I had met this man aged 67years two days ago. He had come to me with the chief dental complaint of shaky two teeth which have been identified with arrows in this picture.
As his mouth was not normal looking — it shows signs of tobacco-related oral mucosal lesion, mouth pre-cancer also called Oral Leukoplakia to be precise. As expected he told me that he has been using tobacco-lime mixture for the last 30years now and is using this particular site of the mouth to dip that tobacco mixture inside the lips and cheeks.
Soon he satisfied my curiosity how come he started so late! He told me that he has been smoking bidis (indian cigarettes) since childhood. However, when he started suffering from cough, his father gave him a ‘valuable advice’ — he was told by his dad to stop smoking bidis and switch over to chewing tobacco (spit tobacco) instead.
Naturally i was surprised to hear that. Spontaneously i uttered — ‘your dad made a big mistake!’. He then tried to explain what his dad’s vision was. His father told him that if he was smoking bidis he was carrying smoke inside your body –but he can safely start using chewing tobacco — no hassles of taking anything inside, just placing some tobacco inside the lips and cheek and just spitting after sometime, his dad told him. His dad himself was very fond of chewing tobacco, this patient told me.
This post highlights the lack of awareness amongst masses about the harmful effects of various forms of tobacco. There are a lot of myths regarding various forms of tobacco use. In India cigarette is considered safer than poorman’s bidi. However, it is misbelief. Even i have a number of my own relatives who had been taking costly brand of cigarettes for decades and when the cough like symptoms become too apparent, they have been switching over to Bidis thinking it as a safer choice. No, it’s not!
I heard from this man for the first time how his father ignorantly thought chewing tobacco even a safer alternative as compared to poor man’s bidi.
I think enough of their story –let me come to the point. His all the dental and oral problems are because of tobacco only. The condition of his mouth that are looking at in the above picture is known as Oral Leukoplakia –which is pre-cancerous white lesion of the mouth. It means it has potential to turn into mouth cancer. The most important for this man is to quit his dad’s old advice along with that tobacco ‘box’ also called Chunotiya — one side carries tobacco and other side has lime which is replenished as and when required.
This man has been motivated to leave tobacco with immediate effect –he has promised also. When he was telling about his dad, he also told me about his younger brothers who, he said, are addicted to so many things which are easily available in the part of India he belongs to – he named ganja, opium, desi daru (country liquor) — he named quite a few others i don’t remember. I wonder why he told me all this — was he telling me that he is holier than others? Perhaps!!