Prevention and control of oral potentially malignant disorders

Oral cavity cancer accounts for approximately 4% of all malignancies and is a significant worldwide health problem. In Southeast Asia, oral cancer account for 40% of all cancers. It is the consensus of health promotion researchers that culturally specific (CS) interventions are important in addressing smoking-related health disparities. Equivocal evidence also exists for tobacco interventions that do not attend to culture specific characteristics, that is, traditional or non-CS interventions. Tobacco use is one of the major public health problems in the world, resulting in 5.4 million deaths every year. Over half of all tobacco consumed in India is smoked as bidi (Indian specific non-filtered cigarette) and about one-fourth of tobacco consumption is in smokeless form. Oral and pharyngeal cancer grouped together is the eighth most common cancer in the world. Two third of these cases occur in developing countries. Tobacco and alcohol are well known risk factors- attributable risk of 75%-95%. It is possible to prevent a substantial proportion of oral cancer even for patients who already have precancerous lesion. There is encouraging evidence from a large primary intervention trial in India that the chance of precancerous lesions and conditions undergoing malignant change is reduced if the patients can be persuaded to curtail their dependence on tobacco (Gupta et al 1992). High risk groups of the population can be identified. Type of screening could be a.Mass Screening b.High risk or selective screening c. Multiphasic screening (health questionnaire, clinical examination, measurements and investigations.) Patients should utilize dental services whatever available. It involves surgical intervention and reconstruction of the tissue destroyed. Based on Ottawa Charter (WHO 1986) there is a range of options for oral health promotion approach to oral cancer prevention. Success depends on political will, inter-sectoral action and culturally sensitive public health messages, disseminated through educational campaigns and mass media initiatives.