Chronic oral non-healing ulcer with a history of tobacco consumption leads to malignancy: A prospective cross-sectional study in Western Maharashtra, India

Abstract

Oral ulcerations are more frequently seen in day-to-day dental practice nowadays. These ulcers are usually ignored in initial presentations. The oral mucosa has a good healing prospectus and hence nonmalignant lesions heal fast. The oral ulcers that don't heal form a significant number and are presented to dental clinics for evaluation. Usually, oral ulcers with a habit of tobacco consumption are frequently encountered. Tobacco has been traditionally used in India in various forms like smoking and chewing. But nowadays tobacco has been mixed with many adjuncts and used. They are commercially sold as gutkha pouches. Usually, individuals are exposed to tobacco at a very young age and eat for a longer duration of lifespan (i.e. start young and eat old). This has led to alteration in the oral mucosal defense mechanism and chances for potential malignant conversion are enormous. India has the highest incidence of oral cancer in the world and tobacco is one of the major cause of oral cancer. Hence, in this study, we evaluated patients reporting with chronic oral non-healing ulcers and having tobacco habits for their malignant conversion. Patients reporting to Sharada Dental Hospital Miraj during a period of 5 years from 2017 to 2022 were included in the study. A total of 250 patients with chronic nonhealing ulcers belonging to the semi-urban district of Sangli in Western Maharashtra (India) were studied. All these patients had a positive tobacco consumption history and presented with oral non-healing ulcers with a duration of more than 2 months. An incisional biopsy was taken from the suspected lesion and sent for histopathological evaluation. : A total of 250 patients with tobacco habits were presented with oral non-healing ulcers during the study period. A biopsy was performed for all suspected cases. Out of 250 patients, 201 patients had Squamous cell carcinoma and the other 49 were hyperkeratosis, inflammatory fibrous hyperplasia, irritational fibroma, Pyogenic granuloma, and angiomatous hyperplasia. Among 201 OSCC cases, 162 (80.59%) were males and 39(19.4%) were females. From our study, we can say that chronic oral non-healing ulcer with a positive tobacco consumption history is more likely to be a squamous cell carcinoma.