (white patches), erythroplakia (reddish patches), lichen planus, and oral submucous fibrosis (OSMF) are notable.

OSMF, primarily caused by betel nut (supari) chewing, leads to stiff bands forming under the oral mucosa, restricting mouth opening and increasing cancer risk. Lichen planus, an autoimmune condition, poses additional risks for patients with uncontrolled diabetes.

Tobacco use, particularly smokeless forms such as gul, jorda, sada pata, and khaini, is identified as a leading cause of oral squamous cell carcinoma. Combining these with smoking and alcohol consumption significantly raises cancer risk. Human papillomavirus (HPV), commonly associated with cervical cancer, may also contribute to oral malignancies.

Poor dental care further elevates risk. Broken teeth, loose fillings, and repeated trauma to the same area can create chronic irritation, leading to hard patches or persistent wounds that may become cancerous. Nutritional deficiencies, particularly a lack of antioxidant-rich fruits and vegetables, exacerbate susceptibility.

Dr. Sayantha emphasized the importance of early detection. Ulcers persisting for more than ten days without improvement should be examined by registered dental surgeons, oral & maxillofacial surgeons, or ENT head-neck specialists, who can perform biopsies and appropriate tests. Early-stage oral cancer is often fully treatable through minor surgery, while delayed diagnosis may require extensive surgery, radiotherapy, and chemotherapy. Advanced cases can involve cancer spreading to the throat and other regions, necessitating complex reconstructive procedures using tissue or bone transplants.

He also noted systemic gaps in healthcare, including the absence of an effective referral system. Many patients initially consult general physicians who may prescribe ointments or vitamins, delaying specialist care. Some resort to traditional healers, further prolonging diagnosis and treatment. Dr. Sayantha stressed that practicing dentistry without a Bachelor of Dental Surgery (BDS) degree and Bangladesh Medical and Dental Council (BM&DC) registration is illegal, yet enforcement is weak, and quack practitioners continue to operate.

For public awareness, Dr. Sayantha advised seeking care from registered professionals and highlighted that low-cost or free dental services are available at BMU, government hospitals such as Dhaka Dental College Hospital and Dhaka Medical College Hospital, and district health complexes. Each upazila hospital now has a dental surgeon, enabling timely treatment and reducing the risk of severe complications.

In conclusion, prioritizing oral hygiene, avoiding high-risk habits like tobacco and betel nut chewing, and consulting qualified dental professionals promptly are essential measures to prevent oral cancer and improve early detection and treatment outcomes in Bangladesh.