Hello, after seeing the dentist this week I was referred to a maxofacial specialist regarding a white spot (5cm) on one side and a small thinly white streaked area on the opposite side of my inner cheeks (1-2cm or so in area).

Which, of course has me up worried about all the worst case scenarios and disfiguring treatments and costs - read Scarred!

My question: how long can I observe these spots myself safely to see if thy go away on their own? A couple weeks? Longer?

I feel like the dentist was playing it very safe to hustle me of to the maxo specialist doctor. But I don't want to take to long.

Is invasive removal of lots of tissue the treatment to expect if the screening comes back as cancerous? Should the lesions be removed if they are deemed precancerous?

Thank you for any advice you have for me.

Former chewer, now light smoker. Will stopping smoking help these spots heal on their own (if they are going to)?

Thanks.
Me.

Hello Mr Toots

Your white lesion could be related to Oral Frictional Keratosis, a thickening of the epithelium ( like a callus on the skin of the palms of a manual worker) related to food friction during chewing or a habit of chewing the insides of your cheek, as done inadvertently in those who clench on their teeth. This is often seen in posterior cheek areas opposite molar teeth.

Sometimes there is no known cause and it is labelled 'leukoplakia'. Leukoplakia has been defined as a whitish plaque that cannot be characterized clinically or pathologically as any other disease and is not associated with any physical or chemical causative agent except the use of tobacco. Patients diagnosed with idiopathic leukoplakia have the highest risk of developing cancer.

In studies of these patients, 4-17% had malignant transformation of the lesions in less than 20 years. Risk of developing malignancies at lesion sites is 5 times greater in patients with leukoplakia than without leukoplakia. The location of the leukoplakia is significant in terms of the degree of dysplastic or malignant changes, with the floor of the mouth and the ventral surface of the tongue being especially high risk. Although leukoplakia is more common in men than in women, women with leukoplakia have a higher risk of developing squamous cell carcinoma .

Professor Scully's article on Oral Leukoplakia discusses risk, treatment and measures that might reduce the risk.

The white patch (leukoplakia) may need a biopsy or watchful observation - it is most times not cancerous. From the information I have given and your reading of the articles linked to, you might get an idea of which it is. If it is not hurting you or increasing in size, etc don't worry needlessly, but your dentist is concerned enough to get an appointment with an oral & maxillofacial surgeon for advice for it is better to get a proper diagnosis early - you will sleep better! Stopping smoking will MOST definitely help reduce your risk.

Let us hope all turns out well. Let us know how you get on.

Best wishes
Vinod

Thank you for the linked information. I will make that appointment soon, just to be safe. Though i am also a (little) relived to hear that my current condition probably won;t require extensive surgery - of course only a proper diagnosis will tell.

Thanks again.