Betel Chewing Research Articles

New updated Classification and Treatment modality for Oral Submucous Fibrosis: A Review

Oral submucous fibrosis (OSMF) is a premalignant condition mainly associated with the practice of chewing betel quid containing areca nut, a habit common among South Asian people. Data from recent epidemiological studies provide overwhelming evidence that areca nut is the main etiological factor for OSMF. Over the years, many classification systems have been documented in medical literature based on clinical, histopathological, or functional aspects. Each classification has its own merits and demerits. An attempt is made to provide and update the knowledge of classification system of OSMF so that it can assist the clinicians, be beneficial in researches and academics in categorizing this potentially malignant disease for early detection, prompt management, and reducing the mortality. Keywords: Update classification, Blanching, Collagen, Fibrosis, Oral Submucous Fibrosis

The Role of Selected Habits, Periodontal Disease and Oral Hygiene Status on the Occurrence and Prognosis of Oral Mucosal Lesions

Patients with an array of benign oral mucosal diseases comprising fibro-epithelial polyps, lipomas and lichen planus commonly present to Oral & Maxillofacial units. While managing their specific conditions, it is important to assess for their risk habits such as betel chewing which is associated with a high burden of periodontal disease as evident from research findings. Moreover, recent research has found the association of periodontal disease with increased risk for an array of cancers. In addition, several systematic reviews and some research articles as well have suggested periodontal disease as an independent emerging risk marker for oral cancer , however could be attenuated when adjusted for major confounding factors such as smoked and smokeless tobacco and alcohol use

Tobacco and Cancer: A Terrific Conditional Cross-Talk

The exact history of tobacco use by human is still in dark. But, tobacco and its products have been used in two forms- smoked (combustible) and smokeless (non-combustible) tobacco. Pika (indigenously prepared hand-rolled bidi using a piece of leaf of kendu plant, Diospyros melanoxylon)/, bidi, cigarette, cigars and pipes etc are used as smoked items while khaini, snuff, gutkha, paan masala, betel quids (BQs) etc are used as non-smoked items. According to World Health Organizations, due to tobacco epidemic more than 8 million people are being killed in a year globally. It has also been estimated that more than 7 million of those deaths are due to direct tobacco use while around 1.2 million death cases are the result of non-smokers being exposed to second-hand smoke (SHS) [1]. Epidemiological studies have shown that there is an indomitable nexus between tobacco and cancer. Age, gender and economic status of the tobacco users, type and quantity of tobacco and above all frequency of tobacco use are some of the important conditions involved in the terrific cross-talk between tobacco and cancer.

Betel Nut Chewing Decreased Calcaneus Ultrasound T-Score in a Large Taiwanese Population Follow-Up Study.

Chewing betel nut is common in Taiwan. Although previous studies have shown that chewing betel nuts is associated with adverse health effects, findings about the impact on bone density have been inconsistent. Therefore, the aim of this study was to investigate the correlation between betel nut chewing and calcaneus ultrasound T-score in a longitudinal study of 118,856 participants from the Taiwan Biobank. Of these participants, 27,002 were followed up with for a median of 4 years. The T-score of the calcaneus was measured in the non-dominant foot using ultrasound. Multivariable analysis showed that a history of chewing betel nut (coefficient β = −0.232; p < 0.001) was significantly associated with low baseline T-score in all participants (n = 118,856). In addition, a long duration of betel nut chewing (per 1 year; coefficient β = −0.003; p = 0.022) was significantly associated with a low baseline T-score in the participants with a history of chewing betel nut (n = 7210). Further, a long duration of betel nut chewing (per 1 year; coefficient β = −0.004; p = 0.039) was significantly associated with a low ΔT-score in the participants with a history of chewing betel nut (n = 1778) after 4 years of follow-up. In conclusion, our results showed that betel nut chewing was associated with a decrease in calcaneus ultrasound T-score, and thus, it is important to stop chewing betel nut to help prevent an increased risk of osteoporosis in the Taiwanese population.

