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The growth of common Streptococcus species, in particular Streptococcus intermedius , Streptococcus anguinis , and Streptococcus mutans from saliva are shown to be suppressed by prolonged exposure to the aqueous extracts of betel nut such as tannic acid ( Streptococcus anginosus , is shown to induce the synthesis of inflammatory cytokines and NO (Sasaki et al., 2001) signifying potential mechanisms of carcinogenesis

These include: Heavy alcohol use: People who drink alcohol heavily (defined as more than three drinks per day) are two to three times more likely to develop oral cancer than people who dont drink alcohol at all HPV infection: Human papillomavirus (HPV) is a virus that is spread through sexual contact