I
Please contact the Siletz Community Dental Clinic if you experience
dental pain or a dental emergency. The staff will do everything possible to see you
as soon as reasonably possible.
Because of high volume, check-in time is Monday-Thursday fron^
8:30-9 a.m. and Friday from 10-10:30 a.m. Afternoon check-in time is
Monday-Friday from 1 -1:30 p.m.
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Tooth Talk: Nicotine and oral cancer can come from several sources
By Mary Ellen Volansky, RDH, MS
Which of the following is not a name
for chewing tobacco - scrap, guy, chowers,
flab, chits, chawsky?
OK, I had a personal stake in plac
ing the last one on this list. Now, which
do you think is not a name for chewing
tobacco? Read on.
Chewing tobacco is one of the oldest
methods of consuming tobacco. American
Indians of both North and South America
chewed the leaves of the tobacco plant.
Frequently, the tobacco was mixed with
the mineral lime, which was added to
enhance the effect on the chewer.
Chewing tobacco was prevalent until
the 20,h century when it was overtaken by
- cigarette smoking.1 This advancement
led to increased addiction to tobacco and
increased lung and oral cancers - those
with a 30 percent survival rate2 - and a
greater risk of periodontal disease and
tooth loss.
Marissa Esposito, a dental hygiene
student at the Lincoln College of New
England, provided the following statistic
in an article she wrote for the April 2011
issue of the American Dental Hygienists’
Association magazine, Access: In the
U.S., oral cancer is the most commonly
diagnosed form of cancer, with over
30,000 patients presenting each year.3
She went on to address other aspects
of oral cancer incidence in the United
States: 1) Oral cancer is responsible for
over 8,000 deaths annually;4 2) The high
incidence of death is related to lack of
early detection; 3) When diagnosed early,
the survival rate is more than 90 percent.5
Early detection
The main focus of Esposito’s article
* was early detection. Please be aware that
we at the Siletz Dental Clinic provide oral
cancer screenings. With every exam and
recall visit, you will receive an oral cancer
screening. This has been standard practice
in dentistry in general and specifically at
this clinic.
If you would like an oral cancer
screening, just ask. We also will provide
18
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Siletz News
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them at the Health Fair on June 29 from
3:30-6:30 p.m. (See page 7.)
28 cancer-causing ingredients
There are 28 cancer-causing agents in
chewing tobacco and snuff.6 Those chemi
cals cause changes to the cells they touch.
Those cellular changes are pre-cancerous
and generally have the following appear
ance: whitish roughness and grooves, later
changing to irregular folds with varying
depths with a surface coloring that is
white and/or yellow.
Those of you who chew tobacco prob
ably have noticed your own tissue changes
or we have shown them to you. They will
be found in the spots where the tobacco
is placed, usually between the teeth and
cheek or lip. These precancerous changes
are called leukoplakia.7
Incubation period of 10 years
Ninety percent of people with mouth
cancer are tobacco users.8 Now consider
that mouth cancer has a 10-year incuba
tion period.9 Thus, if you use carcinogenic
substance(s), it can take 10 years for
problems to begin to show in our bodies.
This is especially important to remember
when trying new products that contain
cancer-causing substances, like those
listed in this article.
All of these products contain nico
tine; a few have other item(s) that have
their own cancer-causing impact. With an
incubation period of 10 years, we won’t
have much data on the health effects of
these fairly new tobacco products for a
while yet.
Some people believe if you are not
smoking tobacco, you are not at risk of
cancer. False. “The lack of smoke gives
people the deception that these products
are safer ... As long as you’re getting
nicotine hits and irritation inside the
mouth, it is not any safer.”10
The only possible good side to these
smokeless nicotine products is there is
no secondhand smoke to increase risks
of cancer to nonsmoking people.
June 2011
My concern is the same as Esposito’s
regarding early detection - What will be
the signs, symptoms and health risks for
the long-term use of dissolvable nicotine
found in orbs/sticks/strips and possibly
other products to come?
Orbs, sticks and strips are prod
ucts manufactured by the R.J. Reynolds
Tobacco Company. Each one has nicotine
in it.
The products are flavored with cinna
mon or mint and resemble popular candies
such as Tic Taes.11A smoker of a cigarette
generally will receive about 1 milligram
of nicotine.12 Each Camel Orb, stick and
strip delivers about 0.6 to 3.1 milligrams
of nicotine.13
It’s not just the user who can be at
risk with these dissolvable products. If
they’re left lying around, a child might
pick them up thinking they are candy. An
adult might think they are candy and give
them to a child.
Here are the numbers that support
these concerns - 13,705 cases of tobacco
product ingestion reported to poison
control centers and 70 percent involved
infants 1 year of age or younger.14 Small
children can experience nausea and
vomiting from as little as 1 milligram
of nicotine.15
Hookah products arrived here from
the Far East, India, China and East Africa.
The hookah, also called a water-pipe,
allows the smoke from tobacco to pass
through water to be cooled.
There are cafés in Oregon - two
in Eugene and six in Portland - where
you can share a hookah experience with
friends. Dr. Saxton has been told there
is sugar added along with the flavoring.
Betel nuts are really areca nuts
(from the areca palm) wrapped in betel
leaves. They are chewed for a mild
stimulant that causes a mild hot sensa
tion in the body and slightly heightened
alertness. The effects vary from person to
person - the reaction has been compared
to drinking a cup of coffee.16
Often the betel nut is mixed with
tobacco, lime and/or flavorings and
spices.17 The effect on the body of the
betel nut now will have the added effect
of nicotine and the lime to enhance
both effects.
There is archaeological evidence that
betel leaves have been chewed along with
the areca nut since very ancient times.18
Both continue to play important roles in
many cultures, including those in India,
Vietnam and New Guinea. In Vietnamese,
the phrase “matters of betel and areca” is
synonymous with marriage.
One last comment on betel nuts:
Chewing them causes the saliva to turn
red. Repeated chewing of betel nuts
causes the chewer’s teeth to turn black.
Check out the Wikipedia sites listed below
for pictures, including pictures of orbs
next to a pack of Tic Taes.
Back to chew. Which one is not a real
name for chew? Well, they all are. Here
are a few more: dipsky, pinch, wad and
chewpoos.
http://en.wikipedia.org/wiki/chewing_tobacco
The Velscope by Marissa Esposito, ADHA
Access magazine, March 2011, p 6
3
Petrosky R. Velscope-cancer screening, 2010.
Available at www.drpetrosky.com/velscope.
htm. Obtained from ADHA Access, March
2011,p6
4
The Velscope by Marissa Esposito, ADHA
Access Magazine, March 2011, p. 6
5
Ibid
6
http://cancer.gov/cancertopics/tobacco/
smokeless-tobacco
7
http://cancer.gov/cancertopics/factsheet/
Tobacco/smokeless, last viewed 5/4/11
8
Ibid
9
Ibid
10 Emerging Tobacco Products, by Josh Snyder,
ADHA Access, March 2011, p. 12
11 www.pediatrics.org, download May 4, 2011,
from the American Academy of Pediatrics
webpage
12 http://tobaccoproducts.org/index.php/Camel_
Sticks,_Camel_Orbs_and_Camel_Strips
13 Ibid
14 http://pediatrics.aappublications.org/cgi/
content/full/125/5/896
15 Big Tobacco Harms Innocent Children with
Nicotine Pellets, April 19, 2011, course:
Harvard School of Public Health; http://
sciencecodex.com/tobacco
16 http://en.wikipedia.org/wiki/Areca_nut
17 http://en.wikipedia.org/wiki/Betel
18 http://en.wikipedia.org/wiki/Betel
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