The mouth, consists of two regions, the vestibule and the oral cavity proper. The vestibule is the area between the teeth, lips and cheeks. The oral cavity is bounded at the sides and in front by the alveolar process (containing the teeth) and at the back by the isthmus of the fauces. Its roof is formed by hard palate and soft palate and the floor is formed by the mylohyoid muscles and is occupied mainly by the tongue. Mucous membrane lines the sides and under surface of the tongue to the gum lining the inner aspect of the jaw mandible. It receives the secretions from the submaxillary and sublingual salivary glands.

The oral cavity may host benign or malignant tumors. The differential diagnosis and identification might be complex and will surely require examination by a specialist. Sometimes biopsy and specialized analysis might be sufficient for diagnosis.Among malignant tumors, oral carcinomas are the most common. Statistics show that they are most likely to arise mainly in the tongue, the lips, the gums and the floor of the mouth.

The main predisposing factors are smoking and alcohol abuse. When these factors are combined, the incidence of cancer increases more than tenfold. Nevertheless, there still is a small percentage of patients that does not smoke nor drink.

Some of those may carry a genetical predisposition, be chronically injured (from an artificial denture for instance) or be exposed to viruses with carcinogenic impact, such as HPV (Human Papilloma Virus).

In fact, incidence of oral and pharynx cancer in patients that don’t smoke nor drink is currently on the rise especially because of the HPV virus. As far as lip cancer is concerned, the main cause is sun exposure.

SYMPTOMS

Most cancers are accidentally discovered by the patient or the dentist. He is the one who notices on the tongue a sore that doesn’t heal, or even a red or white plaque. The offended area might be painful, bleed or suffering from a denture that doesn’t fit perfectly.

TREATMENT

In most cases neoplasms of the oral cavity should be operated. Most surgeries are operated without external incisions and the recovery is very short. Some malignant tumors may require further treatment with radiation or medicine.The aim of the treatment is to get rid of the neoplasm while keeping the functions of the mouth (speech and swallowing) intact. Significant advances in surgery, radiotherapy and oncology now maximize the effect of the treatment and minimize patient discomfort.Contemporary approach of oral cancer is multifactorial. To ensure the best oncological and functional result in complex cases, several medical specialties, such as radiotherapy, oncology and plastic surgery, might contribute.To offer an integrated support after surgery, in case of functional deficit a very experienced team of speech therapists takes over.

PROGNOSIS

The prognosis of the disease depends upon the stage of the disease, that is the expansion. The kind of the therapeutic approach as well as the first treatment are decisive for the outcome of the treatment plan.Still, prevention is better than cure. Therefore, it is very important to stay away from smoke, alcohol and sun exposure.