Effects of Chewing Tobacco Use...

If you use spit tobacco, here’s what you might have to look forward to:

• Cancer. Cancer of the mouth (including the lip, tongue, and cheek) and throat. Cancers most frequently occur at the site where tobacco is held in the mouth.
• Leukoplakia. Whoa, what’s this? When you hold tobacco in one place in your mouth, your mouth becomes irritated by the tobacco juice. This causes a white, leathery like patch to form, and this is called leukoplakia. These patches can be different in size, shape, and appearance. They are also considered pre-cancerous. If you find one in your mouth, see your doctor immediately!
• Heart disease. The constant flow of nicotine into your body causes many side effects including: increased heart rate, increased blood pressure, and sometimes irregular heart beats (this leads to a greater risk of heart attacks and strokes). Nicotine in the body also causes constricted blood vessels which can slow down reaction time and cause dizziness, not a good move if you play sports.
• Gum and tooth disease. Spit tobacco permanently discolors teeth. Chewing tobacco causes halitosis (BAD BREATH). Its direct and repeated contact with the gums causes them to recede, which can cause your teeth to fall out. Spit tobacco contains a lot of sugar which, when mixed with the plaque on your teeth, forms acid that eats away at tooth enamel, causes cavities, and chronic painful sores.
• Social effects. The really bad breath, discolored teeth, gunk stuck in your teeth, and constant spitting can have a very negative effect on your social and love life. An even more serious effect of spit tobacco is oral cancer, and the surgery for this could lead to removal of parts of your face, tongue, cheek or lip.

Symptoms of Using Chewing Tobacco

Check your mouth often, looking closely at the places where you hold the tobacco. See your doctor right away if you have any of the following:

• a sore that bleeds easily and doesn’t heal
• a lump or thickening anywhere in your mouth or neck
• soreness or swelling that doesn’t go away
• a red or white patch that doesn’t go away
• trouble chewing, swallowing, or moving your tongue or jaw
• even if you don’t find a problem today, see your doctor or dentist every three months to have your mouth checked. Your chances for a cure are higher if oral cancer is found early.

Introduction to Leukoplakia

Leukoplakia is a condition in which thickened, white patches form on your gums, on the inside of your cheeks and sometimes on your tongue — usually as a result of chronic irritation. Tobacco, either smoked or chewed, is the main culprit, but irritation can also come from ill-fitting dentures and long-term alcohol use.

Although anyone can develop leukoplakia, it's most common in older men. People with compromised immune systems sometimes develop an unusual form of the disorder called hairy leukoplakia.

In general, leukoplakia isn't painful, but the patches may be sensitive when you touch them or eat spicy foods. And though the disorder usually isn't dangerous, it can be serious. A small percentage of leukoplakic patches show early signs of cancer, and many cancers of the mouth (oral cancers) occur next to areas of leukoplakia. For that reason, it's best to see your dentist if you have unusual changes in your mouth lasting longer than a week.

Signs and symptoms

Leukoplakia first appears as flat, gray sores — usually on your gums or on the insides of your cheeks and sometimes on your tongue. Over weeks or months, leukoplakic sores develop into patches with the following characteristics:

• White color
• Thick, rough texture
• Hardened surface

Sometimes you may also have raised red lesions (erythroplakia), which are more likely to show precancerous changes.

A type of leukoplakia called hairy leukoplakia primarily affects people whose immune systems have been weakened by medications or disease, especially HIV or AIDS. Hairy leukoplakia causes fuzzy, white patches that resemble folds or ridges on the sides of your tongue. It's often mistaken for oral thrush — an infection marked by creamy white patches on the pharynx and the insides of the cheeks that's also common in people with HIV/AIDS.

