A Cause of Cancer — that No One Told You About
Trauma caused by sharp teeth is frequently debated in the sciences, and many perspectives prevail. While some doctors are confident that this could be risky, few argue that it is still a myth.
In this piece, I want to take you on a journey about why this condition is still an enigma despite much evidence.
There are interesting case reports that emphasize that sharp teeth can precipitate ulcers which later evolve into cancers — depending on the chronicity (frequency) of injury.
While this evidence seems compelling, case reports are considered a lower level of evidence in medicine.
There needs to be a more systematic study to prove if a specific agent is responsible for cancer. Generally, the findings should be verified in a controlled setting on multiple patients. This is why case-control studies are preferred. There are some available, but more is good.
Doctors are still figuring out ways to understand the basic biology surrounding trauma associated oral cancers.
There is also another facet to this story. Patients usually do not recollect when the injury started — this is one of the inherent limitations of trauma studies. However, suppose the patient strongly recalls persistent irritation (months) before an ulcer. In that case, oral cancer could be directly attributed to this stimulus only. It is often observed that the more the trauma — the higher the likelihood of cancer (years of trauma>months of trauma>days of trauma).
Usually, in the clinical setting, spotting a (non-healing) ulcer or a suspicious growth near a sharp tooth is a crucial finding.
It is also vital to look into what animal studies are saying. A small group of Argentinian researchers tried to solve this problem by experimentally inducing chronic traumatic ulcers in hamsters. This study revealed that chronic irritation could accelerate tobacco and alcohol-induced carcinogenesis. This means — trauma has a typical enhancing effect.
Although this animal study informs us of crucial insights about trauma, we should understand that animal studies don’t necessarily mimic all aspects, and real-time clinical situations can differ significantly.
This is why we have to also rely on clinical studies and integrate all pieces of evidence (animal and human studies).
In humans, trauma could be more than a passive amplifier. I say this because many patients who develop trauma-associated oral cancers do not smoke or consume alcohol. Some do, but many don’t.
Here is the biggest twist in the trauma tale — although the evidence is inconclusive — we cannot ignore it. This is why clinicians have been striving to alert academia about this mysterious entity.
From experience and intuition, many dentists know that sharp tooth can be potentially dangerous and has to be corrected. Therefore, don’t miss a dental appointment if you have one.
If you wish to know more about trauma and its risks —do read the first part:
