The chemicals in gutka are capable of transforming healthy cells in the mouth to cancerous ones in a matter of weeks.
Nutritionist and dentist Dr Sahar Javed Chawla was on SAMAA TV’s show Naya Din on Tuesday to talk about the dangers of the widely available addictive substance.
Gutka (betel quid) is made of crushed areca nut (also called betel nut), tobacco, catechu, paraffin wax, slaked lime, artificial flavouring and spices. It is chewed on its own or wrapped in betel leaves (paan leaves).
The areca nut is used as a psychoactive substance which gives gutka its reputation of being a stimulant and mouth freshener, said Dr Chawla. It gives a feeling of alertness similar to caffeine, euphoria and a heightened sense of self.
It also increases saliva production, said the dentist, which helps digestion similar to how the nicotine in cigarettes does.
The areca nut has saccharides, carbohydrates, fat, crude fibre, polyphenols, tannins and catechins, explained the dentist. Arecoline is the main alkaloid which gives it the name areca nut.
“Though it’s present in the lowest quantity but it is the most disease-causing,” said Dr Chawla. “It’s converted by saliva enzymes into arecaidine. This is what causes inflammation and cancer.”
How areca nut transforms cells
The mixture, that is chewed and kept in the mouth, acts on the inside of the mouth first.
It starts killing the cells between the gum and cheeks, said Dr Chawla. Then it shrinks the blood vessels. Over time the lesion is prone to hypoxia inducible factor (HIF) formation. This increases blood vessels production and allows cancer cells to grow.
Dangerous cancer-causing chemicals can then metastasise (spread). As the destruction continues, fibrotic white stretchy bands are formed which cause difficulty in opening the mouth, said the dentist.
Over time other functions such as chewing and talking also become difficult as the disease progresses.
In South Asia 35 to 40% of cancers are mouth cancers, said Dr Chawla. Areca nut in gutka is responsible for 18% of those.
“The earlier one gives up the habit [of chewing gutka] the better,” said the dentist.