GENERAL
DENTISTRY
Leukoplakia
Leukoplakia
is a white or gray patch that develops on the tongue or the
inside of the cheek. It is the mouth's reaction to chronic
irritation of the mucous membranes of the mouth. Leukoplakia
patches can also develop on the female genital area; however,
the cause of this is unknown.
The growth
can occur at any time in your life, but it is most common
in the elderly.
"Hairy"
leukoplakia of the mouth is an unusual form of leukoplakia
that is seen only in people who are infected with HIV, have
AIDS, or AIDS-related complex. It consists of fuzzy, hence
the name "hairy," white patches on the tongue and
less frequently elsewhere in the mouth. It may resemble thrush,
an infection caused by the fungus Candida which, in adults,
usually occurs if your immune system is not working properly,
and may be one of the first signs of infection with the HIV
virus.
What
Causes Leukoplakia?
• Irritation from rough teeth, fillings, or crowns, or ill-fitting
dentures that rub against your cheek or gum
• Chronic smoking, pipe smoking, or other tobacco use
• Sun exposure to the lips
• Oral cancer, although rare
• HIV or AIDS
What
Are the Symptoms?
The presence
of white or gray colored patches on your tongue, gums, roof
of your mouth, or the inside of the cheeks of your mouth may
be a sign of leukoplakia. The patch may have developed slowly
over weeks to months and be thick, slightly raised, and may
eventually take on a hardened and rough texture. It usually
is painless, but may be sensitive to touch, heat, spicy foods,
or other irritation.
How
Is Leukoplakia Diagnosed?
Your dentist
may suspect leukoplakia upon examination; however, a biopsy
will likely be taken to rule out other causes, such as oral
cancer. During the biopsy, a small piece of tissue from the
lesion will be removed to be examined in a lab. A numbing
agent will be used so that you will not feel any pain.
How
Is Leukoplakia Treated?
Treatment,
if needed, involves removing the source of irritation. For
example, if leukoplakia is caused by a rough tooth or an irregular
surface on a denture or filling the tooth will be smoothed
and dental appliances repaired. If leukoplakia is caused by
smoking, you will be asked to minimize or stop smoking or
using other tobacco products.
Leukoplakia
is usually harmless, and lesions usually clear in a few weeks
or months after the source of irritation is removed. If eliminating
the source of irritation is ineffective in reducing leukoplakia,
the lesion may need to be surgically removed. The lesion can
be removed either by your general dentist or by an oral surgeon
in their office under local anesthesia.
Hairy leukoplakia
requires treatment with an antiviral medication.
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ORAL
CANCER
The
Importance of Early Detection
Your dentist
has recent good news about progress against cancer. It is now
easier than ever to detect oral cancer early, when the opportunity
for a cure is great. Currently only half of all patients diagnosed
with oral cancer survive more than five years.
Your dentist has the skills
and tools to ensure that early signs of cancer and pre-cancerous
conditions are identified. You and your dentist can fight and
win the battle against oral cancer. Know the early signs and
see your dentist regularly.
You Should Know
Oral Cancer
often starts as a tiny, unnoticed white or red spot or sore
anywhere in the mouth.
It can affect any area of the oral cavity including the lips,
gum tissue, check lining, tongue and the hard or soft palate.
Other signs include:
- A sore that
bleeds easily or does not heal
- A color change
of the oral tissues
- A lump, thickening,
rough spot, crust or small eroded area
- Pain, tenderness,
or numbness anywhere in the mouth or on the lips
- Difficulty
chewing, swallowing, speaking or moving the jaw or tongue.
- A change
in the way the teeth fit together
- Oral Cancer
most often occurs in those who use tobacco in any form.
- Alcohol use
combined with smoking greatly increases risk.
- Prolonged
exposure to the sun increases the risk of lip cancer.
More than 25%
of oral cancers occur in people who do not smoke and have no
other risk factors.
Oral Cancer
is more likely to strike after age 40.
Studies suggest that a diet high in fruits and vegetables may
prevent the development of potentially cancerous lesions.
Regular
Dental Check-ups Important
Regular dental
check-ups, including an examination of the entire mouth, are
essential in the early detection of cancerous and pre-cancerous
conditions. You may have a very small, but dangerous, oral spot
or sore and not be aware of it.
Your dentist will carefully
examine all areas of your mouth. In about 10% of patients, the
dentist may notice a flat, painless, white or red spot or a
small sore. Although most of these are harmless, some are not.
Harmful oral spots or sores often look identical to those that
are harmless - testing can tell them apart. If you have a sore
with a likely cause, your dentist may treat it and ask you to
return for re-examination.
Dentists often will notice a
spot or sore that looks harmless and does not have a clear cause.
To ensure that a spot or sore is not dangerous, your dentist
may choose to perform a simple test, such as a brush biopsy,
which usually is painless and can detect potentially dangerous
cells when the disease is still at an early stage.
If your dentist notices something
that looks very suspicious and dangerous, a scalpel biopsy may
be recommended. This usually requires local anesthesia. Your
general dentist may perform this procedure or refer you to a
specialist for it.