What are Oral Lesions?

Oral lesions are flat or raised abnormal tissues that can occur anywhere in the oral cavity -- lips, cheeks, gums, and tongue, as well as the roof and floor of the mouth. Most oral lesions are benign (noncancerous). However, in general, lesions that bleed, grow rapidly, are painful, or have irregular borders need to be evaluated by a dentist or oral surgeon right away. If a lesion is suspected to be malignant (cancerous), then a biopsy (sample of tissue) may be taken and examined in a laboratory to determine whether harmful cells are present.

Oral fibromas are the most common benign lesion that occur in the mouth. They usually arise from constant cheek or lip biting, rubbing the cheek or tongue against a rough tooth, or using dentures. Mucoceles are another common noncancerous oral lesion. They form out of salivary glands and usually appear on the lower lip. Aside from the look and feel of these benign lesions, they typically do not cause any symptoms. Mucoceles tend to burst open after a few days or weeks and then heal on their own, whereas oral fibromas do not go away without treatment. Bothersome fibromas may be surgically removed, or excised, along with a tiny portion of surrounding healthy tissue.

Mouth ulcers are painful, open lesions. They may be caused by injury, infection, drugs, and certain medical conditions, like diabetes or blood disorders. Canker sores are the most common type of mouth ulcer. Most ulcers heal on their own, but non-healing ones should be biopsied for cancer. Ulcers may be treated using medicated sprays, gels, ointments, or creams. They may also be removed by a procedure called ablation, which destroys lesions using such techniques as laser or chemicals.

Oral leukoplakia is characterized by white or grayish patches on the tongue, cheek, gums, or floor of the mouth. It is usually benign but may also be precancerous. Smoking or drinking alcohol puts a person at an increased risk of developing leukoplakia, and sometimes the patches go away when tobacco or alcohol use is stopped. Treatments for leukoplakia include medication, surgical excision, and ablation.

Oral melanomas are malignant and appear as brownish lesions, most often on the roof of the mouth. They tend to spread to other parts of the body quickly, so detecting and treating them early are key in achieving favorable results. Excision, chemotherapy, and radiation are the most common treatments for melanomas.

Depending on the size and type of lesion that was removed, a hospital stay may or may not be required. Benign lesion ablation and excision can be performed at oral surgery centers, while removal of melanomas or other malignant lesions may need to be done at a hospital and require a few days' stay. Elevating the head when lying down, applying wet gauze on the affected area, and using an ice pack over the cheek for 2 to 3 days following surgery help reduce bleeding and swelling. Eating soft foods like applesauce, baked bananas, or soups with soft meats is recommended for about a week after the procedure. Normal activities may be resumed two to three days after a benign lesion excision, whereas recovery from a malignant lesion removal may require a few weeks.

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