Evaluating Alterations of the Oral Microbiome and Its Link to Oral Cancer among Betel Quid Chewers: Prospecting Reversal through Probiotic Intervention

Areca nut and slaked lime, with or without tobacco wrapped in Piper betle leaf, prepared as betel quid, is extensively consumed as a masticatory product in many countries across the world. Betel Quid can promote the malignant transformation of oral lesions as well as trigger benign cellular and molecular changes. In the oral cavity, it causes changes at the compositional level in oral microbiota called dysbiosis. This dysbiosis may play an important role in Oral Cancer in betel quid chewers. The abnormal presence and increase of bacteria Fusobacterium nucleatum, Capnocytophaga gingivalis, Prevotella melaninogenica, Peptostreptococcus sp., Porphyromonas gingivalis, and Streptococcus mitis in saliva and/or other oral sites of the cancer patients has attracted frequent attention for its association with oral cancer development. In the present review, the authors have analysed the literature reports to revisit the oncogenic potential of betel quid and oral microbiome alterations, evaluating the potential of oral microbiota both as a driver and biomarker of oral cancer. The authors have also shared a perspective that the restoration of local microbiota can become a potentially therapeutic or prophylactic strategy for the delay or reversal of lip and oral cavity cancers, especially in high-risk population groups.

Automated summary

Areca nut and slaked lime wrapped in Piper betle leaf, known as betel quid, is widely consumed as a chewing product. The consumption of betel quid can lead to oral lesions and dysbiosis in oral microbiota, which may contribute to oral cancer development. Certain bacteria, such as Fusobacterium nucleatum and Porphyromonas gingivalis, have been frequently associated with oral cancer in betel quid chewers. This review analyzes the potential oncogenicity of betel quid and the alterations in oral microbiome, and suggests that restoring the local microbiota could be a therapeutic or prophylactic strategy for oral cancer.