Tobacco consumption is one of the leading causes of death worldwide. Ironically, it is also one of the biggest preventable causes of death. In India, tobacco has been extensively used In both smoking as well as smokeless form. The urban as well as rural population consume tobacco in a variety of forms that are available in the country.
Smoking forms of tobacco mainly includes use of cigarettes and Bidi. Apart from this, there are a variety of forms like hukka, chillam, etc which are also used. Smoke released from these forms of tobacco contain nicotine, which has the most pathogenic effects on living tissues. In the oral cavity, the gums are highly affected due to nicotine. The inhaled smoke affects the gums and then the lungs mainly. Orally, these patients present with severe staining of teeth. They often complain of persistent oral malodor also. The most common oral problem in smokers being, severe pyorrhea. Also known as periodontitis, this disease silently affects the gums and the underlying bone leading to loss of gingival tissue and bone. All of these effects are due to nicotine which had a profound effect on the blood supply of the oral tissues.
On the other hand, the smokeless forms of tobacco include use of tobacco in pan, along with betel nut. Unlike the smoking form, the smokeless form has its main effect on the oral cavity only. The area of the oral cavity where the tobacco is placed, most changes occur in that localised region. Tobacco and the other components inside the pan exert their pathologic effects in the region. The main deleterious effect of tobacco on oral cavity is occurrence of oral cancer. Once oral cancer starts, it spreads easily to the nearby areas causing extensive involvement. Patient survival becomes difficult in advanced cases. Tobacco causes oral cancer, betel nut causes a clinical condition called oral submucous fibrosis. There is thickening of the mucosa, which is the skin lining the oral cavity. This leads to progressive reduction in mouth opening. There is severe burning sensation on eating hot and spicy foods.
The most common complaint of patients using tobacco is occurrence of stains. These stains can be removed by scaling. Scaling is a procedure performed to remove all kinds of external deposits formed over the tooth surface. Once done, however if the patient continues the use of tobacco, stains tend to reccur.
Oral submucous fibrosis, to a some extent is irreversible. The reduced mouth opening can be corrected to a great extent if the treatment is continued for a prolonged period. The burning sensation is treatable and shows good reduction with medications. The treatment period depends on the severity of the condition. Patients are motivated to quit the habit for good results.
Oral cancer once if starts, can be treated effectively if diagnosed at an early stage. The prognosis of the patient also is good if diagnosed early. At later stages, the metastasis/spread of cancer makes it difficult to treat the patient effectively. Prolonged chemotherapy and radiotherapy combined with surgical excision have to be done.
Deleterious oral habits need to be addressed early and the issues should be treated. Visit us for more info at Dr Saurabh’s Dental clinic and implant centre, shop no 2, Vinayak residency, Keshav Nagar, University road,Udaipur.