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Thomas P. Connelly, D.D.S. Headshot

Mouth Health: Tobacco Use, Alcohol, and Oral Cancer

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More than 35,000 Americans will be diagnosed with Oral Cancer this year. Most of them will be tobacco users of some kind -- smokers, former smokers, and smokeless tobacco users.

A few statistics:

There is no nice way to paint the picture, so I'll just start swinging away with my brush -- of people 50 years of age or older and diagnosed with oral cancer, more than 75% of them are/were tobacco users. And some studies I've seen that include throat and larynx cancers put the number closer to 90%. That's nine out of ten. That's a HUGE correlation that is worthy of any tobacco user's attention.

I'm not saying that if you smoke or dip you are definitely going to get oral cancer, but with numbers like I just mentioned above, the risks you are taking with every smoke or chew are profound. I realize talking about this kind of thing to anyone who smokes is sometimes futile. Plus, whenever you use any kind of statistics, there are counterpoints to be made. In short, statistics can largely mean what you want them to mean, and many can be skewed or argued against (for example, I would guess 100% of people diagnosed with oral cancer drink water. And probably 90% of them ate sandwiches from time to time. And it's likely 90% of them watched a movie in the last five years as well. See what I mean? People will counter with something like that, as if the tobacco numbers mean nothing.)

But as a dentist, I can tell you that I have seen the damage that smoking and tobacco use cause firsthand. My sandwich and water examples above notwithstanding, there is no getting around the fact that tobacco use is the leading cause of oral cancers -- by a MILE. You can throw alcohol use in there as well -- heavy alcohol use (20+ drinks a week) is almost as bad as tobacco use.

Now, here's the real kicker... you know how some people say smoking and drinking go together? Oral cancer thinks so as well. Smoking and drinking together, especially when both are done in above-average quantities, increase your chances of contracting oral cancer markedly. People who smoke and drink heavily are almost 15 times more likely to contract oral cancer. That guy you see in the bar four times a week smoking and doing shot after shot of whiskey? His chances of getting oral cancer when he's older are pretty darn good (although I'd like to ask what YOU are doing in the bar four times a week also! But that's for another day. J )

Again, there is no way to say this nicely or tactfully - if you use tobacco or alcohol with any kind of regularity, you are at a significantly higher risk for oral cancer. And if you use tobacco and alcohol together? The risk increases exponentially.

When to see your Dentist about Oral Cancer Symptoms:

There are likely 4 million web pages out there with Oral Cancer symptoms. I won't be the four millionth and first. Just type "Oral Cancer" into Google and take your pick of what comes up. The nature of the internet is that it's very informative in regards to disease symptoms. The downside to that is it can make you think that every bump in your mouth is oral cancer.

My advice is pretty simple: get two dental checkups/cleanings a year (which you should be doing anyway.) And specifically ask your dentist to do an oral cancer screening. He or she will check for the most common signs. Doing this twice a year will ensure that you will catch anything fairly quickly (the survival rate is much higher the earlier any cancer is caught.) Some progressive dentists even have a new light (called a VELscope) that can detect possible cancer trouble spots before they can be seen by the naked eye.

In regards to sores or such that you can see/feel, let me start by saying that the mouth is an incredibly diverse place, with all kinds of things happening. Sores, bumps, bleeding, etc are all quite common. Anything from a simple canker sore to biting your cheek can produce a "cancer-like symptom" and scare the daylights out of anyone. My standard advice here is almost any mouth sore that does not show signs of healing in two weeks should be looked at. This will eliminate 99% of sores/lumps/etc in the mouth, as most either heal outright or show marked improvement in two weeks time. So if you notice a red or white sore, etc, give it two weeks before you start worrying yourself to death.

To wrap this up, watch the tobacco and alcohol, and see your dentist. And may you be oral cancer free for life.

Keep smiling!

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