These substances damage the sensitive mucosa, causing constant irritation and microtrauma to the mucosa. Chemicals present act as toxin. The phenol in the betel nut with its caustic burning effect destroys the mucosa causing oral ulcers. The betel nut also has tannins, which act as astringents, precipitating protein and damaging the mucosa. The majority of patients are between 20-30 years of age, although some are as young as 13.
Males are more affected than females.
Another study by the Regional Cancer Centre, Thiruvananthapuram, in collaboration with Johns Hopkins University of the US, showed mutagenic activities which could cause genetic deformaties amongst users of pan masala, with or without tobacco. The Goa government had put curbs on sale of gutka and now it is the Madhya Pradesh government which is following suit. Manufacturers of gutka and pan masala are protesting the ban with persuasive arguments about freedom of consumer's choice. Haresh Vishrolia is fighting against oral cancer. He s not able to speak and communicates through pen and paper.