The recent Annual State Review Meeting of the National Oral Health Programme, held in Kohima on September 11 and 12 was more than a routine administrative gathering. It was, in effect, a sobering acknowledgement that oral cancer has quietly grown into one of the most pressing public health threats facing Nagaland. The remarks made by the Commissioner & Secretary, Health & Family Welfare Department, deserve to be read not merely as ceremonial exhortation but as an urgent diagnostic of a crisis that has, for too long, been allowed to fester in the shadows of neglect.
Oral health, it was rightly noted, is treated as a peripheral concern rather than an integral part of general health. This framing itself is part of the problem. Dental caries and periodontal disease are often dismissed as minor discomforts to be endured rather than warning signs to be investigated, while oral cancer, the most severe consequence of prolonged neglect, is frequently detected only after it has advanced beyond easy treatment. Such delay is not incidental; it is the predictable outcome of a healthcare culture in which awareness, prevention, and early screening have not been prioritised with the seriousness they demand.
The risk factors driving this crisis are neither mysterious nor unfamiliar. Tobacco use, particularly in smokeless forms, remains deeply embedded in everyday social life across the region. Betel-quid chewing, often combined with tobacco, is a practice so normalised that its carcinogenic potential is routinely overlooked. Excessive alcohol consumption compounds this risk, while persistent viral infections, including Human Papillomavirus, add a further layer of vulnerability that receives comparatively little public attention. Poor oral hygiene, meanwhile, is both a consequence of limited access to dental care and a contributing factor to disease progression, creating a cycle that is difficult to break without deliberate intervention.
What makes the tobacco statistics especially alarming is the demographic spread they reveal. Data from the Global Adult Tobacco Survey point to widespread tobacco use among adults, but it is the findings of the Global Youth Tobacco Survey, 2019, that ought to trouble policymakers most. A significant proportion of children aged 13 to 15 are already using tobacco in some form. This is not a distant risk to be addressed in future decades; it is a present-day emergency being seeded in classrooms and communities today, with consequences that will surface as cancer diagnoses ten to fifteen years from now if left unaddressed.
Against this backdrop, the initiative taken by the Dr K & T Keditsu Foundation, in partnership with the Dental Department of NHAK, the Department of Health & Family Welfare, and supporting institutions including TANUH-AI Centre of Excellence and the Indian Institute of Science, Bengaluru, is commendable. Equipping Dental Surgeons across the State with practical, hands-on training in biopsy and diagnostic procedures is precisely the kind of capacity-building that has been missing. Early and accurate diagnosis, after all, is the fulcrum on which patient outcomes turn.
Yet training programmes, however well-intentioned, cannot substitute for sustained policy commitment. What is required is a comprehensive, war-footing approach, as was aptly described: aggressive public awareness campaigns targeting tobacco and betel-quid use, particularly among adolescents; strengthened screening infrastructure at the primary health level; and a cultural shift in how oral health is perceived and prioritised. Without such measures, the State's healthcare system risks being overwhelmed by a cancer burden that was, in large part, foreseeable and preventable. The window for decisive action is narrowing, and it must not be allowed to close.
