Self-Mouth Mirror Examination: A Boon to Tobacco-Related Potentially Malignant Lesions and Oral Cancer

Abstract

Background and context: The tobacco related potentially malignant disorders and oral cancer occupies the major burden of diseases caused by smokeless and smoking tobacco in general in southeast Asia and in particular India. The major challenge is due to lack of awareness about ill effects of tobacco especially in rural India. Community awareness is adopted as a measure to reduce mortality and morbidity of oral cancer and also other cancers caused by tobacco. In developing countries like India, the problem is magnified because of low literacy levels and lack of logistics and IEC material. The qualified human resource especially professionals to assist is also another road block. Intervention is designed to create awareness about ill effects of tobacco through a simplified IEC pictorial brochure called Self-Mouth Mirror Examination (SELFMEE). Aim: To aware public about ill effects of tobacco and how to notice the disorders caused at early stages. Capacity building of dental and paramedical and nursing workers toward tobacco control. Strategy/Tactics: Young dental and medical professional and paramedical workers such as nursing students and ancillary workers were trained to educate public about self-mouth mirror examination. Thus spreading awareness against tobacco and promoting health by counseling and treatment of diseases diagnosed. Program/Policy process: Village constituency of a elected legislative member from rural India (katol) was considered to implement policy of SELFMEE. 75,000 homes coming under the ten primary health centers were surveyed nearly covering 200,000 population. The procedure was explained through visual demonstration of brochure. Sign and symptoms were explained and the sensitized populations was screened at primary health centers. Outcomes: 5100 citizens reported to have complaints which were examined by young dental and medical professionals mainly residents. 900 citizens were found to have oral diseases. Majority of the 800 showed the signs and symptoms of a potentially malignant disorder caused by smokeless tobacco and areca nut mixture (gutkha/kharra). Ten oral cancer cases were detected. Eight early cancers were treated at tertiary medical college centers. Two inoperable cases were given palliative treatment. The oral submucous fibrosis cases were advised tobacco and areca quid cessation. What was learned: Mouth mirror examination performed by self-helped tobacco users to observe the ill effects of tobacco habits by themselves thus becoming active partner in tobacco control. The self-motivation to quit habits is effective. Young dental and medical professions were trained in effective cancer control.