Oral leukoplakia: an update for dental practitioners

Dr Brian Maloney, Dr. Sheila Galvin, Professor Claire Healy
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Abstract

Oral leukoplakia (OLK) is a common mucosal pathology frequently encountered in general dental practice which belongs to a group of conditions known as oral potentially malignant disorders (OPMDs). This inferred risk of progression to oral squamous cell carcinoma warrants an understanding of the etiology of this condition, its clinical presentation, and how patients diagnosed with OLK are managed in both general and specialist care practices. To update the dental practitioner on the current understanding concerning the diagnosis and management of OLK. A search strategy was conducted in the MEDLINE Ovid and Embasse databases and the Cochrane Library. No time limit was applied. The search results were limited to those in the English language. The etiology for oral white patches can range considerably from innocuous frictional keratosis to oral squamous cell carcinoma. A thorough history and clinical examination should precede referrals to secondary care, with the elimination of risk factors a priority. In cases where white patches are suspicious or remain despite managing known risk factors, prompt referral to a specialist centre is warranted. Despite the extent of research in this field, controversy remains in OLK management and there is currently no agreed international consensus on the management of OLK from governing bodies. Therefore, management is primarily governed by local contemporaneous guidelines, and management is based on the most reliable predictor of malignant transformation: the grade of dysplasia. Despite various treatments, OLK may still undergo transformation to malignancy. General dental practitioners (GDPs) are the health care practitioners best placed to detect OLK on a daily basis, given the volume of patients encountered from various backgrounds. An understanding of the causes and presentation of OLK will allow GDPs to recognise this entity in practice, and facilitate further management and treatment in a bid to prevent transformation.
口腔白斑病:为牙科医生提供的最新信息
口腔白斑病(OLK)是普通牙科临床中经常遇到的一种常见粘膜病变,属于口腔潜在恶性疾病(OPMD)。这种病症有可能发展为口腔鳞状细胞癌,因此有必要了解这种病症的病因、临床表现,以及在普通和专科医疗实践中如何管理确诊为口腔鳞状细胞癌的患者。向牙科医生提供有关 OLK 诊断和管理的最新信息。在 MEDLINE Ovid 和 Embasse 数据库以及 Cochrane 图书馆中采用了检索策略。没有时间限制。搜索结果仅限于英文版。口腔白斑的病因范围很广,从无害的摩擦性角化病到口腔鳞状细胞癌都有可能。在转诊到二级医疗机构之前,应先进行全面的病史和临床检查,并将消除危险因素作为优先事项。如果白斑可疑或在控制了已知风险因素后仍然存在,则应立即转诊至专科中心。尽管在这一领域开展了大量研究,但在 OLK 的管理方面仍存在争议,目前国际管理机构尚未就 OLK 的管理达成一致共识。因此,管理主要受当地同期指南的制约,管理的依据是恶性转化最可靠的预测指标:发育不良的等级。尽管采取了各种治疗方法,OLK 仍有可能转变为恶性肿瘤。全科牙科医生(GDP)是最适合每天检测 OLK 的医疗保健从业人员,因为他们会遇到大量来自不同背景的患者。了解 OLK 的病因和表现,将有助于全科医生在实践中识别这种实体,并促进进一步的管理和治疗,以防止转化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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