I have now been practicing dentistry here for almost five years. I have learned that Saipan, approximate population of some 60,000 people, has one of the highest incidences of oral cancer in the world.
There is no question in my mind that this is directly related to Betel Nut chewing. As with cigarette smoking, wherein everyone who smokes does not get lung cancer, everyone who “chews” does not get oral cancer.
That said, the risks are extremely high. I warn every patient because there is essentially no treatment that can either treat the disease and/or cure it. There are so many blood vessels in the head and neck area that once the disease takes hold, it is literally a death sentence.
What we observe on almost every “chewer” are areas on the inside of the cheek (we can always tell which side of the mouth the Nut is chewed on) that we call pre-cancerous lesions. They are usually white in color in the early stages. These are lesions that can become pre-cancerous and then cancerous, if not detected early, and removed.
I am emphasizing the oral cancer aspect of this issue first. There are multiple dental issues involved:
•The teeth are worn down so badly that they resemble cow’s teeth. One may not think this is important, but it is for three reasons:
-the muscles loose their capacity to support the lower jaw, and, this, in turn,
-can cause joint problems in front of the ears, and severe pain.
-the effectiveness of the teeth to be able to chew is significantly diminished, there-by placing a strain on the digestive system.
•The bone around the teeth is literally eaten away and the teeth become so loose that they can be frequently removed with the fingers.
•The gums become inflamed and/or infected.
•The teeth become orange/brown in color, and the debris goes under the gums and causes inflamed gums that carry all of this debris into the main blood stream.
•The tongue becomes orange-brown and very susceptible to a cancerous lesion, and the coloring cannot be removed.
So, from a dental health stand-point, Betel Nut chewing is a very, very serious issue. To anyone who has serious heart disease, and carries Nitro-glycerin pills around with them in case of an emergency, they are instructed to place them under the tongue, because they dissolve quickly and are absorbed into the bloodstream almost instantly.
Just think about all of the Betel Nut juice that is in the mouth for hours at a time. So much of this juice is absorbed into the main blood stream and goes to all organs of the body. There is no way this is healthy.
I know it is addictive. I know it is an “upper.” We give out type-written instructions to those who exhibit any interest to stop the habit.
With all of the health-care issues present on Saipan right now, Betel Nut chewing is right up on the top of the list as a serious causative factor to a non-treatable disease: oral cancer. And, with the absorption of the “juice” into the bloodstream, it could easily and reasonably play a major role in many other debilitative diseases.
It is truly a “fox in the hen-house” of health measures affecting the people of the CNMI.
