Non-surgical Management of Oral Leukoplakia in Indian Scenario

Management of potentially malignant disorders such as leukoplakia depends onearly interception &prevention of malignant transformationwhich includes several factors such as age of patients, systemic factors ,history of habits ,size & site of lesion ,its type & clinical features ,natural history & histopathological features .This is achieved by habit counseling for tobacco dependence and use of chemo preventive agents after diagnosis of leukoplakia. Even though numerous manuscripts have dealt with management of oral leukoplakia ,still there is lack of a proper protocol which will aid in appropriate management of oral leukoplakia. Linking all these considerations we hereby aim to propose guidelinesfor appropriate management of oral leukoplakia in Indian scenario. 1 2 3 4 1 2,3,4 Department of Oral Medicine and Radiology, Department of Oral Pathology , SGT Dental College and Hospital, Budhera, Gurgaon, Haryana, India. Renu Tanwar, Aparna Dave, Manpreet Kalra, Pulin Saluja INTRODUCTION : Leukoplakia is a potentially malignant disorder affecting oral cavity especially in males of middle aged1.Establishing the clinical diagnosis of leukoplakia, followed by histopathologic analysis,leads to consideration of the appropriate clinical management which should be designed according to the anticipated clinical or biologic behavior. Balancing the lesional qualities with treatment modality and associated morbidity becomes the major clinical decision. With such considerations in mind, a wide choice of treatments has been used, ranging from those which are locally directed to others which are systemic. In the absence of histologically demonstrated dysplastic changes, careful and routine follow-up observations of leukoplakia may be appropriate in conjunction with elimination of any riskassociated behavior or habits. In order to conduct treatment for OL, the degree of epithelial dysplasia may be assessed. In the presence of moderate or severe epithelial dysplasia, surgical treatment is recommended. However, OL presenting low to moderate malignant risk may be either completely removed or not, and the decision should consider other factors such as location, size and, in the case of smokers, the patient's engagement in smoking cessation. This manuscript emphasizes on non-surgical management of oral leukoplakia in Indian scenario. MANAGEMENT PROTOCOL : Management depends onearly interception &prevention of malignant transformationwhich includes several factors such as age of patients, systemicfactors ,history of habits ,size & site of lesion ,its type & clinical features ,natural history & histopathological features .This is achieved by habit counseling for tobacco dependence and use of chemo preventive agents after diagnosis of leukoplakia. Even though 1,2,3,4 numerous manuscripts have dealt with management of oral leukoplakia,still there is lack of a proper protocol which will help in managing oral leukoplakia.Linking all these considerations we hereby aim to propose guidelines which are as follows(FIGURE 1) Figure 1: Flow diagram for management of oral leukoplakia. CLINICAL EXAMINATION : Proper clinical examination should be done on the day of reporting of the lesion ; type, size and location of lesion should be carefully recorded. Low NON-SURGICAL MANAGEMENT OF ORAL LEUKOPLAKIA IN INDIAN SCENARIO Journal of Dental Sciences University