man speaking with dentist about erythroplakia

Erythroplakia: What This Red Spot May Mean

The inside of a healthy mouth normally ranges from pink to brown in color. However, a condition called erythroplakia can create an alarming spot of red. If you notice a red patch in your mouth, it's time to visit your dentist.

Spotting an Oral Lesion

Erythroplakia is a lesion — an area of tissue that has suffered injury or disease — in the mouth that is smooth and red in color. As explained by the World Health Organization (WHO), the lesion may be asymptomatic, meaning it might not cause pain. Typically, it is found on the inside of the cheek, on or under the tongue or on the soft palate. The outline of the lesion is well-defined, meaning it appears different from the healthy tissue around it. The Oral Cancer Foundation reports that a white lesion called leukoplakia is a similarly distinct patch that can form a mixed red and white lesion called erythroleukoplakia.

Potential Risk Factors

How this type of lesion originates in the mouth is unknown. However, there are several risk factors outlined by the Canadian Cancer Society that may increase your chances of developing erythroplakia, including smoking and chewing tobacco and excessive alcohol consumption. In general, older men are more likely to develop this lesion, according to the WHO.

Is It Oral Cancer?

Erythroplakia is not cancer, which is very important to remember. However, it is considered precancerous, meaning the cells in the red lesion have a risk of becoming cancer cells. The Canadian Cancer Society notes that approximately 50 percent of these red lesions turn into a type of oral cancer called squamous cell carcinoma. Through regular screening and follow-up, your dental or medical professional will monitor any precancerous patches.

The only way to definitively diagnose a lesion in your mouth is to visit your dentist. The lesion could be erythroplakia, or it could be a different type of lesion, as outlined by the WHO:

  • An oral symptom of the chronic autoimmune disorder lupus
  • A fungal infection called thrush, or candidiasis
  • Denture-induced stomatitis, or painful swelling and sores caused by improper denture cleaning

Your dental professional may take a biopsy to help guide diagnosis and treatment. Additionally, as described by a study in Oral Diseases, they may apply a dye called toluidine blue to help identify abnormal cells and guide the location for biopsy.

Treatment Options

Armed with a diagnosis, you and your dentist can decide on the appropriate treatment. Many lesions can be surgically removed and monitored to make sure they don't come back, reports The Oral Cancer Foundation. If your dentist determines that surgery is necessary, they may recommend one of three routes, explains the Canadian Cancer Society: traditional surgery, laser surgery or cryosurgery.

While traditional surgery is often performed with a scalpel, the Canadian Cancer Society explains that laser surgery is performed with a heated laser that makes bloodless cuts. Alternatively, cryosurgery applies intense cold to freeze and remove the affected area, reports a study in Contemporary Clinical Dentistry. Your dentist will help you decide which type of surgery is best for you. No matter how you approach treatment, it is important to eliminate high-risk behaviors like smoking, which may increase your chances of developing oral cancer.

Erythroplakia can be a puzzling diagnosis. If you find a red spot in your mouth and you think it may be a precancerous lesion, make an appointment with your dentist and return for regular follow-up care to monitor these irregular cells. Most importantly, stay on top of your routine dental visits so your dentist can perform regular oral cancer screenings and help you stay healthy.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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