Prevalence of oral mucosal lesions in the geriatric population of Chhattisgarh- A real world evidence

Introduction: Patients with oral mucosal diseases are known to encounter severe and life-threatening symptoms, preventing them from eating and drinking, and influencing daily life in many ways. They may even serve threat to interpersonal relationships, appearance and an individual’s positive self-image. Aim: We aimed to search out the prevalence and to achieve more knowledge about oral soft tissue lesions in the geriatric Chhattisgarh Population and possibly identify new avenues of research in this area. We also aimed to make available this baseline data about the magnitude of the oral diseases for planning National / State / Regional health programs to formulate strategies to prevent & treat these lesions. Materials and Methods: It is a Prospective and observational correlation study, performed in an exceedingly period of two years which included the individuals of age 60 years and above from the Chhattisgarh Population. The chosen individuals were then screened for the presence of oral mucosal normal variations by 3 individual examiners and the diagnosis was rendered. Results: In the present study, the prevalence of oral mucosal lesions was found to be 80 %. The most prevalent lesion was found to be smoker’s palate (26.6%) followed by smoker’s melanosis (17.01%), leukoplakia (8.5%), angular cheilitis (3.7%), tobacco pouch keratosis (3.2%), carcinoma (2.1%), oral submucous fibrosis (1.9%), fibroma (1.4%), gingival enlargement (0.7%), candidiasis (0.4%) ulcer (0.2%), erythema multiforme (0.14%), mucocele (0.14%), and herpes (0.14%). Conclusion: The results show that Bidi associated lesions are more prevalent in our population. A high prevalence of some lesions in this population commands national programs toward oral health awareness. Although some recent curbs have been put on the manufacture, sale and advertisements of gutka and pan masala, further education is necessary to reduce or eliminate the use of these preparations. Keywords: Oral Medicine

Need for Regulation of Pan Masala Advertisements in Television Media

Tobacco industries have resorted to brand stretching to keep their brands visible through sale of non-tobacco products like elaichi (cardamom) and paan masala, as seen in television advertisements aired during Indian premier league matches. The direct and indirect forms of advertisements of tobacco products in digital media remains unchecked. Strict ban should be enforced as these advertisements lure children and the youth into consumption of tobacco products later in life. In addition to providing tobacco cessation services to patients, oral health professionals should be aware of the marketing strategies of tobacco companies so that we can advise governing authorities to enact new laws and enforce existing laws in order to curtail tobacco consumption in our country.

CN+pN0 disease does not portend a less favorable prognosis compared with cN0pN0 in patients with resected oral cavity squamous cell carcinoma.

BackgroundWe compared the clinical outcomes of patients with oral cavity squamous cell carcinoma (OCSCC) with cN+pN0 versus cN0pN0 disease.MethodsA total of 1309 OCSCC patients with pN0 disease were included. Of them, 1019 and 290 cases had cN0pN0 and cN+pN0 disease, respectively. For comparison purposes, we also examined 799 patients with pN+disease (cN0pN+/cN+pN+, n = 239/560). Subgroup analysis was performed in a propensity score‐matched cohort with cN0pN0 and cN+pN0 disease (n = 284 each).ResultsCompared with cN0pN0, patients with cN+pN0 had a higher prevalence of the following variables: betel chewing, pT3−4, depth ≥10 mm, perineural invasion, and treatment with surgery and adjuvant therapy. The prognosis of patients with cN+pN0 (mean: 52 nodes) and cN0pN0 (mean: 39 nodes) disease was similar both in the original cohort and after propensity score matching. However, the 5‐year outcomes were more favorable for cN+pN0/cN0pN0 compared with cN0pN+/cN+pN+ (local control, 88%/88%/83%/81%; neck control, 94%/93%/82%/76%; distant metastases, 4%/3%/13%/31%; disease‐free survival, 84%/83%/68%/52%; disease‐specific survival, 92%/92%/77%/57%; overall survival, 81%/82%/59%/42%; all p values <0.001; cN+pN0 versus cN0pN0, all p values >0.05). cN+pN0 disease (vs. cN0pN0) was not significantly associated with local control, neck control, distant metastases, and survivals either in univariable or multivariable analyses.ConclusionsDespite a higher risk factor burden, the prognosis of patients with cN+pN0 disease did not differ from that of cases with cN0pN0. The higher nodal yield and the more frequent use of adjuvant therapy in cN+pN0 disease may explain the lack of significant differences in terms of neck control compared with cN0pN0 disease.

Estimation of magnesium carbonate, calcium carbonate and pH of pan masala and smokeless tobacco products

Estimation of magnesium carbonate, calcium carbonate and pH of pan masala and smokeless tobacco products

Prevalence of Tobacco Use in Young Adult Literate Girls of 18-25 Years in Meghalaya, India: A Cross-Sectional Study.

