1. By
Dr. R.S.CHAITANYA
B.D.S

2.  INTODUCTION
 EPIDEMIOLOGY
 ETIOLOGY
TOBACCO
ALCOHOL
DIET AND NUTRITION
UV RADIATION
FUNGAL INFECTIONS
VIRAL INFECTIONS
TRAUMAAND DENTAL IRRTATION
GENETIC FACTORS

3.  Cancer is one of the major threats to public health in
developed and developing countries.
 Cancer is second most common cause of death.
 Cancer has 4 characteristics
Clonality
Autonomy
Anaplasia
Metastasis

4. Originates from single
cell – proliferates to
clone of malignant cell

5. Growth is not regulated

6. Lack of normal coordinated cell
differentiation

7. Capacity for
discontinuous growth
and dissemination of
other parts of the body

8. According to INTERNATIONAL CLASSIFICATION OF DISEASES
(WHO 9th version)

9.  Oropharyngeal cancer is the eighth most
common cancer in worldwide.
 The prevalence of oral cancer is particularly
high among men.
 Incidence rates can vary in men from 1 to 10
cases per 1,00,000 population.
 The high incidence rates relate directly to risk
behaviors such as smoking, smokeless
tobacco, alcohol consumption.

10.  47%of Indians aged
15years or more use
tobacco in one form or
other.

11.  A dose relationship has been shown between
the chewing habit and oral cancer.
chewing risk
2 times/day 8.4
6 times/day 17.6
over night 63
 Increased risk of oral cancer is seen in those
who only chew as compared to those who only
smoke.

12. TOBACCO
ALCOHOL
DIET AND NUTRITION
UV RADIATION
FUNGAL INFECTIONS
VIRAL INFECTIONS
TRAUMA AND DENTAL IRRTATION
GENETIC FACTORS

13. Derived from Nicotiana tabacum and Nicotiana
rusticum.
CONSTITUENTS:
Nicotine
Tar
Carbon monoxide
Nitrogen oxide
Hydrogen cyanide and other ciliatoxics
Metals
Radioactive compounds

14. CONSTITUENTS
 Nicotine
 Tar
 Carbon monoxide
 Nitrogen oxides
 Hydrogen cyanide
 Metals
 Radioactive compounds
EFFECTS
 Carcinogen
 Stains the teeth
 Myocardial
oxygenation, atherosclerosi
s
 Lung damage
 Deleterious effect on the
cilia of lung
 Carcinogens
 Carcinogens

15. SMOKED TOBACCO
 Bidi
 Chillum
 Chutta
 Cigarettes
 Dhumti
 Hookah
 Hookli
SMOKELESS TOBACCO
 Khaini
 Mainpuri tobacco
 Mawa
 Mishri
 Paan
 Snuff
 Zarda
 Gutka
 Gudaku

16. 0.2 to 0.3 gms of sun
dreied tobacco flakes
are hand rolled.
Nicotine 1.7 to 3.0 mgs
Tar 45to50mgs

17.  A 14 cms straight
conical clay pipe
 Coarsely cut tobacco
pieces and a glowing
charcoal is kept on top
 It is held vertically and
to prevent tobacco from
entering mouth a
pebble stone is
introduced

18. Cured tobacco is wrapped
in a dried tobacco leaf.
It is also called as cigar

19. 1 gm of tobacco cured in
the sun or artificial heat
is covered with a paper
Nicotine 1-1.4mg
Tar 19-27mg

20. Rolled leaf tobacco is
used inside a leaf of
jack fruit tree

21. Tobacco smoke is drawn
through the water in the
base of hookah which
cools and filters the
smoke
It is also called water pipe
or hobble-bubble

22. Clay pipe of 7 to 10 cms
long with a mouth
piece and a bowl

23. Powdered sundried
tobacco, slaked lime-
paste mixture
occasionally with used
with areca nut

24. Tobacco, slaked
lime, finely cut areca
nut, camphor,cloves

25. Thin shavings of areca
nut + tobacco + slaked
lime are wrapped in
cellophane paper and
tied in a shape of a ball
It should be vigorously
mixed before
consumption

26. The roasted tobacco is
powdered + catechu(a
residual extract
obtained by soaking the
heartwood of acacia
catechu

27. Betel leaf+ areca nut+
tobacco +lime+
cinnamon or coconut or
cloves or sugar are
wrapped in betel leaf

28. Finely powdered air
cured and fire cured
tobacco leaves+ areca
nut + lime carried in a
metal container
It is locally called
MUKKU PODUMU

29. Tobacco leaf is boiled in
water along with lime
and spices until
evaporation. The
residual tobacco is
dried and coloured with
dyes.

30. Crushed betel nut,
tobacco, sweet or
savory flavorings

31. Paste of powdered
tobacco, molasses, and
other ingredients
primarily used to clean
the teeth.

32. Synergistic effect between
tobacco and alcohol.
Heavy drinkers who smoked 20
cigarettes/day– 24 times to
get cancer.
Dehydrating effect of alcohol on
mucosa increases the potential
carcinogens

33. Vitamin A, C, E &Antioxidant
[β-carotene] , copper zinc and
manganese
shows protective effect against
cancer.
Red chilli powder has
emerged as a risk factor to
cancer

34. Squamous cell carcinoma of
vermillion border of lip
especially in those who
work outdoors
Increased risk in factor
individuals

35. Dysplastic
lesions[leukoplakia]
with candidial infection
have greater risk of
malignancy

36. Human herpes virus1
Herpes simplex virus1
Human
immunodeficiency
virus have been
associated with
squamous cell
carcinoma

37. Continuous irritation
from jagged teeth and
dentures poor oral
hygiene are risk factors
for oral cancer

38. Alterations in in many
genes have been
implicated in
development and
progression oral cancer
Eg:3p (FHIT)
9P (CDKN2A)