Oral cancer is a disease affecting your mouth tissues and poses a significant public health concern all over the world. The cancerous cells multiply uncontrollably in areas within your mouth causing discomfort. In the United Kingdom, it is estimated that around 8846 new cases of oral cancer are diagnosed each year, with an increase of 46% in death rates in the last 10 years, based on a mouth cancer UK report.¹ Despite advancements in treatment, there are obstacles such as ensuring prevention strategies are made aware.

Everyone of all ages and backgrounds should understand the importance of preventing oral cancer. Whether you're a non-smoker or a long-time tobacco user, aware of your family history or not, proactive steps can significantly reduce your risk of developing this potentially life-threatening condition.

In this article, we will delve into simple yet effective strategies to prevent oral cancer, offering insights accessible to all, regardless of your medical knowledge. From lifestyle modifications to community initiatives, each approach plays a vital role in promoting oral health and reducing the incidence of oral cancer.

Understanding oral cancer risk factors 

Tobacco use 

In South and Southeast Asia, betel quid chewing with tobacco, or smokeless tobacco, used to be popular but has decreased in the last few decades due to the introduction of cigarettes, the modern and “cooler” option.² Hence, the locals who use smokeless tobacco generally have cancer in their cheek area. Western countries have a higher usage of cigarettes, which is why the locals who smoke cigarettes have tongues that are commonly affected by cancer.³ As a result, oral precancerous numbers and cancer in young adults have rapidly elevated.

Alcohol consumption 

According to a study, there is plenty of evidence in humans that alcoholic beverages cause cancer. Drinking alcohol in high amounts may cause malignant tumours in your oral cavity, which could be due to the ethanol content in the beverage.⁴ 

Human papillomavirus (HPV) infection 

There is growing evidence that HPV can cause oral cancer, particularly in the base of the tongue, tonsils or the area at the back of the mouth. HPV could also enhance some of the cancer cells caused by alcohol or tobacco usage.³ 

It is more commonly known as a cervical cancer vaccine because studies have shown it reduces cervical cancer rates. However, HPV can also cause mouth, throat, anal and genital cancer.

Poor oral hygiene 

Poor oral hygiene can lead to mouth cancer, based on a study, even if you do not drink alcohol, use tobacco, are from a well-educated background or come from a good socio-economic background.⁵ 

Ultraviolet (UV) exposure

UV rays can also cause mouth cancers as well as skin cancers. You can get UV exposure through sunlight even on a cloudy day in your mouth by opening your mouth outside. Furthermore, processes like teeth whitening procedures that use phototherapy could be risky for your mouth.⁶ 

Effective oral cancer prevention strategies 

Tobacco cessation 

There are various peer support groups available to treat you if you have tobacco addiction. A study was done to show there might be benefits to discussing your problems with other people who are in similar circumstances and are not health professionals.⁷ Recovery from addiction is higher when the addicts actively participate in peer support groups and evidence shows positive influence from other peers through watching them is also important.

If you smoke, you will probably become addicted to nicotine in cigarettes. Nicotine replacement therapy is available to you if you wish to quit smoking, in the form of chewing gum, patches, oral spray, etc. They can be bought in pharmacies or obtained through the NHS Stop Smoking service. 

To reduce the number of oral cancer incidents, The Framework Convention on Tobacco Control (FCTC) was the first international treaty organised by the World Health Organisation (WHO) in 2005. Its purpose is to control tobacco usage and distribution worldwide and is still ongoing today.⁸ 

Moreover, a global knowledge hub was created under FCTC to analyse and create information and policies regarding smokeless tobacco control. The hub celebrated World No Tobacco Day (WNTD) in 2017 by spreading awareness and holding cancer screening camps.⁹ 

Did you know that smokeless tobacco users need to spit? So, a population that uses smokeless tobacco a lot can lead to many spit areas in public places, thus creating a dirty environment. This may cause various disease transfers, including tuberculosis. Policymakers should not ban spitting in public though, as swallowing the smokeless tobacco juices could cause a higher number of aerodigestive cancers. They should provide plastic bags to these users as done in Singapore.² 

Limiting alcohol consumption 

Did you realise that some mouthwashes contain alcohol? You should ensure you pick alcohol-free mouthwashes, although alcohol can kill bacteria. You should also try to track and reduce your alcohol drinking habits to successfully have a healthier lifestyle. There are recommended intake guidelines in the UK that state we should not drink more than 14 units a week. To clarify what a unit is, it is 8 g or 10 ml of pure alcohol which is what an average adult can manage in one hour. 