Background:Several national-level surveys have recognized a high prevalence of tobacco use in North-eastern (NE) India. However, information on tobacco use in specific population subgroups still lacks from the region. The present study determines the prevalence and influence of determinants like education and family income on tobacco use in senior school and college-going girls in Shillong, Meghalaya. Additionally, the prevalence of dual use of smoking and smokeless (SLT) tobacco with alcohol and non-tobacco Pan Masala has been examined. Methods:A cross-sectional study was conducted among 18-25 years girls in educational institutions in Shillong. Data were analysed using statistical software SPSS version 22. The categorical data presented as frequency (%). Chi-square was employed to see the association between variables. Results:(i) 8.10% of girls were current users of all forms of tobacco; 1.85% were smokers, 4.0% used SLT, and 2.25% were dual users of tobacco (ii) Of the 6.25% current users of SLT, 5.4% used a single smokeless tobacco product whereas 0.85% used multiple products of SLT (iii) 79.5% of tobacco smokers and 30.2% of current SLT users were dual users with alcohol (iv) 37.2% tobacco smokers and 18.5% SLT users were dual users with non-tobacco Pan Masala (v) Tobacco smoking was positively associated with educational status and family income whereas SLT use was independent of educational status and income of girls’ families. Conclusions:The study shows a relatively high prevalence of tobacco use and dual tobacco use with alcohol in the study population of educated young adult girls, underscoring a public health concern. It is recommended that an education-based comprehensive awareness program be initiated for tobacco and alcohol control in Meghalaya to improve knowledge and health-seeking behaviour change in this high- risk subgroup to control increasing NCDs.

Plant-Based Antioxidant Extracts and Compounds in the Management of Oral Cancer.

Oral cancer continues to be a leading cause of death worldwide, and its prevalence is particularly high in developing countries, where people chew tobacco and betel nut on a regular basis. Radiation-, chemo-, targeted-, immuno-, and hormone-based therapies along with surgery are commonly used as part of a treatment plan. However, these treatments frequently result in various unwanted short- to long-term side effects. As a result, there is an urgent need to develop treatment options for oral cancer that have little or no adverse effects. Numerous bioactive compounds derived from various plants have recently attracted attention as therapeutic options for cancer treatment. Antioxidants found in medicinal plants, such as vitamins E, C, and A, reduce damage to the mucosa by neutralizing free radicals found in various oral mucosal lesions. Phytochemicals found in medicinal plants have the potential to modulate cellular signalling pathways that alter the cellular defence mechanisms to protect normal cells from reactive oxygen species (ROS) and induce apoptosis in cancer cells. This review aims to provide a comprehensive overview of various medicinal plants and phytoconstituents that have shown the potential to be used as oral cancer therapeutics.

Chemical Composition, Pharmacological, and Toxicological Effects of Betel Nut.

Betel nut, the fruit of Areca catechu L, has a long medical history in Southeast Asia. It is native to Malaysia and is cultivated and processed extensively in subtropical regions, such as South China and India. Betel nut almost appears as a “snack” in various occasions in most parts of China. Clinically, betel nut can play a certain pharmacology role and was used in malaria, ascariasis, arthritis, enterozoic abdominalgia, stagnation of food, diarrhea, edema, and beriberi. The nervous excitement of betel nut chewing has made it gradually become popular. However, chewing betel nut can induce oral submucosal fibrosis (OSF) and oral cancer (OC). At the same time, long-term chewing of betel nut also causes inhaled asthma, sperm reducing, betel quid dependence (BQD), and uterine and esophageal cancers. The main components of processed betel nut are the goal of this review. This study will mainly start from the pharmacological activity and toxicology study of betel nut in recent years, aiming to seek its advantages and disadvantages. In the meantime, this study will analyze and emphasize that betel nut and arecoline are the high-risk factors for oral cancer, which should arouse attention and vigilance of the public.

