Category: Oral Medicine And Radiology

MANAGEMENT OF LEUKOPLAKIA

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LEUKOPLAKIA

  1. Habit counselling: Removal of etiology
  2. Conservative therapy:
  • Vitamin therapy – Protective effect on epithelium (Vitamin A)
  • Vitamin A + Vitamin E: inhibit metabolic degradation
  • Retinyl palmitate is used as an antioxidant and a source of vitamin A added to low fat milk and other dairy products to replace the vitamin content lost through the removal of milk fat.
  • Isotretinoin, also known as 13-cis-retinoic acid with dosage of 1.5 – 2mg/kg body wt. for 3 months.
  • Vitamin A can be sourced from the food we eat, through beta carotene, for example, or in supplement form.
  • Antifungal medication Nystatin can be used for candidal Leukoplakia
  • Vitamin B complex for commissural leukoplakia
  • Vitamin A can be found in: Carrots, Citrus fruits, hard cheese, spinach, milk, eggs, fish

3) Surgical Approach

References: Ghoms, Textbook of Oral Medicine

Dr. Mehnaz Memon🖊

EFFECTS OF RADIATION ON ORAL TISSUES

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➡️ The general term Radiation is applied in 2 different forms of energy-

  • Electromagnetic Radiation
  • Particle Radiation

➡️ Cellular defects occur due to-

  1. Denaturation of nucleoprotein
  2. Coagulation
  3. Inactivation of enzyme system
  4. Toxic effects of protein breakdown products.

🔹 Effects on Oral Mucosa:

  • Lower dose of X-Ray – Erythema
  • Therapeutic radiation – Mucositis
  • Effect of Radiation therapy:
  1. Initial changes – Hyperemia & Edema
  2. Later – Ulceration with fibrinous exudate
  3. Loss of taste (damage to microvilli & outer surface of taste cells)

⬇️

Restores within 60-120 days post-radiation therapy

4. Difficulty in eating –

  • Lidocaine mouthrinse as topical anesthetic
  • Nasogastric tube feeding

🔹 Effects on Salivary Glands:

  1. Xerostomia
  2. Loss of secretion
  3. Post radiation sialadenitis ( ⬆️ serum amylase)
  4. ⬇️ lubricating capacity, pH & buffering capacity.

🔹 Effects on Teeth:

  1. Radiation caries – cervical areas of teeth
  2. Brittle tooth
  3. Alterations of saliva – thicker and more tenacious after irradiation
  4. Xerostomia
  5. Cariogenesis acclerated – frank lesions within 3 months. Prevention: Application of 1% NaF gel
  6. Complete cessation of odontogenesis ➡️ Anodontia. Stunting of roots of teeth. Occur at time of tooth formation.

🔹 Radiation mucositis of palate:

  • Post radiation yellowish white necrotic exudate.

Dr. Mehnaz Memon🖊

References: Shafers Textbook Of Oral Pathology 7Ed