Prevalence of oral ulcers and its association with addictions in rural population of western Uttar Pradesh and eastern Rajasthan

Abstract

Results: Study findings showed, mouth ulcers and trismus were common symptoms and tobacco chewing and smoking were common addictions. There were statistically significant associations among the symptoms and addictions as well as predominance in rural populations. The majority of smokers (27.1%) belonged to age ≥55 years whereas the tobacco chewers (29.2%) and alcohol abusers (45.8%) in the age group 25-34 years. Also the risk of developing mouth ulcers and trismus in this area are approximately 35 (MRR: 35.7,) and nearly eight (MRR: 7.7, 95% CI: 2.2-26.6) times higher respectively in males.However, joint use of smoked and smokeless tobacco increases nearly three times more risk of either mouth ulcers or trismus. Conclusion:Male individuals are more exposed to certain addictions such as tobacco (smoked and smokeless) and alcohol. The prevalence of oral ulcers is primarily associated with the addictions. Therefore, these persons are more at risk of further developing head neck cancer. A large level community screening and awareness are required especially among the rural population of India.# Screening and early detection are very useful methodologies, since precancerous lesions, in situ carcinoma as well as early stage of head and neck cancer have significantly good survival outcome after treatment. 5,6 The screening method of oral cavity malignancies is relatively simple and can be done effectively by visual inspections. 7 It is also mentioned in the literature that visual inspection of oral cavity by proper trained personnel is well accepted and accurate method of screening for oral cavity malignancies. [8][9][10] Oral self examination is a simple way of assessing self-perception of oral health and its validity has been proven. It is also a cost effective, less time consuming procedure. 11Literature mentions that visual inspection method for oral screening could be restricted to high-risk individuals and organized visual screening is a worthwhile initiative of control for oral cancer in addition to primary prevention efforts to reduce tobacco and alcohol use, 12 as well as, it has potential to prevent deaths due to oral cancer. 13 Despite the fact, that the oral cavity is accessible for visual examination and those oral cancers and premalignant lesions have well-defined clinical diagnostic features, oral cancers are typically detected in their advanced stages in our country. In fact, in India, 60-80% of patients present with advanced disease, as compared to 40% in developed countries. 14 Consistent with patients presenting for medical care with more advanced disease in India compared with developed countries, overall survival is also reduced. 15,16Early detection would not only improve the cure rate, but it would also lower the cost and morbidity associated with treatment. For planning of national or regional oral health promotion programs, as well as to prevent and treat oral health problems, baseline data about the magnitude of the problem is required. India has a vast geographic area, divided into states, wh...

Bacteria in the oral cavity of individuals consuming intoxicating substances

“…It is well known that smoking and alcohol related carcinogens are activated by oral microbes leading to oral and certain gastrointestinal cancers [5,6] by converting ethanol to acetaldehyde, a genotoxin [7] or activating tobacco-specific nitrosamines [8]. Smoking harms oral health by affecting response to treatments [9], causing frequent nausea [10], facilitating adhesion of C. albicans leading to oral thrush [11,12], inducing lesion [13,14], mouth ulcers [15] and causing cellulitis [16]. Alcohol consumption is associated with osteomyelitis [17], impaired vision especially color vision [18,19], induces drowsiness [20], weakness, myalgia and anorexia [21,22].…”

“…Betel nut consumption is linked to insomnia, nausea [2,23,24], periodontitis [25][26][27][28], regulating appetite [29]. Chewing gutkha (processed betel nut) affects the oral mucosal lining and soft and hard tissues [15], causing tooth decay and gingival recession by loosing periodontal connective tissue fibers [30]. Long term consumption of intoxicating substances probably shifts the transitory pathogens to colonize, decreasing the number of commensal organisms [31][32][33] or triggers the opportunistic pathogens to infect the host eventually leading to various health problems including diseases such as chronic periodontitis and oral cancer [34].…”