What are Premalignant Lesions of the Oral Cavity?

What are Premalignant Lesions of the Oral Cavity?

Every time you visit the dentist for your regular dental checkup, he doesn't just gauge the health of your teeth and gums but also checks around for any lesions or abnormal changes on the soft tissues in and around the mouth. Most of the time, he will be able to identify an Oral Premalignant lesion just by looking at it, although sometimes he might need a biopsy before making any conclusions.

In any case, if you've got a lesion in your mouth, it's important to know whether it is going to develop into cancer or is already cancerous.

What is a Premalignant Lesion?

A oral premalignant lesion of the oral cavity is a precancerous, morphologically-altered tissue in your mouth which is more likely to develop oral cancer than is normal tissue. It is a potentially malignant abnormality in the tissue in and around your mouth. It's important to recognize and manage these early to avoid complications. Such a lesion is also called dysplasia.

While it's a blanket term for a variety of pathologies that can arise in your mouth, the most commonly described premalignant oral lesions are leukoplakia, submucous fibrosis, erythroplakia, and lichen planus.

How is an Oral Premalignant Lesion Detected?

If you have one of these, there's a good chance that you won't have any pain. You might not even know you have a lesion until you're sitting in a dental chair as your dentist examines your mouth and soft tissue. This is why regular dental checkups are key to maintaining your oral health.

To check for a lesion, the dentist will look inside and outside the lips, cheeks, gums, palate, the floor of your mouth, the sides of and under the tongue, and the back of your mouth. If he is not sure, he might remove a small piece of the lesion (biopsy) and send it off to a pathologist. This is a minor procedure carried out under local anesthesia and only takes a few minutes.

I Have a Premalignant Lesion- Does that mean I have Cancer?

Having dysplasia or a premalignant lesion doesn't mean that you are definitely going to develop cancer. Some lesions may always stay at a dysplastic stage, never transforming into cancer. Others may subside and everything goes back to normal. But you should always get it checked out if you find anything abnormal in your mouth.

How to tell if a Lesion is a Cause for Concern?

Your dentist will have an idea of whether a lesion is suspicious. Usually, white, red, or mixed white-red patches may raise suspicion. These may be ulcerated, and raise more suspicion when found on high-risk areas like the side of the tongue, under the tongue, the floor of your mouth, or at the top of the throat. If the dentist is unable to wipe away a white patch with a piece of gauze, it might be leukoplakia. A red one without an obvious cause may be defined as erythroplakia. In some cases, a person might have both white and red- that would be termed erythroleukoplakia. While any lesion without a cause may be risky, those with a red component are usually more likely to be premalignant.

Am I at Risk for a Premalignant Lesion?

Mostly, people over the age of 40 get these, but you can get one even if you're young, and habits like tobacco and alcohol can increase your chances.

What Happens if I am Diagnosed with a Premalignant Lesion?

If you have received the bad news, you might have questions. After the biopsy, you'll be given a diagnosis like epithelial hyperplasia/hyperkeratosis, epithelial dysplasia, or squamous cell carcinoma. So what’s next? Firstly, you'll need to give up tobacco and smoking and limit alcohol intake if you do partake in that. If you have severe dysplasia, you have a high risk of developing oral cancer. With mild dysplasia, you might have to frequently visit an oral cancer specialist so he can look for any changes. Moderate and severe dysplasia are more likely to develop into cancer. In that case, maxillofacial surgery might be required, where the doctor will use a small scalpel or a laser beam to remove the lesion along with a small margin of healthy tissue. This short surgery may be performed under a local anesthetic, and you may be able to come back home the same day with medicines for pain and discomfort after the surgery. Regardless of the severity, you will have to make changes to your lifestyle and adopt a healthy diet. 

Finally, you should know that even after removal, lesions can recur, and sometimes, new ones can develop elsewhere, so it's important to keep getting regular checkups and keep your dentist in the know as well. An oral premalignant lesion isn’t a cancer sentence, but it might be a wake-up call.

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