Detection of Helicobacter pylori infection by 14 C urea breath test in asymptomatic adults: A pilot study in Kanbauk village tract

As Helicobacter pylori infection is highly prevalent estimated to be affecting more than 50% of the world's populations and implicated in the pathogenesis of several gastric diseases including gastric cancer, early detection of infection even before symptoms appears to be one of the most important strategies in management. This study was aimed to detect infection by 14C urea breath test and to describe the risk factors in asymptomatic adults at Kanbauk village-tract, located in Southern Myanmar. It was a community-based, cross-sectional prevalence study conducted between 4 and 9 October 2019. After thorough history taking, physical examination, obtaining informed consent, and fasting for 5 h, H pylori infection was detected by 14C urea breath testing. Among 149 volunteers, infection was detected in 68.46% of the study population. The prevalence of H pylori infection in male patients was 66.7% and in female patients was 75%. There was no statistically significant association between H pylori infection and gender (P = 0.36). The mean age of H pylori infected patients was 37.4 years (SD ± 9.14) and it did not differ significantly (P = 0.421). Subjects who never attended government school were found out to have a significant association with H pylori infection (P = 0.006). Other factors such as family income, household numbers, smoking, betel chewing habit, alcohol consumption, BMI and blood groups were found to be no significant risk factors for H pylori infection. The prevalence of H pylori in Kanbauk village tract was comparable to two different community studies conducted in Myanmar.

Analisis Kosmologi Pola Tiga dalam Tradisi Nyeupah pada Masyarakat Sunda

Nyeupah is a term in Sundanese society which means chewing betel leaves. Nyeupah itself has other terms such as nyirih for the Java area and Nginang for the Sumatra area. Consuming betel leaf has been done by our ancestors since the middle of 15th century, where the Chinese, Indians, Persians and Europeans had made transactions for herbs and spices in Nusantara. The Nyeupah tradition in Sundanese society has long existed and it is proved by the existence of Jangjawokan regarding Nyeupah. Jangjawokan is a Sundanese poem which can be interpreted as containing archaic or ajimantra. This article has been written to analyze the Nyeupah tradition in Sundanese society with a three-pattern cosmological approach to be able to give deeper meaning dealing with this tradition.

Prevalence of dementia and its associated risk factors among elderly patient attending Outpatient Department of a tertiary care hospital in Lucknow

Background: Dementia is a broad category of brain diseases that causes a chronic, progressive and gradual decrease in cognitive function i.e. ability to think and remember that is great enough to affect a person’s daily functioning beyond what might be expected from normal ageing. According to American Psychiatric Association, “Dementia is a syndrome caused by a variety of brain illnesses that affect memory, thinking, behaviour and the ability to perform everyday activities”. Aim &amp; Objectives: To assess the prevalence of dementia among the patients above 60 years of age attending the outpatient department of Tertiary care super specialty hospital. To assess the risk factors associated with occurrence of dementia in patients attending outpatient department of Tertiary care super specialty hospital. Settings and Design: Study design: - Cross-sectional observational study. Study area: - Tertiary care super-specialty hospital. Study setting: - Outpatient department (OPD)of Tertiary care super specialty hospital. Methods and Material: Study population: - Patients above 60 years of age and attending Outpatient Department of the tertiary care super specialty hospital. Duration of Study: - 4 months. Sample size:- 223 elderly participants from the registration counter of the Outpatient Department of tertiary care hospital. Statistical analysis used: Data was analysed using SPSS, version 24.0. Univariate Logistic Regression, Multivariate Logistic Regression, Odds Ratio. Results: The study was conducted on a total of 223 patients out of which only 210 patients completed the questionnaire and matched our criteria. Thus, 210 patients are analysed for the result. In our study which included the patients above 60 years of age out of which the maximum participants (52.4%) were of age group 65-75. In our study 66.2% participants had normal cognitive functioning while 33.8% of total participants were found to have dementia. Out of these 33.8% participants having impaired cognitive functioning, 13.8% and 20% had severe and borderline dementia respectively. Dementia was found to be more common in females. Conclusions: Statistically significant association of dementia has been found with female gender, rural residence, joint family and a greater number of family members, poor education, pan masala consumption, daytime drowsiness, and problem in sleep pattern, social intolerance and frequent fights.

Outcome and treatment toxicity in east-indian versus white-canadian patients with oral cavity cancer following postoperative (chemo-)radiotherapy delivered under similar multidisciplinary care: A propensity-matched cohort study

