Download Oral Leukoplakia

White Lesions of the Oral
Cavity
Dr Kinda ALSHAWA
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Causes of white oral lesions
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oral hairy leukoplakia
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Oral Leukoplakia
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manifests as patches that are bright
white and sharply defined that cannot
be rubbed off
The surfaces of the patches are slightly
raised above the surrounding mucosa.
Age: middle age 4-6 decades
male > female
Site: Tongue, floor of mouth, buccal
mucosa,palate, lower lip, retro molar
sites
Individuals with OL are not
symptomatic.
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Oral Leukoplakia
The most common are uniformly white plaques
(homogenous OL) prevalent in the buccal mucosa, which
usually have low premalignant potential.
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Homogenous Oral Leukoplakia
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Oral Leukoplakia
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verrucous leukoplakia
has a stronger malignant potential than homogenous
leukoplakia.
consists of white flecks or fine nodules on an atrophic
erythematous base.
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Oral Leukoplakia
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Five clinical criteria demonstrate a particularly high
risk of malignant change.
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The verrucous type is considered high risk.
Erosion or ulceration within the lesion is highly suggestive of
malignancy.
The presence of a nodule indicates malignant potential.
A lesion that is hard in its periphery is predictive of
malignant change.
OL of the anterior floor of the mouth and undersurface of
the tongue is strongly associated with malignant potential.
In all cases, the relative risk of malignant potential is
determined by the presence of epithelial dysplasia
upon histological examination.
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Oral Leukoplakia
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Oral Leukoplakia
Causes of Leukoplakia
n Irritation from rough teeth or rough places on
the dentures, fillings and crowns.
n Smoking,chewing tobacco or snuff in the
mouth for a long period of time.
n alcohol
n nutritional deficencies
n micro-organisms (treponema pallidum ,
candida albicans ,human papilloma virus )
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SCC on Oral Leukoplakia
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Oral Leukoplakia
Treatment
n The goal of the treatment is to eliminate the lesion.
Removal of the source of irritation is important and
may lead to disappearance of the lesion.
n Dental causes such as rough teeth, irregular denture
surface or fillings should be treated as soon as
possible.
n Smoking or other tobacco use should be stopped.
n Surgical removal of the lesion under local
anaesthesia.
n Vitamin A or vitamin E supplements may shrink
lesions.
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Fordyce’s Granules
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White Sponge Nevus
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Nicotine Stomatitis
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Pre-cancerous
This is on the palate and
occurs on the cheeks and
gums as well.
The combination of the
cigarette/cigar/pipe smoke
and heat causes the tissue
to swell and turn white
(thicken) with red irritated
spots and streaks .
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Nicotine Stomatitis
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LINEA ALBA
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A horizontal streak on the
buccal mucosa at the level
of occlusal plane extending
from the commissure to
the posterior teeth
Associated with pressure
,frictional irritation , or
sucking trauma from the
facial surfaces of the teeth.
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Submucosal nodules
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Mucocele
Hemangioma
Pyogenic granuloma
Fibroma
Venous lake
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Mucocele
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Hemangioma
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Hemangioma
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port-wine / Sturge-Weber syndrome
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Pyogenic granuloma
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Fibroma
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venous lake
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Oral Cancer
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The most common type of
oral cancer is squamous cell
carcinoma (SCC)
Oral malignancies also include
lymphomas, salivary gland
malignancies, sarcomas of all
types, melanoma, and very
frequently metastasis from
other cancers
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Squameous cell carcinoma
The floor of the mouth and ventral surface of the tongue
are some of the most common intraoral sites for developing cancer
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Risk Factors of Oral Cancer
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Tobacco is one of two major
risk factors for oral cancer
Alcohol is the second major
risk factor for oral cancer
Viruses
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malignant melanoma
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Amalgam tattoo
This can happen when a piece of a silver filling is left in the
extraction site to “rust” and cause what looks like a tattoo. This
lesion can be confused with malignant melanoma .
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Kaposi sarcoma of the palate
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