Leukoplakia

[Kim O'Therapy, BSN, RN]

So, the other day, I overheard a patient telling someone that his wife died of oral cancer because she chewed the side of her mouth. Now, I have been poking around the internet to see what I can find. I did find some information regarding leukoplakia and the belief that it may be caused by "chronic irritation of the oral mucosa". I'm curious because, ever since I quit smoking, I have been a chronic cheek chewer and have a horrible, white line of buccal scar tissue to prove it. Can you direct me to any resources you may know of, or comments that may be helpful? Thanks ahead of time!

[adria37]

Sorry my initial response to your post was deleted due to a lack of citing a source. I was not back online in time to add it.

Source: uptodate: oral lesions leukoplakia

"Oral leukoplakia is a precancerous lesion that presents as white patches or plaques of the oral mucosa. It represents hyperplasia of the squamous epithelium, which is believed to be an early step in the transformation of clonally independent premalignant lesions from hyperplasia, to dysplasia, to carcinoma in situ, to invasive malignant lesions. Leukoplakia is also seen in purely inflammatory conditions not associated with malignancy. An association exists between leukoplakia and human papillomavirus (HPV).

Leukoplakia itself is a benign reactive process. However, between 1 and 20 percent of lesions will progress to carcinoma within 10 years. The clinical significance and natural history of oral leukoplakia depends upon the presence and degree of dysplasia. As an example, squamous hyperplasia is a common response to carcinogen exposure, mechanical irritation, or other noxious stimuli. Leukoplakic lesions that arise in trauma-prone regions of the oral cavity (cheek, dorsum of tongue) where the mucosal is normally thick, show evidence of dysplasia less often than do lesions in areas where the mucosal is normally thin (ventral tongue, retromolar triangle). In these latter regions, carcinogen exposure is a proportionately greater cause than mechanical trauma.

Risk factors for oral leukoplakia are similar to that of squamous cell carcinoma; it is particularly common in smokeless tobacco users. Any indurated areas should be biopsied to rule out carcinomatous changes. In addition, recent developments in chemoprevention, most notably the demonstration of the impact of retinoid compounds on premalignant lesions of the oral cavity and oropharynx, have triggered renewed interest in possible preventive approaches to oropharyngeal cancer in patients with precancerous lesions."

[adria37]

oops here is the actual link if you are interested.

http://www.utdol.com/utd/content/topic.do?topicKey=pri_derm/12156&selectedTitle=1~25&source=search_result

[Kim O'Therapy, BSN, RN]

[bANANA]Thank You ![/bANANA]

[renerian, BSN, RN]

Kim, I have the same white lines on both sides of my mouth from teeth grinding at night.

Good reference information from posters.

renerian