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Soft Tissue Changes and Precancerous Lesions

Changes in the texture, composition or appearance of the skin inside the mouth can indicate the formation of a precancerous lesion. There are two main kinds of lesions that patients should watch for: leukoplakias, or white lesions, and erythroplakias, or red lesions.

Most leukoplasias are not precancerous, and are instead caused by some type of irritation in the mouth; Erythroplakias are much rarer, but are much more frequently precancerous. If you observe either a white or a red lesion in the soft tissue in your mouth that does not go away in 1-2 weeks, speak with your dentist or oral and maxillofacial surgeon.

Symptoms

In general, you should be aware of any changes occurring in the skin of the gums, the skin on the inside of the cheek, the tongue, or the floor or roof of the mouth. Take special note of any red or white patches, lumps or thickening of skin, a sore that either does not heal properly (after a 1-2 week period), or that tends to bleed easily or excessively. Also, take note of a persistent sore throat, hoarseness, or difficulty maneuvering the jaw during chewing or swallowing. Be sure to consult your dentist or oral and maxillofacial surgeon right away if you notice any of these symptoms.

Diagnosis

A biopsy may be necessary to identify the type of lesion and to determine whether or not it is precancerous. A small piece of the area containing the lesion is cut away and examined visually under a microscope.

Treatment

Some lesions that are found to be benign can be managed by simply removing the irritants or factors that may be causing them. For example, because heavy smoking is a strong irritant to oral tissues, cutting down or quitting smoking can allow some lesions to heal on their own.

Precancerous lesions generally must be surgically removed, along with a small area of the surrounding tissue just to make sure that no abnormal tissue remains.

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