Tooth Whitening

Treatment options in the management of cancer of the floor of the mouth (FOM) consists of radiotherapy alone, surgery alone, or a combination of these two modalities.1 and 2 Presently, the role of chemotherapy remains investigational. Early tumors are equally amenable to treatment by surgical resection or radiotherapy; therefore, a single modality is preferred as the definitive treatment in T1 and T2 tumors. Other factors such as potential complications, cost, convenience, compliance, long-term sequelae of treatment, and willingness of the patient must be considered for selection of the initial treatment. On the other hand, advanced-stage tumors require combined therapy with radical surgery and adjuvant radiotherapy for a successful outcome. In these cases, the factors that influence the choice of surgical approach for the primary tumor are the size of the primary tumor, its depth of infiltration, its location in the oral cavity (anterior versus lateral/posterior), and its proximity to the mandible. Both tumor growth and treatment significantly compromise speech and deglutition, particularly when the tumor involves FOM and the mandible. Newer concepts of immediate reconstruction and use of microvascular techniques have dramatically improved the results of treatment for this group of patients.

Selection of treatment modality (more…)

The survival of patients with oral cancer remains poor despite recent surgical advances. About 30-40% of patients with intra-oral cancers will survive five years; the short survival time is caused, largely, by late detection.[1] Public awareness of oral cancer as compared with other cancers is low and this contributes to delays in diagnosis.[2] However, the mouth can be examined by healthcare professionals with much greater ease and accuracy than many other parts of the body. All healthcare workers need to be aware that a patient with an ulcer or white patch that persists beyond three weeks should be referred for further evaluation to an oral physician or to an oral and maxillofacial surgeon. Tobacco use is a major cause of oral cancer, and doctors and other health professionals can contribute to primary prevention by making patients aware that tobacco, in all forms, predisposes them to oral cancer.

Methods (more…)

In Western countries, tobacco and alcohol are the principal risk factors for cancers of the oral cavity, including those of the tongue and the mouth. Dietary factors ate also believed to be important, but their exact roles have not been clearly established. Most epidemiologic studies have considered all cancers of the oral cavity together. The study de scribed here, conducted in northern Italy, evaluated cancers of the tongue and mouth separately.

One hundred two men with cancer of the tongue, 104 men with cancer of the mouth, and 726 male controls admitted to the same hospitals for diseases other than cancer were interviewed. The dietary questionnaire included information on 14 indicator foods as well as alcoholic and nonalcoholic beverages. Information was also collected on smoking habits and medical history. (more…)

Most mouth cancer is oral squamous cell carcinoma. This is uncommon in the developed world, except in parts of France, but is common in the developing world, particularly South East Asia and Brazil. It is mainly seen in men over middle age (though it is increasing in younger people), tobacco users, and lower socioeconomic groups.

Aetiological factors (acting on a genetically susceptible individual) include tobacco use (75% of people with oral cancer smoke), betel use (Bidi leaf, and often tobacco, plus spices, slaked lime, and areca nut), alcohol consumption, a diet poor in fresh fruit and vegetables, infective agents (Candida, viruses), immune deficiency, and (in the case of lip carcinoma) exposure to sunlight.

Additional primary neoplasms may arise mainly in the aerodigestive tract. This occurs in up to 25% of people who have (more…)

Oral cancer diagnosis. As recently reported in Clinical Cancer Research, researchers led by Dr. David Wong at UCLA’s Jonsson Cancer Center have identified a combination of four RNA biomarkers in saliva that can be analyzed to detect cancers of the mouth and throat. Although saliva contains the same biomarkers that are found in blood and urine, the concentrations are much lower in saliva, which has heretofore prevented its use in cancer diagnosis. Using saliva to detect cancer would provide

a cheaper and less-invasive method of diagnosis. The researchers are hopeful that their findings will lead to the ability to diagnose other types of cancer through saliva testing as well.