You should also not depend on alcohol whenever you feel stressed or down, as that can lead to a bad habit. Having days without drinking alcohol is a good start to slowly reducing your alcohol consumption.

Practising good oral hygiene 

You should practise brushing and flossing your teeth regularly, and visit the dentist regularly for check-ups. The NHS recommends you brush twice daily for about 2 minutes each. Through this, your dentist should be able to catch if there are any irregular mouth ulcers or bumps which could be cancerous. 

HPV vaccination 

The HPV vaccine protects you against HPV infection. Under the NHS vaccination programme, the vaccine is called Gardasil 9 which is effective for combatting nine types of HPV.  

The HPV vaccine mimics the HPV virus so your body’s immune system produces antibodies to defend against HPV. Antibodies are your body’s first line of defence and help to clear an infection. Your immune system will memorise the HPV virus so it can recognise and react quickly the next time you are infected by the real virus.

A study shows that protection by Gardasil lasts for about 10 years.¹⁰ The eligible people who can get the vaccine are:

1. 12 to 13-years-old for free under the NHS
2. Assigned females at birth (AFAB) aged under 25 years for free under the NHS
3. Assigned males at birth (AMAB) born after the 1st September 2006 for free under the NHS
4. People AMAB aged under 45 who have sexual intercourse with people AMAB
5. High-risk group- Individuals with HIV

Healthy diet and nutrition 

Eating a diet high in fruits could reduce the risk of you getting oral cancer, according to research.¹¹  Other foods like vegetables, curcumin, and green tea can also lower the chances of getting oral cancer. On the other hand, foods that cause inflammation such as red meat and fried foods could cause the opposite effect.¹² 

As long as you eat a balanced meal, and incorporate fruits and vegetables into your diet in 5 portions a day, you should be able to obtain as many micronutrients and vitamins from your food consumption to lead a healthy life.

UV protection 

You should limit your dental treatments that expose your mouth to UV emissions. Ask your dentist or health professional if you need the treatment but are unsure about the risk of getting oral cancer. They should follow the standard protocols for using their equipment.

Community and educational initiatives 

So, have there been any policies introduced by the UK government to prevent oral cancer? In 2015, smoking in cars with children was made illegal which lowers secondhand smoking - another risk for mouth cancer. The HPV vaccination was introduced for school AFAB in 2007 and school AMAB in 2019, which will shield about 800,000 children annually from certain cancers like mouth.¹ 

There should be more public awareness campaigns such as more education in schools and conducting more workshops for adults surrounding oral health. It is best to start learning when young, so oral health education should be implemented more into the study curriculum at primary schools. 

FAQs

What are the 5 signs of oral cancer?

1. Mouth pain that doesn’t heal 
2. A lump in the lips, mouth, or cheek which is similar to an ulcer
3. A white or red patch on any area in the mouth
4. A sore throat or an uncomfortable feeling in your throat that doesn’t disappear
5. The lip or inside the mouth feels numb¹³

What can be mistaken for mouth cancer?

It could be lichen planus, which can cause white patches inside your mouth, or canker sores. 

Summary

Effective prevention strategies include quitting tobacco, moderating alcohol consumption, maintaining good oral hygiene, getting vaccinated against HPV, adopting a healthy diet, and protecting oneself from sun exposure. These strategies, while simple, can significantly lower the likelihood of developing oral cancer. By participating in public health programs and advocating for oral cancer prevention, you can contribute to the combined effort in combating this disease.

Therefore, oral cancer may not be fully prevented but its risks can be reduced. By implementing these strategies and supporting broader initiatives, you can play a vital role in reducing the burden of oral cancer on yourselves and your communities. Together, we can make a tangible difference in improving oral health and overall well-being.