The oral mucosa is the soft tissue that is lined with the surface of the oral cavity that communicates with the outside world, which not only bears the pressure, slashing force, pulling force and friction generated during the chewing process on the surface of the oral soft tissue, but also resists the external mechanical stimulation and restricts the invasion of microorganisms and toxic substances.
Oral mucosal disease refers to diseases that occur in the soft tissues of the oral mucosa, including ulcer diseases, blistering diseases, etc. With the development of the economy and the improvement of people's awareness of oral health, the incidence of oral mucosal diseases has increased, and the incidence of oral mucosal diseases has also shown an upward trend.
Oral mucosal disease not only affects the daily physiological activities of patients such as eating, swallowing, and speaking, but also indirectly affects the patient's sleep and the treatment of oral related disciplines, resulting in a decrease in quality of life.
For example, in patients with Sjögren's syndrome, due to the reduced saliva flow, the erosion of oral tissues is reduced, resulting in the accumulation of a large amount of food debris around the oral implant, causing peri-implantitis, and in patients with lichen planus, implant restoration is often not possible because the quantity and quality of alveolar bone do not meet the requirements of implant restoration.
There are many kinds of oral mucosal diseases, and the causative factors are complex, and poor dietary Xi is one of them.
For example, long-term chewing of betel nut can lead to the occurrence of oral submucosal fibrosis and even cancer; drinking a large amount of alcohol will increase the permeability of the oral epithelium, increase the invasiveness of harmful substances, and cause mucosal damage; long-term tobacco use will damage the immune function of the oral mucosa and cause the occurrence of oral cancer.
As a stimulus, high temperature is thought to be closely related to the occurrence and development of esophageal cancer. A high-temperature diet can damage the esophageal mucosa, cause inflammation of the esophageal epithelium, and ultimately promote the development of esophageal cancer. The oral cavity is the beginning of the digestive tract and the first place where food comes into contact, and the influence of temperature on its mucosa cannot be ignored, but the effect of high temperature on the oral mucosa is still unclear.
The appropriate temperature is the basis for the function of cells, and the static and closed mouth temperature in the oral cavity is about 36°C-37°C. Whether different temperatures have different effects on the oral mucosa and which temperature gradient causes damage to the oral cavity has not been accurately reported.
Capsaicin in food is a common condiment that is loved by people. In the mainland, the spicy population is as high as 40%, mainly distributed in the Yunnan-Guizhou-Sichuan area. In recent years, with the development of Sichuan and Chongqing, Sichuan cuisine and Chongqing hot pot have been liked by more and more people, and the number of spicy people has increased rapidly.
Chili peppers give a strong "burning sensation" to the senses, especially when eating hotter meals. Previous studies have shown that capsaicin has the effects of inhibiting tumor cell proliferation and analgesia, and related analgesic drugs have been applied in clinical practice.
However, epidemiological investigations have found that a hot and spicy diet is a risk factor for oral cancer. Studies have also shown that long-term heat and spicy diets can irritate and damage the oral mucosa, causing local inflammation and increasing the risk of keratinization and viral infections.
1. The composition and physiological function of the oral mucosa
Depending on the location and function, the oral mucosa can be divided into covered mucosa, chewing mucosa and special mucosa. The gums and hard palate belong to the masticatory mucosa, and the dorsal mucosa of the tongue belongs to the specialized mucosa. Except for special mucosa and chewing mucosa, they are all covered mucosa.
The oral mucosa mainly has barrier protection function, sensory function, etc. The barrier protection function of the oral mucosa is mainly composed of salivary barrier, epithelial barrier, immune cell barrier and immunoglobulin barrier. The salivary barrier is the first line of defense for the oral mucosa.
The mechanical scouring effect of saliva on the oral mucosa removes toxic substances on the one hand, and prevents the adhesion of microorganisms on the other hand. At the same time, mucin, lysozyme and lactoferrin contained in saliva also play a role in lubrication, anti-drying and antibacterial;
The intact epithelium is a natural physiological barrier to prevent foreign bodies and microorganisms from entering the deep tissues, and the lymphocytes present in the epithelium, including T cells and helper T cells, produce lymphokines when stimulated by antigens and exert immune functions, forming an immune cell barrier.
Secreted immunoglobulin A in saliva is the most important immunoglobulin, which attaches to the surface of epithelial cells or bacteria, has a strong antibacterial effect and the protein degradation of digestive hydrolase enzymes, forming an immunoglobulin barrier. The sensory function of the oral mucosa is manifested in its ability to respond to pain, touch, and temperature stimuli.
In addition, there are thirst receptors on the oral mucosa, which play an important role in regulating the thirst mechanism.
Effects of poor dietary Xi on the oral mucosa
Xi that adversely affect the oral mucosa include alcoholism, smoking, betel nut chewing, and spicy diets. These Xi can cause physical or chemical irritation to the oral mucosa and impair mucosal function.
1. Alcoholic beverages
Alcoholic beverages are a group of different kinds of beverages that contain ethanol and their ingredients vary in content, type, and concentration, with the main components being ethanol and water. Epidemiological studies have shown that consuming 50 grams of alcohol per day significantly increases the risk of cancers of the mouth, pharynx, larynx, and esophagus compared to those who do not drink alcohol.
Studies have shown that ethanol disrupts the arrangement of lipid molecules in the oral mucosal epithelium, opens the intercellular permeability barrier pathway, leads to increased permeability of the epithelial barrier, increases the penetration of carcinogens, and the invasiveness of bacteria to the oral epithelium.
Acetaldehyde can directly bind to DNA through carbonyl groups to form covalent compounds, resulting in changes in DNA structure and interfering with DNA synthesis, and acetaldehyde can also inhibit the activity of DNA repair enzyme O6-methylguanine DNA methyltransferase and interfere with DNA repair.
