The Prevalence of Precancerous Lesions in Primary Dental Health Care

Abstract

Benign and premalignant States of the oral cavity related to impairments of epithelial keratinization are classified as oral precancerous lesions, and can be hereditary, reactive, immunologic, infectious, idiopathic, or neoplastic. Epidemiologic studies conducted worldwide have identified the following types of oral precancerous lesions to be priorities according to their prevalence and clinical implications: leukoplakia, erythroplakia, oral lichen, actinic cheilitis, candidal leukoplakia, papillomatous lesions, tertiary syphilis, and oral submucous fibrosis. Five of these eight clinical entities, i.c. leukoplakia, crythroplakia, oral lichen, actinic cheilitis and candidal leukoplakia, and their importance in the prevention of oral carcinoma are discussed in detail. General practitioner and polyvalent practicing dental medicine doctor have a major role in the early diagnosis of neoplasms in the head, neck and oral cavity region. Early diagnosis is associated with better treatment options and lower probability of visible mutilations. The occurrence of oral precancerous lesions is influenced by the following factors: cigarette smoking and alcohol abuse, showing positive correlation with both the amount and duration of particular habit; exposure to detrimental factors (occupational and environmental) and radiation (sunlight and ionizing); uncontrolled medication; viruses; and inappropriate dietary habits. Successful prevention of oral precancerous lesions requires regular visits to dentist office, elimination of harmful habits, and healthy lifestyle. In case of clinical manifestation of an oral precancerous lesion, dental doctor should reach an accurate diagnosis by use of laboratory tests and not infrequently biopsy finding, i.e. clinical diagnosis should be verified or ruled out by pathohistology. Therapy and regular control visits are prescribed according to the diagnosis.