Document Detail

A survey of the current approaches to diagnosis and management of oral premalignant lesions.
MedLine Citation:
PMID:  18056099     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Early diagnosis of oral premalignant lesions (OPLs) and oral squamous cell carcinoma facilitates treatment with less aggressive approaches and results in a better prognosis. The authors conducted a study to identify current practices in the diagnosis and management of these oral lesions by oral medicine professionals. METHODS: The authors sent a questionnaire to 176 diplomates of the American Board of Oral Medicine and asked them to complete the questionnaires and return them by mail. RESULTS: The initial clinical approach taken by most of the responders included visual examination, elimination of possible local causes and two-week follow-up. Adjuvant clinical tests included toluidine blue, oral brush biopsy and exfoliative cytology. If there was no clinical improvement after two weeks, most responders recommended that a biopsy be performed. Induration, red component, nonhomogeneous surface and ulceration were characteristics of lesions that increased the responders' decisions to perform a biopsy. Lesion symptoms and location also contributed to their decisions to perform a biopsy. Follow-up more frequently than twice a year was recommended for red lesions, lesions with histologically confirmed dysplasia or both. Most clinicians recommend a biopsy during follow-up of an OPL whenever the lesion changes in appearance. CONCLUSIONS: The findings of this survey may provide background for initial guidelines to be used by oral practitioners to diagnose and manage OPL. Clinicians' awareness of the complexity of OPL diagnosis and management is important, and referral to an experienced provider is recommended.
Joel B Epstein; Meir Gorsky; Dena Fischer; Anurag Gupta; Matthew Epstein; Sharon Elad
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American Dental Association (1939)     Volume:  138     ISSN:  0002-8177     ISO Abbreviation:  J Am Dent Assoc     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-01-22     Revised Date:  2008-06-26    
Medline Journal Info:
Nlm Unique ID:  7503060     Medline TA:  J Am Dent Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1555-62; quiz 1614     Citation Subset:  D; IM    
Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, University of Illinois at Chicago, 801 S. Paulina Street, Chicago, IL 60612, USA.
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MeSH Terms
Carcinoma, Squamous Cell / diagnosis*,  therapy
Early Diagnosis
Erythroplasia / diagnosis,  therapy
Leukoplakia, Oral / diagnosis*,  therapy
Middle Aged
Mouth Neoplasms / diagnosis*,  therapy
Precancerous Conditions / diagnosis*,  therapy
Statistics, Nonparametric
Comment In:
J Am Dent Assoc. 2008 Apr;139(4):395-6; author reply 396-8   [PMID:  18385019 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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