Excessive reactive oxygen species can lead to the decoupling of mitochondrial electron transport chains, down-regulate the level of ATP production, up-regulate the expression level of pro-apoptotic protein Bcl-2-related X protein, and finally rupture the outer mitochondrial membrane, leading to apoptosis, DNA fragmentation, lipid peroxidation, and protein oxidation, resulting in loss of membrane integrity and changes in protein structure and function.
2. Tobacco
According to the World Health Organization, the use of tobacco products is considered one of the biggest public health threats in the world. Epidemiological studies have shown that smoking can cause a variety of malignant diseases such as lung cancer, oral cancer, nasopharyngeal cancer, and oropharyngeal cancer.
Tobacco smoke contains gaseous and particulate toxins, some of which cause damage to the immune function of the oral mucosa. Studies have shown that tobacco smoke activates neutrophils and macrophages, resulting in increased levels of pro-inflammatory factors and chemokines such as interleukin-8, tumor necrosis factor-α, and monocyte chemoattractant protein-1.
Studies have found that the additive cinnamaldehyde in e-cigarettes can modify the protein sulfhydryl groups in immune cells, change the protein structure and function, inhibit the phagocytic function of neutrophils and macrophages, and inhibit the tumor cell killing ability of natural killer cells.
The substance in cigarette smoke that is closely related to oral cancer is nicotine. Nicotine is a highly toxic and volatile oily liquid substance, soluble in water, ethanol, etc., and can be quickly absorbed by the oral mucosa. Nicotine promotes the occurrence of oral cancer by inducing cell proliferation and anti-apoptotic effects. Studies have found that nicotine can cause cancer by activating the protein kinase B signaling pathway to induce cell proliferation.
3. 槟榔
Areca nut is mainly composed of sugars, polyphenols, fats, various alkaloids, tannic acids, flavonoids, copper, and some crude fibers and rare tannins. Epidemiological studies have shown that betel nut is the most important cause of the occurrence and development of oral submucosal fibrosis.
OSF is a chronic inflammatory disease characterized by progressive atrophy and fibrosis of the connective tissue of the oral mucosa, which eventually causes tissue contracture hardening and decreased mobility, and is a potentially malignant lesion, and its main pathological change is extensive collagen fiber deposition in the connective tissue under the oral mucosa.
Areca nut can lead to the formation of OSF by promoting collagen synthesis in subepithelial connective tissue and reducing collagen degradation. Studies have found that the alkaloids in areca nut, including arecaine, arecanine, tetrahydroniacinic acid and methyl tetrahydronicotinate, can stimulate collagen synthesis by fibroblasts, and can also reduce collagen degradation by reducing collagenase synthesis.
The flavonoids in areca nut can inhibit the dissolution of collagen fibers by collagenase, resulting in an increase in collagen fibers. In addition, the high concentration of copper in betel nut can increase lysine oxidase activity, promote collagen cross-linking, and reduce degradation.
Areca nut induces malignant transformation by promoting angiogenesis and epithelial-mesenchymal transition in OSF lesions. In OSF local lesions, a variety of endogenous angiogenesis-promoting factors, such as hypoxia-inducible factor 1α and vascular endothelial growth factor, were elevated.
4. High-temperature diet
Under normal circumstances, the temperature in the oral cavity is about 36 °C ~ 37 °C, and the appropriate temperature is the basis for the normal physiological activities of cells, and more than 43 °C is considered a harmful temperature.
Thermal damage caused by continuous harmful temperature stimulation can activate the immune system, resulting in the release of inflammatory factors such as interleukin-1, interleukin-6, and TNF-α, which can cause the expression of damage-related pattern molecules such as high mobility protein B1, heat shock protein, uric acid, etc., which further stimulates the immune system and aggravates the inflammatory response. Long-term and repeated chronic inflammatory stimulation can lead to cancer.
5. Spicy diet
The main active ingredient in spicy foods is capsaicin. Capsaicin is a vanillamide-containing alkaloid that is highly irritating and can cause a burning sensation. Capsaicin mainly works synergistically with high-calorie foods in the mouth. Capsaicin can activate the TRPV1 receptor, causing Ca2+ to enter the cell from the extracellular, triggering the release of neuropeptides and excitatory amino acids from nerve endings, and finally causing pain sensation in the cerebral cortex and a burning sensation.
In this process, high temperature (>43°C) and capsaicin synergistically activate TRPV1 receptors, resulting in peripheral C fiber sensitization and amplifying the thermal stimulation effect on the oral mucosa. Long-term heat and spicy diets can irritate and damage the oral mucosa, causing local inflammation and increasing the risk of keratinization and viral infections.
6. Carbonated drinks
The acidic environment it creates can impair the physiological functions of cells. For example, fibroblasts in the oral mucosa assume the function of synthesizing and updating fibers and substrates, and play an important role in wound healing, and the optimal pH value for their normal physiological functions is 7.2~7.5.
In vitro experiments have found that the acidic environment created by the long-term use of carbonated beverages in large quantities will lead to the continuous release of reactive oxygen species in fibroblasts, causing DNA damage and reducing cell viability.
III. Conclusion
Alcohol, tobacco, betel nut, high temperature, etc. can significantly increase the possibility of oral mucosal lesions, and the superposition of various risk factors will significantly increase its harm. For example, a case-control study from India reported an 11-fold increased risk of oral cancer with a combination of chewing tobacco, betel nut, smoking, and alcoholism.
In daily diagnosis and treatment, patients should be strengthened to understand the dangers of these bad diet Xi, improve their awareness of self-care, and prevent the occurrence of diseases.
That's all for this article, it can be seen that many bad diet Xi habits can damage the oral mucosa, if you have anything else you want to add, please leave me a message in the comment area.