Increased consumption of tobacco and tobacco products in the last 2 decades had increased the incidence of oral cancer all over the world. Oral cancer amount to about 40% of all cancers. Historically the death rate associated with oral cancer was high not because it was hard to discover or diagnose but due to the fact that it was routinely discovered late in its development. Even today 2017, the statement is valid as the world mortality rate and 5 year survival rate due to oral cancer had shown very less decrease. As the saying goes prevention is better than cure. So many lives would have been saved if these cases were detected earlier. Oral cancer has various signs and symptoms before malignancy occurs. Signs developed much below symptoms arise. Often oral cancer is only discovered when the cancer has metastasized to another location, most likely the regional lymph nodes.

The sign and symptoms of oral cancer and progress of the disease can be compared to a giant iceberg floating in sea. The disease will not be noticed by the patient as the lesion does not produce any pain or discomfort. The main role of dentist in identification of oral cancer mainly focused on picking up the signs before malignancy starts. It is a disease with long incubation period and most of the times start as a premalignant lesion. Precancerous lesion may be in the mouth for years without the patient may be aware. This make the dentist the primary investigator in early detection and identification of these lesions and make the patient aware. Few patients may have full developed cancerous lesions which the dentists may be able to diagnose and refer for management. Once the lesion is changed into malignancy it spreads very fast and symptoms may occur in very advanced stages. In advanced stages the disease become almost non curable and associated with high mortality rate. The role of dentist is at all levels i.e. prevention of occurrence of oral cancer, early diagnosis and referral to oncologist for treatment in advanced cases. The role of dentist can be divided as follows:

Role as educator
The dentist should act as an educator by educating the patient about the deleterious effects of the tobacco and tobacco products. He can be associated with NGOs (Non-Government Organisations) and GOs (Government Organisations) to create awareness about deleterious effects of tobacco in society. Counsel the teenager’s patients to say no to tobacco and its products.

Role as interventionist
Dentists should be able to identify signs of use of tobacco usage. Identify other ethological factors which can cause OC: sharp tooth, traumatic tooth, viral infections, and role of heredity. Tobacco causes various signs of its use in oral cavity this includes staining of teeth, melanosis of the oral cavity, recession of gums, bad breath, early loosing of teeth etc. Also by identifying the lesions the dentist may also refer the patient for tobacco cessation and counselling to psychiatrist or tobacco cessation clinics.

Role as clinician
To identify premalignant lesions in their early stage and to carry out basic diagnostic procedure to differentiate between benign or malignant nature. To keep the patients on long term follow up.

Role as interdisciplinary practitioner
Although oral cancer is very old disease and lot of advances has been done in treatment and education of the peolpe both at primary and tertiary level had been done by Government and Non-government organisations. Still most of the people who are aware that they have OC have very less knowledge about the process of the disease, treatment options and specialist to approach. The role of the dentist in those cases is to educate about the disease, treatment options and is to refer the patient to specialist for treatment.

Oral cancer is a pandemic disease and associated with high mortality and morbidity rate. Role of dentist is paramount in decreasing the incidence of Oral Cancer worldwide.