Abstract
SUMMARY Oral precancer, consisting of leukoplakia, erythroplakia, and oral submucous fibrosis, has a well-documented malignant transformation rate that may be related to the prevalence and degree of dysplasia present in the lesion. This rate does not diminish with duration of the lesion; therefore, long-term surveillance is essential for the proper management of patients afflicted with these lesions. Prevention consists of removal of risk factors, particularly the use of tobacco products and alcohol. To prevent submucous fibrosis, chewing of betel products must cease. ST is a risk factor for leukoplakia and cancer. Identification of high-risk lesions is facilitated by regular complete clinical examination supplemented by vital staining with toluidine blue. Treatment consists of removal of the lesion by surgery (laser, scalpel, or electrosurgery) and occasionally by cryotherapy. The laser is least damaging to surrounding normal tissue, does not cause scarring or edema, and is not painful. Biologic manipulation with retinoids holds promise but is not yet adequately reliable or sustainable because of side effects.
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