The most important aspect of treatment is the discontinuation of the habit. Surgery is usually the only treatment modality once the cancer has set in. Resection of the lower jaw results in cosmetic disfigurement.
Various methods for reconstruction and replacement have been used, such as the use of micro vascular anastomotic techniques for restoration by a composite flap. The dentures usually don’t fit well on the metal bar or the bone grafted mandibular defect. Thus adequate mastication becomes a problem. In most cases primary closure of the defect is preferred to protect the soft tissues. Tongue dysfunction is seen usually when floor of the mouth is involved. Flaps that are used to correct the defects usually contract resulting in scar tissue formation that restricts the movement of oral tissues resulting in problems in speaking, drinking and eating. Radiation therapy is sometimes employed for the treatment of oral cancer but it has its own complications such as burning of tissues, reduced saliva, etc.
The 5 year survival rate of patients with oral cancer is only 50%. That means half the people who get oral cancer due to tobacco including smokeless tobacco die within five years. There is correlation between the stage of lesion, age and sex of the patient, location of the lesion and duration and type of smokeless tobacco product use. The disease is progressive, and associated with leukoplakia, and high local activity, mandibular involvement and metastasis.
Despite aggressive treatment, morbidity is high with respect to cosmetic effects, mastication, deglutition and related health problems and other dental complications.