Bengaluru oncologist warns urban Indian women not to ignore non-healing mouth ulcer, explains its link to oral cancer

Oral cancer among urban Indian women often starts with persistent mouth ulcers, Dr Shruthi S says. Watch out for these warning signs and triggers.

Persistent mouth ulcers in women should no longer be dismissed as minor irritations – these are increasingly being recognised as the potential first sign of a worrying rise in lip and oral cavity cancers among urban Indian women.

Dr Shruthi S also highlighted how poor oral hygiene exacerbates the danger. (Freepik)

In an interview with HT Lifestyle, Dr Shruthi S, consultant, surgical oncology, Fortis Hospital, Bannerghatta Road, Bengaluru, highlighted this evolving health crisis, noting a departure from the historical trend where these cancers were predominantly observed in men and rural populations.

Warning signs you shouldn't ignore

She said, “A mouth ulcer that refuses to heal could be more than a minor irritation. Increasingly, we are seeing a worrying rise in lip and oral cavity cancers among women in urban India, a shift from the earlier pattern where these cancers were mostly seen among men and rural populations. Many women delay seeking help because they think the ulcer is due to acidity, stress, vitamin deficiency, or accidental biting, when in reality, it can be the first sign of cancerous change.”

Beyond tobacco: new drivers of oral cancer

Although tobacco chewing remains a dominant risk factor, Dr Shruthi identified several 'newer triggers' contributing to the rise in female patients: “While tobacco chewing remains a major cause, newer triggers are emerging. Continuous exposure to sun, especially on the lips, passive smoking at home, increased alcohol intake, HPV infections, and poor nutrition have also contributed to the rise.”

Overlooked triggers for oral cancers

According to the doctor, one of the most significant and overlooked triggers for oral cancers in women stems from sources inside the mouth: chronic mechanical irritation – this constant, low-level physical trauma can lead to cancerous changes over time.

Dr Shruthi said, “One of the most overlooked triggers for lip and oral cancers in women is chronic mechanical irritation inside the mouth. When a sharp tooth edge, a broken filling, or an untreated cavity repeatedly rubs against the same spot, the skin inside the mouth becomes inflamed and fragile. Over time, this constant friction can lead to repeated injury to the cells lining the mouth. If this condition persists for months, it can lead to abnormal cell growth, which may eventually develop into cancer. Similarly, long-term ill-fitting dentures can also rub against the gums and inner cheeks.”

Dr Shruthi pointed out that many women inadvertently delay seeking specialist help, often attributing the persistent ulcer to common, non-cancerous causes. This delay, fuelled by self-diagnosis, allows the potentially malignant condition to progress unnoticed.

“Many women think the discomfort is normal or tell themselves they will 'adjust to it', but the irritation only worsens over time. In such cases, ulcers continue to form in the same place, and healing becomes slower. This continuous cycle of injury and incomplete healing is a significant risk factor yet is rarely recognised,” she said.

When to see a specialist?

Dr Shruthi stressed that any mouth ulcer that persists for longer than 2–3 weeks requires an immediate check-up by a specialist. She detailed the key warning signs for oral and lip cancer:

● Persistent sore or ulcer irrespective of whether pain is present or not

● White or red patches inside the mouth

● Difficulty in opening the mouth

● Sudden loss of tooth

Poor oral hygiene multiplies the risk

Dr Shruthi also highlighted how poor oral hygiene exacerbates the danger. “Poor oral hygiene adds another layer of risk. When teeth are not cleaned properly, bacteria accumulate, leading to chronic gum infection, bad breath, and inflammation. Constant infection weakens the tissues and reduces their ability to repair themselves. The combination of irritation plus bacterial inflammation makes the environment inside the mouth more vulnerable to cancerous changes,” Dr Shruthi said.

To prevent serious complications, she advised regular dental check-ups, timely fillings, correcting sharp teeth, and replacing loose dentures. She concluded, “Regular dental check-ups, timely fillings, correcting sharp teeth, and replacing loose dentures can prevent serious complications later. Any ulcer caused by chronic irritation must be reviewed and treated early, not managed casually at home.”

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.