PurposeWe compare clinical behaviour of East-Indians and White-Canadians with oral cavity squamous cell carcinoma (OSCC) treated at a Western institution within a uniform health care system. Materials/methodsNewly diagnosed OSCC patients who underwent postoperative (chemo-)radiotherapy (PORT/POCRT) between 2005 and 2017 were included. Data on ethnicity and other variables were extracted from patient-questionnaires, a prospective database and supplemented by chart review. Baseline characteristics were compared between East-Indian versus White-Canadian groups. A propensity-matched (1:1 ratio) of East-Indian versus White-Canadian cohorts was generated to compare locoregional control (LRC), distant control (DC), overall survival (OS), and acute and late toxicities. ResultsA total of 53 East-Indian and 467 White-Canadian OSCC patients were identified. Compared to White-Canadians, East-Indian patients were younger, had less exposure to smoking and alcohol (p < 0.001), but more chewed betel (areca) nut /tobacco (43% vs 0.2%, p < 0.001). Buccal/retromolar-trigone/lower gingiva primaries were more common in East-Indians (49% vs 25%, p < 0.001). Median follow-up was 5.0 years. Propensity-score paired analysis revealed inferior 3-year LRC (68% vs 81%, p = 0.030), non-significantly lower OS (61% vs 75%, p = 0.257), but similar DC (81% vs 87%, p = 0.428) in East-Indian versus White-Canadian patients. Actuarial rate of toxicities was higher in East-Indians vs White-Canadians: acute toxicity at 6 weeks: 47% vs 30%, p = 0.012; chronic trismus at 5-years: 16% vs 2%, p = 0.013. ConclusionEast-Indian OSCC patients have a greater betel nut/ chewable tobacco exposure compared to White-Canadians and a different distribution of OSCC sites. Propensity-matched cohort analysis showed lower LRC and higher toxicities in East-Indian OSCC patients, suggesting a complicated interaction between genetic/biological and life-style factors.

HPV IN ORAL SQUAMOUS CELL CARCINOMA - CHANGING TRENDS IN THE RISK FACTORS AND DEMOGRAPHICS OF ORAL CANCER IN THE INDIAN SUBCONTINENT

<h3>Background</h3> Human papilloma virus (HPV) is a double-stranded DNA virus that infects the epithelial cells of skin and mucosa. It is established now that sexual contacts, both conventional and oral, are means of transferring HPV through direct skin-to-skin contact. A small number of oral cavity cancers are related to HPV infection that may not be due to oral habits. <h3>Objective</h3> To review the existing literature on the association of HPV and oral cancer and to highlight the uniqueness of their clinical presentation and histopathologic appearance. <h3>Methods</h3> A literature search was undertaken, and all relevant data were collected where an association of HPV and oral cancer was established. The focus was on studies involving an Indian population where known risk factors were not present in oropharyngeal cancers. <h3>Results</h3> Several studies reveal the characteristic clinical presentation of oropharyngeal cancer without known etiologic factors such as tobacco smoking or chewing and use of betel nut with or without additives. Women of younger age groups are more likely to fall into this category. HPV of high-risk strains has been isolated from the affected tissues, and a certain uniqueness is observed in the microscopic features of such HPV-associated oral cancers. <h3>Conclusions</h3> The prototypical patient with oral cancer is no longer an elderly man with the habit of smoking or chewing tobacco or betel nut and/or drinking alcohol for many years. HPV is emerging as a powerful risk factor and is increasingly recognized as a subgroup of oral squamous cell carcinoma with a distinct biological and clinical profile.

Prevalence and Risk Factors for Oral Potentially Malignant Disorders in Indian Population.

Background:The present study was conducted to assess risk factors and prevalence of potentially malignant disorders (PMDs) among Indian population.Materials and Methods:1280 Indian population of both genders were enrolled. Habits such as smoking bidi, cigarette, consumption of tobacco such as in the form of zarda, chaini khaini, pan masala, arecanut, and alcohol were recorded. Risk factors and prevalence rate of disorders were recorded.Results:There were 750 (58.6%) males and 530 (41.4%) females. Speckled leukoplakia was seen among 470 (36.7%), oral lichen planus (OLP) in 246 (19.2%), oral submucous fibrosis (OSMF) in 274 (21.4%), erythroplakia in 120 (9.3%), and oral squamous cell carcinoma (OSCC) in 107 (8.3%) participants. Maximum cases of speckled leukoplakia (162) was seen in the age group of 31–40 years, OLP (99) in 41–50 years, OSMF (95) in 31–40 years, erythroplakia (48) in 21–30 years, OSCC (44) in 41–50 years.Conclusion:Risks factors associated with PMDs were found to be tobacco and arecanut. There was higher prevalence of leukoplakia. Age group of 31–40 years had higher cases and most common site was buccal mucosa and vestibule.

