Muslim Khan, Qiam Ud Din, Abdus Salam, Qiam ud Din.
Niswar as a risk factor in the aetiology of oral cancer.
J Pak Dent Assoc Jan ;16(2):77-81.

OBJECTIVE: Squamous Cell Carcinoma (SCC) is the most common malignant epithelial tissue neoplasm of the oral cavity which is derived from the stratified squamous epithelium. The oral cancer is an important cause of morbidity and mortality. Oral Squamous Cell Carcinoma is a common problem in the region because of use of smokeless tobacco in the form of niswar, low socio-economics, lack of dental motivation, bad oral hygiene and delay in consultations. PATIENTS AND METHODS: A total of 100 patients of Oral Squamous Cell Carcinoma were collected for a period of one year i.e., from August 2004 to July 2005 to determine niswar dipping as a risk factor in the aetiology of the oral Squamous cell carcinoma through history taking, clinical examination and histopathological confirmation. Amongst these 100 patients 76 were males and 24 females. Male to female ratio was 3.16:1. The age range was 26-75 years, with the mean age of 61.57 years; SD +11.5. RESULTS: While the most commonly involved age group was 7th decade of life (40%), followed by 6th and 8th decade i.e., 28% and 16% respectively. 80% of the patients had a positive history of snuff (Niswar) dipping, while 20% had not. Amongst the snuff (niswar) dippers 80% of the patients developed the lesion at the site where niswar was placed (primary site), while 20% developed the lesion elsewhere in the mouth where niswar was not placed (secondary side). Mandibular left gingivolabial sulcus was the most common site of oral Squamous Cell Carcinoma (48.75%), which was also the most common site of niswar dipping in both male and female patients. Amongst the secondary sites the most commonly involved site in niswar dipper patients was posterior lateral border of the tongue (11.25%), followed by retro-molar trigone (4%) and buccal mucosa (3.75%). CONCLUSION: Among the non-snuff dippers the most common sites, where the lesion has developed were Maxillary right buccal and labial sulcus (20%) and anterior hard palate (20%)

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