Share
Delicious
Save

Tobacco-related oral lesion

This patient whose dental photograph is given here had come to me for the extraction of a root piece of a front tooth. While I was injecting local anaesthetic, I noticed that inner side of his upper lip is quite rough and does not appear to be healthy.

When I asked this man whether he is aware of those lesions inside his upper lip, he replied –Yes, doctor, these are due to tobacco use. I was surprised how come tobacco use can lead to such lesion inside the upper lip. He further told me that he has the habit of dipping tobacco-lime mixture on the inner side of upper lip. I was surprised as I had rarely seen such a case of tobacco-dipping in the upper vestibule.

Justifying his habit he narrated that he got into this habit of using his upper lip for “tobacco sucking” because he somehow found dipping in lower vestibule quite cumbersome during parties when he was required to spit repeatedly. Even since he has adopted this method he does not have to bother about the “spitting”.

Tobacco-related oral lesion

He also told me that it is only during party time that he has to use his upper lip for tobacco dipping –otherwise he uses the lower lip and cheek  for placing that mixture (“cancer mixture”). You can see that the tobacco habit has played havoc with his oral tissues. The lesions that you see in the upper and lower regions are tobacco-related oral mucosal lesion.

Most of the tobacco-related oral mucosal lesions are considered pre-cancerous ie there is the possibility of malignant transformation. The lesions that appear to be quite harmless type can turn cancerous and then there are no U-turns. The prognosis/outcome of oral cancer as we all know is quite grim.

When I explained all these facts to him, he was convinced enough to immediately kick this habit of tobacco dipping.

But while I was talking to this patient, I was remembering our Oral Surgery Professor who almost used to remind us —“Listen  to the patient carefully, he is giving you the diagnosis”. In this case also who gave me the clue to the lesions on the inner side of upper lip. I also know that some players like those playing soccer also are into this habit of smokeless tobacco dipping while they are actively engaged in the game. Better they also learn a lesson from this case –creamy snuff is as deadly  tobacco- leaves , if not more !