What Causes Oral Cancer?

By Premier Dental of Ohio

How an oral health screening can diagnose oral cancer

Common Oral Cancer Causes

Oral cancer is a disease that kills approximately one person every hour. There are some cases (less than ten percent) that do not have an identifiable cause. In the majority of cases, there is a specific identifiable cause or causes. This means that in most cases, we can prevent oral cancer from occurring by avoiding the various causes.

In this article, we will highlight the known causes of oral cancer, their impact on the risk for oral cancer and overall health, and how you can avoid them.


Smoking cigarettes, cigars or pipes is definitely linked to oral cancer.  One study found that eight out of every ten oral cancer patients is a smoker. Tobacco smoke contains thousands of harmful chemicals, more than seventy of which are known carcinogens (cancer causers).   

Tobacco leaves contain radioactive particles, and those who smoke for the majority of their life end up receiving very high doses of radiation from it.

The nicotine in tobacco causes a variety of adverse health effects all over the body. It constricts blood vessels, making it difficult for the body to heal from injuries or infections. It greatly increases your risk for many types of cancer, including lung cancer, oral cancer, bladder cancer, and others.  

There is nothing good about smoking. According to Johns Hopkins, those who smoke are 10 times more likely to get oral cancer than those who have never smoked.

Smokeless Tobacco

Smokeless tobacco includes chewing tobacco and dip. Some would also include the habit of chewing on a cigar in this category since the cigar remains unlit.  

Smokeless tobacco contains many of the same carcinogens and toxins as smoked tobacco. The effects of smokeless tobacco are interesting in that they work directly on the oral tissues. For example, “dip” smokeless tobacco leaves visible tissue changes in the pouch where the user most frequently places it.  

Those surface tissue changes can develop into oral cancer over time as the cells are continually harmed by the tobacco product.

It is important to understand that smokeless tobacco does not just harm the oral cavity. It greatly increases the risk for bladder cancer as well. This is because the tobacco mixes with the saliva, and the user often swallows it. The chemicals in the tobacco end up in the bladder, where they can cause surface damage that leads to cancer there, too.


The use of electric cigarettes, also called e-cigs, vape pens or Juuls, has skyrocketed in recent years, especially among people under the age of twenty. These devices vaporize nicotine and other chemicals into an inhaled substance without burning them the way that traditional smoking does. Because these devices and the trend is relatively new, more research is necessary to understand exactly how they affect the human body.  

There is preliminary research linking vape usage to a higher risk for oral cancer, but the link is not well understood at this time. Most likely, it is similar to the way in which tobacco causes increased cancer risk: toxic chemicals.

Vape pens use an electric source, usually a small battery, to vaporize the liquid into a substance you can inhale. These chemicals can damage cells in the oral cavity, lungs, and other areas of the body. One study found that vaping does increase the risk for oral cancer.


Alcohol intake is another risk factor for oral cancer.  Those with heavy alcohol use (more than twenty-one alcoholic drinks in one week) have a significantly increased risk for oral cancer over non-drinkers. Alcohol abuse is the second largest risk factor for oral cancer.

Interestingly, those who use tobacco and drink alcohol regularly have an exponentially higher risk for developing oral cancer, as these two risk factors seem to combine synergistically.

Alcohol dries out the tissues and surface cells in the mouth. This makes it easier for the cancer-causing chemicals in tobacco to enter the cells. Alcoholics tend to suffer from nutritional deficiencies, which reduces the body’s immune response against this type of damage.

Alcohol can have other harmful effects on the body, including damage to the tissues in the liver, GI tract, and brain. We also must include the risk of injury due to drunk driving, or even walking. 

Sun Exposure

Many people forget that the lips are part of the oral cavity. One relatively common type of oral cancer is “skin” cancer on the lips. This type of cancer results from the same cause as most types of skin cancer: exposure to harmful UV rays from the sun.

Those who work outside or spend many hours in the sun each day have a high risk for developing cancerous lesions on the lips. The effects of sun exposure are cumulative over time, so the risk for oral cancer on the lips increases with age.

Human Papilloma Virus

Infection with HPV is a relatively new risk factor for oral cancer. Human Papilloma Virus is a sexually transmitted infection affecting millions of Americans. The virus has many different strains, and only a few of these strains are associated with oral cancer.  

Studies show that HPV is causing oral cancers in people who are younger than the traditional oral cancer patient is. It also leads to oral cancer lesions in different areas of the mouth.

HPV-related oral cancer typically occurs at the back of the mouth, near the throat. Traditional oral cancers are more common on the lips, cheeks, tongue, and floor of the mouth. This makes HPV-related oral cancer more difficult to detect during a home screening.

Not everyone with HPV will develop oral cancer.  In fact, most people will clear HPV from their body within two years of infection. Only certain strains increase the risk of HPV-related oral cancer. It is important to know whether you have this virus, and your doctor can test for it via bloodwork.

How Can I Reduce my Risk for Oral Cancer?

You can reduce your personal risk for oral cancer by taking measures against each of the causes we described above. Oral cancer has traditionally been known as a “lifestyle” cancer because of the high risk caused by heavy alcohol and tobacco use. We can add to this the new factor of HPV infection, that having a large number of sexual partners also affects the risk for oral cancer.

In order to reduce your risk for oral cancer, you should do the following:

  • Stop smoking.  
  • Quit using smokeless tobacco.
  • Stop vaping.
  • Enjoy alcohol in moderation only.
  • Protect your lips from sun exposure by wearing a chapstick that contains SPF 15 or greater.
  • Practice safe sex, and limit your number of sexual partners.

The other step to reducing risk is to get get an oral cancer screening. Since they examine your mouth regularly, your dentist is the best person to do this.

More Questions about Oral Cancer?

Call your nearest Premier Dental of Ohio location today to schedule an oral cancer consultation. Our knowledgeable doctors will perform an oral cancer screening and risk assessment. We will also make recommendations for any needed dental treatment to stop and repair active dental disease. Fighting oral cancer also involves maintaining great oral health throughout your lifetime. We love helping our patients do just that.

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