PPT is for primary care physicians and oral health specialist. Gives information about gravity of Tobacco addiction problem, oral cancer and its prevention.
1. Dr Madhu Oswal Thakkar
Muktaa Charitable Foundation
02/12/14
www.mcf.org.in
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2. Ramesh, 35 years ,
plumber, breadwinner,
only son of his old
mother.
Eating Khaini since
he was 12 years
Died after fighting
cancer for 2 years
02/12/14
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4. •Renu , 30 years old,
mother of 3 teenagers,
housemaid.
•Eating mishri since
childhood
•Non healing ulcer in
mouth
•When she presented at
TMH, case was
inoperable
•Died within 3 months
of diagnosis
02/12/14
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5. Who will look after these innocents?
02/12/14
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6. •Vinod, farmer from
Nagar, worked day
and night to see his
sister get married
•Ate 15 pouches of
“Manikchand”
everyday
•Today he can have
just liquid.
•Condition is
untreatable
02/12/14
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8. Tobacco truly kills
Tobacco kills 900,000 people every year
In india one people die every 40 seconds because of tobacco related problems
By 2020, 12 lakh people are estimated to die every year due to tobacco use
Tobacco users loose an average of 20-25 years of non-tobacco life expectancy
Out of 100 teenage smokers in India today, 50 out of them will eventually
die of tobacco- related disease.
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9. Tobacco Use In India
India is the third largest producer and consumer of tobacco in the world.
275million active tobacco users in India. i. e 35% of Indians consume some
form of tobacco
Smokeless tobacco use in India is the highest in the world.
25.9 percent of the adults( 32.9 percent of men and 18.4 percent women) use
smokeless tobacco.
Among smoking forms of tobacco, bidis are the most prevalent form (9.2 percent)
followed by cigarettes (5.7 percent).
Exposure to second-hand smoke remains high with 52.3 percent and 29.0 percent
of the population exposed to second-hand smoke at home and at public places
(mainly in public transport and restaurants) respectively.
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19. 4. Lung and other cancers
5. Tuberculosis
6. Increases the risk of heart
stroke
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20. 7. Increasing vulnerability of sexual and reproductive health
8. Babies born with lower birth weight from habitual
smoker parent (s).
9. Kidney and liver diseases .
10. Blood pressure, exacerbates asthma and
causes impotence, infertility
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21. Pregnancy &
Secondhand Smoke
Pregnant women
exposed to ETS 6 hours
a day pass carcinogens to
the blood of unborn
ETS for 2 hours a day
causes 2 times risk of
low birth weight
02/12/14
Miscarriage
Sudden Infant
Death Syndrome
(SIDS)
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Prematurity
Low birth weight
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23. Tobacco and Oral Cancer
India has the highest number of oral cancer cases in the world
Of 7-8 lakh registered cancer cases every year, 40% are of oral cancer
Annually 130,000 people succumb to oral cancer in India 1
60 to 80 % present in advanced stage
14 deaths per hour
1: http://ocf.org.in
02/12/14
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24. How will the patient present?
Leukoplakia, Erythroleukoplakia or Erythroplakia
Difficulty in opening mouth
Non healing ulcer or nodule
Bleeding in the mouth.
Loose teeth
Dysphagia
Difficulty wearing dentures.
Lump in the neck.
Earache
Hoarseness
Most are asymptomatic
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26. Leukoplakia
White painless, bright white and sharply defined,
slightly raised plaque
Cannot be scraped
Malignant transformation: 3-33% over 10 years
Speckled or verrucous leukoplakias are more likely to
be premalignant
Clinical, not histological
27. Leukoplakia :3 Stages
Stage 1: Nonpalpable, translucent white
Stage 2 : Localized or diffuse, slightly elevated
plaques, irregular outline, opaque white ,fine,
granular texture.
Stage 3: Thickened, white lesions, showing
induration, fissuring, and ulcer formation.
28. Leukoplakia: When to worry?
Verrucous leukoplakia
Erosion or ulceration within the lesion
Nodule in lesion
Hard in its periphery
Anterior floor of the mouth and undersurface of the
tongue
29. Erythroplakia
•Asymptomatic red, smooth, soft, velvety texture macule/s or
patch/s
•In level with or depressed below the surrounding mucosa.
•Less than 1.5 cm well-demarcated
•Floor of mouth, tongue and palate
•High chance of frank malignancy or severe dysplasia.
32. Oral Sub Mucous Fibrosis
Areca nut (Arecoline, copper): Incresae production of
collagen
? Chilli
Genetic factor
Deficiencies of Iron, B complex
Progress : Unpredictable
No treatment
33. This patient of SMF has so much of limitation in opening of mouth that it is
difficult to put even 2 fingers in the mouth
02/12/14
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35. Common sites of oral cancer
Tongue –middle of lateral 1/3 rd
Floor of the mouth
Buccal vestibule and mucosa
Gingiva, hard and soft palate
Bucco-pharyngeal mucosa in smokers.
You tube: http://www.youtube.com/watch?v=q-W_RqQmnlk (Uni of Michigan School of Dentistry)
42. Common sites of oral cancer
Tongue –middle of lateral 1/3 rd
Floor of the mouth
Buccal vestibule and mucosa
Gingiva, hard and soft palate
Bucco-pharyngeal mucosa in smokers.
You tube: http://www.youtube.com/watch?v=q-W_RqQmnlk (Uni of Michigan School of Dentistry)
46. Steps to quit-tobacco
1. Deep Breathing
2. Drink lots of water and fluids
3. Stay away from alcohol, sugar and coffee and
avoid fatty foods
4. After dinner, instead of a cigarette, treat
yourself to a cup of mint tea or a peppermint
candy
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47. 5. Go to a gym and jog around the block or park
for to change your normal routine.
6. Ask friends and family members not to smoke
in your presence.
7. On your quit day, hide all ashtrays and destroy
all your cigarettes.
8. Write down ten good and bad things about being
a nonsmoker and smoker.
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48. Children &
Secondhand Smoke
Coughing and wheezing
Asthma
Ear infection
Sore throats and colds
Eye irritation
Hoarseness
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Children of smokers have higher cholesterol levels, more prone to heart disease, more susceptible to respiratory infections, asthma, ear infections, and anemia