Risk factors

Tobacco use puts you at high risk of oral cancer as well as leukoplakia, and drinking alcohol together with smoking further increases your risk. More men than women develop leukoplakia, mainly because men are more likely to both drink alcohol and smoke. On the other hand, women with leukoplakia tend to show more cancerous changes in their mouth tissues than men do

When to seek medical advice

Sometimes mouth sores can be annoying or painful without being harmful. But in other cases, mouth problems can indicate a more serious condition. For that reason, see your dentist if you have any of the following:

• Sores inside your mouth that haven't healed within a week
• Lumps or white, red or dark patches in your mouth
• Persistent changes in the tissues of your mouth

Screening and diagnosis

Most often, your dentist diagnoses leukoplakia by examining the patches in your mouth and ruling out other possible causes for your symptoms. To help ensure that no early signs of cancer exist, your dentist may perform an oral brush biopsy — removing some cells from the leukoplakic patches with a small brush. The test takes just minutes and requires no anesthesia. The scrapings are then analyzed in a laboratory using a highly specialized imaging system that allows a pathologist to detect a single abnormal cell among hundreds of thousands of healthy cells.

A negative report means no abnormal cells are present. If the report is positive, your dentist is likely to perform another biopsy by removing a small tissue sample and sending it to a laboratory for analysis.

Complications

Leukoplakia usually doesn't cause permanent damage to tissues in your mouth and frequently goes away once you remove the irritating factors. Some sores may become infected, however, or cause ongoing discomfort.

Oral cancer is the most serious complication of leukoplakia. A majority of oral cancers form in the vicinity of leukoplakic patches, and the patches themselves may show cancerous changes. Hairy leukoplakia, on the other hand, isn't painful and isn't likely to lead to cancer. But it may indicate the presence of HIV infection or AIDS.

Treatment

Leukoplakia is usually treated by removing the source of the irritation. For most people, stopping smoking or correcting dental problems clears the condition. When this isn't effective or if the lesions show early signs of cancer, your dentist may choose to remove leukoplakic patches using a scalpel, laser or cryoprobe, an extremely cold probe that freezes and destroys cancer cells.

Researchers are investigating the effects of retinoids — derivatives of vitamin A that are used to treat severe acne and other skin conditions — on leukoplakia. Although they appear effective against leukoplakia, retinoids may cause side effects, even when used topically. Beta-carotene, an antioxidant that's converted to vitamin A in your body, may also completely or partially reduce leukoplakic patches.

Treating hairy leukoplakia
Not all cases of hairy leukoplakia require treatment, and your doctor or dentist may take a wait-and-watch approach. If you need treatment, several options are available:

• Systemic medications. These include antiviral drugs such as valacyclovir and famciclovir, which prevent the Epstein-Barr virus from replicating but don't eliminate it from your body. Treatment with antivirals can clear leukoplakic patches within a week or two, but symptoms often return once therapy stops.
• Topical medications. These include podophyllum resin solution and tretinoin (retinoic acid). Podophyllum solution is a mixture obtained from the dried rhizomes and roots of two common plants. When applied topically, it can heal leukoplakic patches, but it may cause some discomfort and affect your sense of taste. In addition, the patches often return several weeks after being treated. Retinoic acid, a vitamin-A derivative, seems to inhibit the replication of the Epstein-Barr virus, but as with other treatments, hairy leukoplakia often returns when the treatment ends.

Prevention

Most often, you can prevent leukoplakia by following these suggestions:

• Stop using tobacco products. Avoiding all tobacco products is one of the best steps you can take for your overall health as well as one of the main ways to prevent leukoplakia. Talk to your doctor about methods that can help you quit. And if friends or family members continue to smoke or use spit tobacco, encourage them to have dental checkups at least two or three times a year. Oral cancers are usually painless until fairly advanced.
• Avoid or limit alcohol consumption. Alcohol is a factor in both leukoplakia and oral cancer. Combining alcohol and smoking greatly increases your risk of both diseases because alcohol makes it easier for the harmful chemicals in tobacco to penetrate the tissues in your mouth.
• Get needed dental treatment. See your dentist regularly. Smoothing rough edges on your teeth and realigning badly fitting dentures can help prevent leukoplakia.
• Eat plenty of fresh fruits and vegetables. These are rich in antioxidants such as beta-carotene, which reduce the risk of leukoplakia by deactivating harmful oxygen molecules before they can damage tissues. Rich food sources of beta-carotene include dark yellow, orange and green fruits and vegetables, including carrots, pumpkin, squash, cantaloupe and spinach.

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