For years, Madhumita Das, 65, did not care about her dental hygiene. She would not brush her teeth after having sweets at night or bother to fill up her cavities. She ignored the gum infection she had periodically. She even lived with a painless swelling in her jaw, choosing silence over treatment. Yet what began as a small, barely noticeable lump eventually grew into a life-altering oral tumour that ate into her lower jawbone, disfiguring her face completely. She required complex reconstructive surgery at the All-India Institute of Medical Sciences (AIIMS), Delhi.
And yet, it could have all been avoided. Her journey reveals a critical but often overlooked reality in India’s oral health landscape. Poor oral hygiene, delayed medical intervention and lack of specialised oncological care can significantly aggravate oral tumours, sometimes with devastating consequences. In fact, left untreated, these can become cancerous, the incidence of which is now rising in women, many of whom may not have traditional risk factors like smoking and alcohol. Oral cancer is the third most common cancer in women, with studies showing around 25-29% of oral cancer cases being female.
In fact, the presence of Human Papillomavirus (HPV), chewing betel quid, hormonal shifts, nutrient deficiencies, poor dental hygiene and chronic irritation from dental issues can all damage DNA, causing cells in the mouth lining to mutate and grow uncontrollably, forming tumors that can spread. While Madhumati’s biopsy reports classified the tumour as non-cancerous, Dr MD Ray, professor of surgical oncology at the Institute of Rotary Cancer Hospital, AIIMS Delhi explains that “such tumours fall under the broader category of oral cancer care due to their aggressive growth and destructive potential.”
The beginning of an ordeal
The first signs of trouble appeared in the mid-2000s when Madhumita was living in Kanpur. Shortly after her husband passed away in 2005, she developed a tumour in her lower left jaw. At the time, the family consulted a dental surgeon, and in 2008, the tumour was removed surgically. “She lost a portion of her lower jaw which was overwhelmed by the tumour and had artificial teeth fitted. After that, everything seemed fine,” recalls daughter Manshree.
More than a decade later, the swelling returned. Although Madhumita began noticing changes, she chose not to disclose them. Like many from her generation, she believed enduring pain was preferable to burdening her children or undergoing another surgery.
“She could feel it growing but since it wasn’t visible from the outside, she hid it,” says her daughter Manshree. By early 2024, the swelling had grown rapidly, enough to alter the contours of the left side of her face. Dentists saw the scans and suggested the family consult an oncologist.
The family consulted Dr Ray who diagnosed a mandibular tumour, which had overgrown and completely eaten into her jawbone tissues. “The doctor told us it was not wise to hold out a surgery any longer as the tumour could spread to the cheek muscles and deform her face. It could also turn malignant if we delayed it,” says Manshree.
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Why early detection and treatment are needed
Dr Ray says Madhumita’s story underscores the importance of early detection, specialised cancer care and consistent oral hygiene, especially in a country where oral diseases are often dismissed until they become severe. “Low-grade oral cancer cells look more like normal mouth cells, grow slowly and are less likely to spread (well-differentiated). High-grade cells look very abnormal, grow faster and are more aggressive, likely to spread (poorly differentiated). In her case it was a high-grade fast growing tumour, which could become aggressive anytime and had to be taken out,” says Dr Ray.
In November 2024, Madhumita underwent a major surgery at AIIMS Delhi. Surgeons removed the tumour and reconstructed her jaw using a free fibula graft — a bone taken from her right leg and shaped to form a new mandible. A plastic surgery team played a crucial role in the reconstruction. She spent five days in the ICU, followed by weeks of intensive home care.
For the first 45 days after surgery, she was on a completely liquid diet, having soups, purees and juices multiple times a day. Nutrition was carefully monitored to ensure adequate protein and fat intake for healing. Physiotherapy followed to hasten recovery. Today, she exercises daily for at least 30 to 45 minutes, eats soft foods and maintains a strict oral hygiene.
Why you should not ignore a dental hygiene protocol
“She rinses her mouth multiple times a day now and doesn’t let any food remain stuck in the gaps between her teeth,” says Manshree.
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Poor oral hygiene was a significant aggravating factor in this case. Manshree explains that her mother brushed only once a day for much of her early life, often consuming sweets before bedtime without cleaning her mouth. “She had cavities that were never treated and food would get stuck in them. “The doctor told us this could have contributed to chronic infection and poor gum health,” she says.
Poor dental hygiene triggers gum infection in the mouth. This means chronic inflammation, which weakens the immune system locally, creating a space for harmful pathogens to thrive, damage tissues and trigger mutations in cells. Poor oral hygiene allows harmful bacteria to multiply in the mouth, which, research has shown, produce toxins that damage tissues and induce DNA changes in the cells they infect.
Madhumati is recovering well but her experience carries a cautionary message. “This could have been treated much earlier,” Manshree says. “If she had spoken up, if we had reached an oncologist sooner, things might not have gone this far.”
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