Spectrum of lesions of head and neck in a medical college of North India

Head and neck lesions especially oral cancers and pre-cancerous lesions have a high prevalence in India, especially in states like Uttar Pradesh pertaining to use of Pan masala, smokeless tobacco and zarda in the population. The lesions are common in patients of all age groups.This histopathology based study was conducted for the assessment of neoplastic and non-neoplastic lesions of head and neck in the region around North Indian city of Lucknow.This is a retrospective study conducted in the Department of Pathology, T S Misra Medical college and Hospital, Amausi, Lucknow. The head and neck cases for time period of two years and eight months were retrieved from the histopathologic section of department. Thorough analysis of these specimens was done and data was compiled based on histomorphological diagnosis and other parameters like site of lesion, sex and age group.Study was done for 189 biopsies from head and neck region. Peak incidence of case was seen in 21-50 years age group, in the overall age range 3 to 86 years of our study. Male outnumbered female by ratio of 1.77:1. 63 cases of the study were inflammatory, 40 cystic, 46 benign, 14 dysplastic and rest 26 cases were malignant. Commonest malignant lesion was Squamous cell carcinoma of the oral cavity.It was noteworthy that precancerous and malignant lesions of oral cavity constitute a high percentage of head and neck lesions for the present cohort of referral patients.

TOBACCO PRODUCTS: CHEMICAL ANALYSIS AND COMPARATIVE HARMFULNESS

Tobacco consumption is a major social health problem in India as well as throughout the world, because it harms both health and wealth of an addict. Tobacco is a Sthavara Patra Visha received from the plant Nicotiana tobacum/ Nicotiana rusticum leaves by curing them. Tobacco contains an alkaloid nicotine in abundant amount, which is sufficient to make addict like alcohol, cocaine and morphine. There are so many different forms of smoking and smokeless tobacco in India, like cigarette, bidi, gutka, jarda, pan masala etc. Long timed use of Tobacco like adductive products by oral route, acts as a slow poison (Dushi Visha) induces chronic toxicity to the gastrointestinal tract like oral diseases, gingivitis and periodontitis, Leukoplakia (precancerous stage), and may lead to cancer also in advance stage. This chronic toxicity affects cardiovascular system and results as increasing coronary blood flow, heart rate and blood pressure which may trigger the chances of heart attack rate in addict person. Before we can do any effort for reducing toxicity produced by tobacco products its mandatory to knowing the basic knowledge of tobacco products, their chemical composition, their mechanism of action with comparative toxicity and specific tobacco product related to a specific mouth part cancer. Because we can’t stop a person to start tobacco use but we can circulate the knowledge of tobacco products in adolescent groups so that when the beginner chose a tobacco product, he will be aware about the toxicity and affecting organ because of its use. So that, the toxicity can be minimised. Keywords: Tobacco consumption, nicotine, slow poison, cancer, comparative toxicity

English

BACKGROUND Malignancy of oral cavity is quite a common disease entity in Western part of the state of Odisha. This is because of prevalence of habits like smoking, chewing tobacco, and consumption of alcohol. Ignorance about the severity of the condition in early stages leads to delayed diagnosis. METHODS A study was undertaken in Bhima Bhoi Medical College, Bolangir, in Western Orissa from October 2018 to September 2020 to study about different patterns of presentations and histopathological variations of malignancy of oral cavity in this part of Odisha. Patients were thoroughly clinically evaluated, examined, and appropriate investigation protocol was followed to record data. RESULTS About 0.33 % of all patients coming to the outpatient department (OPD) were found to be suffering from carcinoma of oral cavity. Maximum number of cases were males in the 5th and 6th decade with squamous cell carcinoma. Predisposing factors like areca nut and pan masala consumption were noted. A majority of patients were cultivators from lower middle-class families. Other common groups were businessman and industrial workers. They had come with burning sensation in the mouth and restricted mouth opening as complaints. Xerostomia, fibrous bands in mouth, cervical lymphadenopathy were signs that were detected. Cheek was seen to be a primary site of lesion in large number of cases followed by tongue and lip. CONCLUSIONS In spite of them being easily assessable, patients ignored their symptoms leading to delay in reporting to healthcare facility. As the patients were from disadvantaged background, by the time they came to hospital, they were in an advanced stage (stage three). Squamous cell carcinoma is very common in this part of Orissa. Proper guidance to the patients about the symptoms and risk factors will go a long way in early diagnosis and a more favourable outcome post treatment. KEYWORDS Malignancy, Oral Cavity, Predisposing Factor, Stage