I have met online three others in this forum, who, like me have no accepted risk factors for presenting with cancer of the oral cavity, 3 of us tongue, one buccal. All four of us suspect chronic irritation, and, while we cannot prove the connection, each of us has our specific recollections of habits, etc, that we believe set up an irritation in the area affected.

My husband is a dentist who used to believe chronic irritation was not a bona fide cause for oral cancer. He now personally thinks differently.

Yes, I wish there was scientific research on this topic. When I participated in a nutrition survey for oral cancer patients recently, I thought to myself then how interesting and possibly helpful it would be if someone could survey patients to see if irritation played any role in their oral health.

Anne

I totally agree... I am a non smoker, non drinker, vegetarian who used to work out daily. In rads right now so my one hour work out has turned into 30 minutes and two daily dog walks with a yoga thrown in here and there. I had a bad molar on my left side for years... One visit to the dentist he noticed a white thickened patch and sent me to an oral surgeon they removed it.. Biopsied it... Came back as thickened skin - perhaps the hyperkeratosis? Brian mentioned? So once it was removed things seemed to be okay.. (this was 2002) it was sensitive in that area but no real problems. Jump ahead to 2005... I had a that bad molar capped ( it was merely a shell of a tooth before) from that point on my tongue was irritated - not badly but enough to be uncomfortable. I let it go thinking it was because of the molar... Though I had them file it down once or twice with no success. This went on for 2 - 3 years. I finally had a biopsy - I could feel the thickened mass there under my tongue but there was a large area of dysplasia too. Biopsy came back inflamed tissue. I then went and had that molar filed again, and I had allergy testing thinking it was related to the possibility that is was eating something I was allergic to. Well I'm allergic to a lot of things... This past summer I had the molar beside the capped one also capped... The situation with my tongue got worse, I finally had another biopsy - this one came back SCC. And the lesion was 1.5 x 2.5 cm. After I got the diagnosis I was looked at a few sites, and one of them actually listed chronic irritation as a cause of scc.

I totally believe that chronic irritation can cause cancer. That's what happens with lung cancer... Chronic inflammation leads to cell change. Also isn't that why cancers of the tongue, lip and oral mucosa are blamed on smoking? That's what smoking does, chronic inflammation, and irritation of the lungs mouth and lip ? Same principal different cause. I used to be a nurse and a, familiar with the workings of the body, so my first question of course was why?

There should be more studies on this.

My mother's doctor said that her tongue cancer was probably cause by chronic irritation too. My mother doesn't smoke nor drink. The doctor only notice that her left molar was extremely sharp, and my mother always hurt her tongue by biting into it.

When the lump on the underside of her tongue first appear, she thought that she must have bite into it again. And she used the evil mouthwash hoping that it will help with the healing, but after a few weeks, it's clear that the lump wouldn't go away on its own. And she started to have pain in the ear, and she just think that since she has DM, the wound might take a little bit longer to heal.

The ENT doc who dx her said that the cancer was caused by chronic irritation. While she can effectively repair the wound from biting when she was young, after 60 years of biting, something simply went wrong this time round.

I am curious how wide the upper arch of people who had SCC of the tongue. Mine is only 29mm, but i'm OK now as a third of my tongue had been excised. The upper arch is generally 38mm, measured from the lingual surfaces of the first molar to the other. Narrow arches are epidemic, we see them everyday at our practice. The resultant scalloped tongue is also linked to OSA.

Hi Jack and welcome to a fellow Aussie and dentist from the beautiful Gold Coast
As you can see by my signature my cancer was floor of the mouth.
However since then I now have constant issues between the flap and tongue (top).
While my last biopsy in March did show no malignancy part of the report did say...
�The underlying stroma is composed of fibrovascular connective tissue with a patchy perivascular chronic inflammatory cell infiltrate.
Diagnosis TIP OF THE TONGUE: CHRONIC HYPERPLASTIC CANDIDIASI."
My concern as it appears to be for others is that the chronic irritation can turn into cancer.
I am happy to send the whole report and photos' by PM or email and when I get a chance will try taking measurements.
Let me know if you need help adding a signature.
Gabriele

Ii think I have a pretty high arch in my mouth but I do have a cross bite and a narrower bite than most. Don't know if this helps.

ThanksCheryl.
A cross bite and high arch are definitely tell-tale signs of a narrow upper arch. The upper teeth should be outside the lower teeth when they meet together, like the lid covering the base of a box. A cross bite occurs when one or more of the upper teeth is inside the lower teeth, when biting, usually due to the narrowness of the upper arch.
I'm keen to get measurements of your upper arch, (and others), while somebody else can measure It intraorally with a ruler, it is most accurate if you have a model of your arch. Need to take an impression, though.
One of my colleagues has suggested that I should write an article and submit it to a dental journal, but I don't have access to a database, any suggestions?



Jack.

Very interesting about narrow upper arch and scalloped tongue being linked. Both my upper arch and jaw are narrow and my tongue is scalloped, particularly on the right side. I also have a pronounced linea alba on the left cheek. I've been wondering if this was a result of the Bell's Palsy I had on the left in 2002? Ever since then my left cheek lies very close to my teeth on the left and my tongue has tended to lie more to the right side of my mouth.

I've mentioned this to my dentist and everyone else but nobody seems to have a clue.

@Jacko- you might want to contact Dr. Brad Neville, he is the senior dental pathologist at the Medical University of South Carolina in Charleston. He might be able to give you some leads. He and surgeon Terrence Day wrote a very interesting article on oral cancer for an oncology journal a couple of years ago. I don't have the copy in front of me just now but you can access it on the web.

I can measure my arch as I do have plaster casts because of the flouride trays - how should I go about measuring it.

Cheryl,
I use a digital caliper to measure the width from the inside surface of the left first molar tooth to the inside surface of the right first molar. Otherwise use a ruler and do your best to get the most accurate reading. The ideal width should be 38mm.

Thank you Catherine for your suggestion re Dr Brad Neville, i've just started reading his excellent articles.
It's interesting about the Bell's Palsy. Nobody could know for sure, but it seems logical to think that the linea alba on the same side of the paralysis, was due to chronic irritation on that side, ie, cheek biting. In the absence of pain sensation due to biting, there is no protective mechanism for withdrawal. Re scalloped tongue on the other side, it means that the upper arch is too narrow to accommodate the tongue, ie it's 'squashed' against the teeth.

Jack