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What is the cause of erythroplakia in the mouth?

When talking about, the image we first imagine is of course food. However, you may also imagine the mouth helps us eat the food and indulge in delicious meals. Beside the function of eating, the mouth is important for humans as it enables them to speak. Getting regular health screening can help identify problems firsthand that affects the mouth. In certain conditions, lesions or abnormalities in the mouth may be a sign of a serious disease. In this article, we will learn about a disease affecting the mouth known as erythroplakia.

Erythroplakia is defined as the red patch that can be both flat or slightly raised. When the patch is scratched, it bleeds. There are few other changes that may occur to the mouth known as leukoplakia, a white grey patch and erythroplakia, a combination of both red and white patch. The importance of knowing these oral lesions is for healthcare professionals to evaluate if it is a sign of possible cancerous lesions. The good news is, most erythroplakia are actually harmless.

It is more common in men. Erythroplakia is less common than leukoplakia. Erythroplakia can be caused by habits such as tobacco or heavy drinker, long-term trauma to the mouth tissues or even due to the ageing process. Despite anyone who can develop this condition, the risk for cancer increases as age increases. This explains why most cases are seen in people aged 40 and above, especially those with risk factors. Risk factors include poor oral health, long-term trauma to the oral cavity such as from poor fitting dentures, advanced age and infection with human papillomavirus (HPV).

In most cases of erythroplakia, the patient does not have symptoms. However, symptoms such as sore, burning or metallic sensation may be present. Erythroplakia are often seen as having a reddish appearance and tend to be flat. The red patch may be raised or depressed compared to its surrounding tissue. Some may bleed easily even without touching it or slight touch. Doctors or dentists will be unable to remove them by scraping. Erythroplakia may cause voice changes if it affects the throat. The voice changes are usually unexplained hoarseness or completely losing voice. Symptoms may get worse over time. Due to the fact that erythroplakia can be difficult to be detected, it is best for patients with any of the symptoms above to get routine check by doctors or dentist.

When a patient first comes to the doctor and complains about possible erythroplakia, doctors may first suggest to see if the red patch goes away. If the lesion does not go away within a few weeks, doctors will do some further tests to determine if the lesions are cancerous or possible to become one in future.

Once a doctor suspects a patient with erythroplakia, doctors will do close inspection of the mouth. Signs and symptoms along with medical history can be helpful in ruling out other conditions that may cause similar symptoms to erythroplakia. Diagnosis may be confirmed through biopsy. Biopsy is a procedure of taking small sample tissue, in this case the lesion of the mouth. Exfoliative cytology is a diagnostic biopsy method. This procedure is done by gently scraping the mouth and throat with a brush or wooden stick to collect samples. The sample will then be viewed under a microscope. In certain cases, fluorescence staining can help to visualise the abnormal areas in the mouth. This procedure uses special mouth rinse and fluorescent light.

Erythroplakia lesions, even considered as rare, can actually pose great danger to the patient. As a matter of fact, 90% of these lesions are indeed precancerous or cancerous. Thus, it is important for patients to get checked by doctors when they have symptoms or appearance of erythroplakia as it can help doctors to diagnose this condition in a timely manner and provide treatment.

The recommended treatment for a confirmed erythroplakia with high potential of cancer are usually surgery. Most commonly as surgical excision or laser to remove the lesion. Other surgical procedures include cryosurgery. However, there are still high possibilities for the cancer to develop and appear again. Thus, patients may still need to attend long-term follow-up in an attempt to curb this issue. In certain cases, radiation therapy may be considered to kill the cancerous cells. Beside surgery, patients are advised to take preventative measures. This includes avoiding smoke or tobacco products, improving their alcohol habits and to practise a healthy diet focusing on plenty of vegetables and fruits as this diet can provide antioxidants needed to lower the risk for cancer. Patients are also encouraged to practise good oral health and to visit the dentist regularly. Those who wear dentures need to ensure the dentures fit properly and check with relined every 2 to 3 years to avoid long-term trauma to the mouth. Last but not least, patients need to closely monitor the lesion and see if the lesion does resolve on its own or gets worse.

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