SIX weeks ago, I flew to Guam for an evening meeting of The Guam Dental Society.
The subject of the presentation was “Oral Cancer and The Inter- Relationship of Betel-Nut Chewing. One of the doctors who was presenting is now teaching in London, but was originally from Sri Lanka. He was accompanied by a very impressive team now doing research on Guam specifically on the inter-relationship of Betel-Nut and oral cancer.
I was especially interested because here at Toothworks during the previous five months we have found a number of pre-cancerous lesions, and one full-blown case of squamous cell carcinoma. This just reaffirms something I learned in my early days of dentistry: “we see what we know”!
That is, if we as dental practitioners do not know what to look for, then it will pass right by us, to the detriment of the patient!
Allow me to explain the difference between a “pre-cancerous lesion (s) and a full blown intra-oral cancer:
1- The earliest sign is a lesion termed a lichen planus. These appear on the inside of the cheek and sometimes either on the tongue or under the tongue. They are soft and usually white in color. If the habit that causes this lesion is stopped, the lesion will usually disappear on its own.
2. Leukoplakia. These frequently develop from the initial lesion, and are scaly and much harder in texture. Leukoplakias frequently lead to oral cancer! These lesions usually need to be eliminated by excisional biopsy to be certain it is still benign (not cancerous)!
3-Full blown cancers are hard, sometimes open wounds, and are extremely dangerous. This is because the head and neck areas of the body have so many blood vessels, that the cancer spreads like weeds in a garden.
Treatment of oral cancers now involves radiation therapy and frequently chemo-therapy. In order to do radiation therapy, ALL of the remaining teeth MUST be removed prior to the radiation. If this is NOT done, then if a tooth gets infected after the radiation treatment, and is extracted (removed) the bone will never heal! It is a very, very painful condition, and IS NOT treatable!
In my over 30 years practicing dentistry in Houston, Texas, I found one oral cancer on the back of the tongue of my best friend. He smoked some 12 cigars a day. Even pre-cancerous lesions were rare in Texas. My friend died some nine months after the initial biopsy and diagnosis.
Here, on island, we see pre-cancerous lesions weekly. And ALL of them are related to Betel-Nut chewing. In fact, we can tell immediately what side of the mouth the Nut is chewed on.
So, you may be wondering now why a pre-cancerous lesion might become a cancerous lesion? It is all about host-resistance AND, the amount of Betel-Nut consumed/day! If the host resistance is low, the chances of developing cancer are significantly higher. If the patient is over-weight and/or is diabetic, the odds rise precipitously!
And, from the studies shared with me in Guam, it doesn’t matter whether or not lime juice and/or tobacco leafs are included. It is the nut that is toxic!
There are other significant health issues relative to chewing Betel-Nut! In the younger age group (especially teens) the cheeks develop something called trismus. That is, the checks become like steel, and the chewer cannot open very wide, and it is almost impossible to treat dental cavities, because we cannot retract the cheeks so we can see the teeth in the back of the mouth.
When I questioned the doctors on Guam, they also had seen this. When I asked if there was any way to reverse it, the answer was “NO”! Just think what it would be like to have decay on a back tooth, and it was impossible for a dentist to get to the tooth. Think serious toothache and NO TREATMENT!
Another anecdotal issue for me, as a long-time heart patient, and someone who carries Nitro-glycerine in my pocket if ever there is a serious emergency, the pill is placed under the tongue wherein it is absorbed into the blood stream instantly.
Well, going back to anecdotal observations, what do you think happens with all the Betel-Nut juice before it is spit out?
It, too, is absorbed into the blood stream and travels throughout the body to ALL organs, including the heart, the brain, the kidneys, and the digestive tract. THIS IS TOXIC MATERIAL! And it is spread all through-out the body throughout the day!
Let’s add another toxic affect: bone loss around the teeth. Frequently, we can remove these teeth with our fingers. And, as the teeth are lost, the facial muscles begin to collapse, and the chewers look decades older than they really are!
I understand there is a “high” from chewing! Surely, there are other ways to get high! For me, I can walk along the magnificent Pacific Ocean and get “high”.
I understand that the Betel-Nut is addictive. To those of you who have been chewing it for decades, I would urge you to educate yourselves, but even more importantly, DO NOT ALLOW YOUR YOUNG CHILDREN TO CHEW!
I have seven-year-olds in the clinic that are already chewing. And, young teens, because they think it is “macho” and “cultural”.
It is neither! It is toxic, and a substance that only contributes “BAD” things to one’s journey through life. The worst of these is a shortened life-span!
And, lastly, who wants to kiss brown teeth?
So, bottom line: stop the Betel-Nut chewing, get your teeth cleaned, and improve your sex life! Who, in their right mind, can pass up such an opportunity?
