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Review
. 2019 Feb 7;7(1):15.
doi: 10.3390/dj7010015.

Oral White Lesions: An Updated Clinical Diagnostic Decision Tree

Hamed Mortazavi  1 , Yaser Safi  2 , Maryam Baharvand  3 , Soudeh Jafari  4 , Fahimeh Anbari  5 , Somayeh Rahmani  6
Affiliations
Review

Oral White Lesions: An Updated Clinical Diagnostic Decision Tree

Hamed Mortazavi et al. Dent J (Basel). .

Abstract

Diagnosis of oral white lesions might be quite challenging. This review article aimed to introduce a decision tree for oral white lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as "mouth disease", "oral keratosis", "oral leukokeratosis", and "oral leukoplakia". Related English-language articles published since 2000 to 2017, including reviews, meta-analyses, and original papers (randomized or nonrandomized clinical trials; prospective or retrospective cohort studies), case reports, and case series about oral diseases were appraised. Upon compilation of data, oral white lesions were categorized into two major groups according to their nature of development: Congenital or acquired lesions and four subgroups: Lesions which can be scraped off or not and lesions with the special pattern or not. In total, more than 20 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.

Keywords: mouth disease; oral keratosis; oral leukokeratosis; oral leukoplakia.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Decision tree of oral white lesions.
Figure 2
Figure 2
Leukoedema: (A) White appearance of buccal mucosa due to Leukoedema. (B) By stretching the mucosa, the white wrinkled area disappeared.
Figure 3
Figure 3
Superficial oral burn due to placement of an over-the-counter anaesthetic gel.
Figure 4
Figure 4
Pseudomembranous candidiasis due to using broad spectrum antibiotic; pseudo membranes can be scraped off by a piece of gauze.
Figure 5
Figure 5
Habitual biting of cheeks and the lower lip.
Figure 6
Figure 6
Clinical features of oral lichen planus with specific white pattern, (A) reticular OLP; the arrow shows annular form; (B) plaque-like OLP.
Figure 7
Figure 7
Lichenoid contact reaction in buccal mucosa and alveolar ridge due to amalgam build-up of 1st and 2nd mandibular molar.
Figure 8
Figure 8
Leukoplakia on the buccal mucosa.
Figure 9
Figure 9
Oral hairy leukoplakia on the lateral border of the tongue with vertical white folds.
Figure 10
Figure 10
Proliferative verrucous leukoplakia spreading over hard palate and alveolar ridges.
Figure 11
Figure 11
Squamous Cell Carcinoma with verrucous, plaque like and exophytic clinical manifestations at the lateral border of the tongue, extending to the floor of the mouth.
Figure 12
Figure 12
Nicotinic stomatitis on the hard palate.
See this image and copyright information in PMC

References

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    1. Mortazavi H., Safi Y., Baharvand M., Rahmani S., Jafari S. Peripheral Exophytic Oral Lesions: A Clinical Decision Tree. Int. J. Dent. 2017;2017:9193831. doi: 10.1155/2017/9193831. - DOI - PMC - PubMed
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