The role of oral habits in the incidence of oral and jaw cancers and their surgical treatment

Oral and jaw cancers, particularly oral squamous cell carcinoma (OSCC), constitute a significant clinical challenge within the field of maxillofacial surgery. In recent decades, the role of deleterious oral habits as independent or synergistic etiological factors has been increasingly recognized.

Key risk factors include:

• Chronic use of tobacco and alcohol (with a synergistic carcinogenic effect)
• Chewing of tobacco-related substances such as betel quid, nas, and areca nut
• Poor oral hygiene and chronic mechanical irritation (e.g., ill-fitting dentures)
• Parafunctional habits such as bruxism and habitual cheek or tongue biting

These habits promote carcinogenesis through mechanisms such as chronic epithelial irritation, persistent inflammation, oxidative stress, and mutations in tumor suppressor genes like p53, ultimately leading to neoplastic transformation.

Surgical resection with adequate margins remains the mainstay treatment for OSCC. The choice of surgical approach depends on the tumor's size, location, depth of invasion, and involvement of adjacent structures. Common surgical modalities include:

• Local or segmental mandibular resections
• Partial or total maxillectomy
• Elective or radical neck dissection for regional lymphatic spread
• Functional and esthetic reconstruction using regional or free microvascular flaps (e.g., fibular free flap, radial forearm flap)

Prognosis is largely determined by the tumor stage, margin status, and presence of cervical lymph node metastases.

In conclusion, high-risk oral habits play a critical role in the pathogenesis and progression of oral and jaw cancers. Early identification of premalignant lesions and modification of behavioral risk factors are essential for disease prevention. In advanced stages, radical surgical management combined with comprehensive

reconstructive strategies is essential for achieving both oncologic control and functional rehabilitation.