Dental Tribune United Kingdom Edition

March 26-April 1, 20124 News United Kingdom Edition N ew figures from Can- cer Research UK have revealed that the num- ber of oral cancer cases di- agnosed each year in the UK has risen above 6,000 for the first time. A decade ago there were more than 4,400 cases of oral cancer. Now the latest figures show this has risen to more than 6,200. Around two thirds of cases are in men. Oral cancer rates in the UK have risen by around a quarter in the last 10 years from around six to eight cases per 100,000 people. Experts believe that infec- tions with high-risk strains of the human papillomavirus (HPV) may be a key reason for the jump in cases of oral cancer. HPV infections are common with up to eight out of 10 people in the UK infected at some point in their lives. Infections are usually on the fingers, hands, mouth and genitals. Many strains of the virus cause infections that are harmless and get better on their own. Most people will nev- er know they had the virus. But a few strains of HPV are known as high-risk. If these strains persist they can lead to cell changes which could de- velop into cancer. One of these high-risk strains is HPV-16. Richard Shaw, a Cancer Re- search UK expert in head and neck cancers, based at the Liv- erpool Cancer Research UK Centre, said: “We have seen a rapid increase in the number of HPV16-positive cases of oral cancer. We have also noticed that patients with HPV-related oral cancers tend to be younger, are less likely to be smokers and have better outcomes from treat- ment than those whose tumours show no evidence of HPV. “This raises questions as to exactly how these cancers de- velop and why they only affect a small proportion of people who are exposed. “As HPV-related cancers ap- pear to behave quite differently, the Liverpool Cancer Research UK Centre is also involved in Cancer Research UK-funded clinical trials to improve treat- ments.” Traditionally, the main risk factors for oral cancer have been tobacco and alco- hol. Oral cancers tend to take at least a decade to develop so look- ing at lifestyles 20 to 30 years ago can help understand the rise in cases. Over the last 30 years, smok- ing rates in Britain have more than halved. And while figures show that the amount of alcohol bought in the UK over the last 20 years has increased by seven per cent – this is unlikely to be a large enough increase to explain fully the rise in the rates of oral cancers. Experts say this suggests oth- er risk factors may be playing a role – in particular HPV. There were particularly sharp rises in the incidence rates of cancers at the base of the tongue (almost 90 per cent increase) and the tonsil (around 70 per cent increase) – two areas of the mouth where cancers are more commonly HPV-related. SaraHiom,directorofinforma- tion at Cancer Research UK, said: “It’s worrying to see such a big rise in oral cancer rates. But like many other cancers, if oral cancer is caught early, there is a better chance of successful treatment. “So it’s really important for people to know the signs and symptoms of oral cancer - mainly mouth ulcers that just won’t heal, any lumps or thickening in the mouth, lips or throat, or red or white patches in the mouth that won’t go away. “It’s not just doctors who have a vital role to play. “Dentists have an important role to play in spotting oral can- cer early and encouraging their patients to take care of their mouths.” DT HPV pushes oral cancer cases past 6,000 a year I n response to news reports about the risk of tooth decay due to the inclusion of pure fruit juice in ‘five-a-day’ recom- mendations, the Infant & Toddler Forum (ITF) supports increased awareness about the sugar and acid content of juices, and the risk of enamel erosion and sub- sequent dental caries in young children. Kathy Harley, dean of the dental faculty at the UK’s Royal College of Surgeons, has been re- ported as saying that half of five year olds show signs of enamel erosion caused by fruit, particu- larly citrus fruits. She has called for schools to ban fruit juice and to offer milk and water instead. Younger children are also at risk; the first teeth are just as prone to dental caries as perma- nent teeth. It is important to take special care of a child’s mouth in order to prevent tooth decay and avoid dental extractions and fill- ings. Judy More, paediatric dieti- cian and member of the ITF, says: “Parents often think that tooth decay in children’s first teeth is not important as they will grow their adult set in any case. How- ever, the first teeth are just as important as adult teeth, as early loss of the first teeth can lead to overcrowding when adult teeth appear. “Fruit and vegetables are part of a nutritious, balanced diet but fruit is best given as pieces of fruit rather than as juice. Fruit juices are a source of vitamin C, helping with the absorption of iron from plant based foods; however, they are acidic, high-sugar drinks and can cause dental caries. The sugars in sweet foods and drinks are metabolised to acids by the bacteria in dental plaque. These acids, along with the acid already present in drinks like fruit juices, squashes and fizzy drinks, cause demineralisation or softening of the enamel. “If fruit juice is given as a drink it should be well diluted, for example one part juice to about six to ten parts water, and should only be served in a glass, cup or beaker, rather than a bottle. Sucking slowly on sweet drinks in a bottle increases the risk of tooth decay. Well diluted fruit juice, if given, should be with meals and snacks, and three-four oz or 100- 120ml is about right as a single drink portion for one-three year olds. Water and milk are the only drinks that should be offered be- tween meals and snacks.” DT ‘Five-a-day’ causing tooth decay Smoking has already been banned in hospital grounds A Cardiff-based charity, Tenovus, has called for an outright smoking ban in Wales. According to a BBC report, the call was requested on the same day that smoking was banned within the grounds of most Welsh hospitals. The report stated that six of the seven health boards in Wales decided to prohibit smoking in their grounds, whilst the remaining health board, Hywel Dda in Mid and West Wales, is in the process of developing a ban. Even though smok- ing shelters have been dis- mantled at hospitals where outright bans are being imposed, Richard Pugh, com- munity development manager for Tenovus, called for a much more radical approach - a to- tal ban on smoking. “We’ve tapped away at smoking here, smoking there - stop smoking in cars, in res- taurants, in public places,” he said in the BBC report. “Soon- er or later we will get to the point where we stop smoking altogether. “So it’s time to think about the bigger question - and let’s do it now.” Although Welsh govern- ment said it did not have the power to introduce an outright ban, it was reported that the Welsh government’s actions to tackle the harm caused by smoking remained a priority. A spokesman said the government’s ultimate vision was “of a smoke-free society for Wales, in which the harm from tobacco is completely eradicated.” Recently both the Welsh government and Tenovus pro- moted their Fresh Start Wales awareness campaign outside City Hall in Cardiff. The cam- paign aims to encourage par- ents and carers not to smoke in cars carrying children. Stop Smoking Wales will also be available to provide informa- tion on its smoking cessation service. DT Charity calls for outright smoking ban A ban on serving fruit juice in schools has been suggested to help prevent tooth decay in children 4 News