Oral Precancerous Lesions in Childhood: Attention to the Pediatricians and Pediatric Dentists

Precancerous lesions of oral mucosa, known as premalignant disorders, have greater malignant transform risk concerning dysplastic changes, carcinoma in situ or oral cancers. Oral lichen planus, oral leukoplakia, oral erythroplakia, oral submucous fibrosis, dyskeratosis congenita and epidermolysis bullosa are the most common precancerous lesions in varying frequency in children. Although the etiological factors of these lesions are not entirely understood; the main factors are smoking, alcohol consumption or addictive habits such as areca nut chewing. Moreover; these harmful habits are increasing dramatically in children in early ages and it is challenging regarding public health. Despite the oral cancers or precancerous lesions are rarely seen in childhood, early diagnosis and treatment of these lesions are critical regarding differences in treatment procedures in children, elimination of harmful habits that may cause these lesions and providing regular follow-ups. Therefore, it is thought that specialist in different disciplines which involved pediatric patients need to be informed and raised awareness. The aim of this review is to summarize the clinical features, pathogenesis, etiological factors, current treatment approaches and preventive procedures of the most common oral precancerous lesions in pediatric patients.

Çocuklarda Oral Prekanseröz Lezyonlar: Pediatrist ve Pedodontistlerin Dikkatine

Premalign hastalıklar olarak da bilinen oral mukozanın prekanseröz lezyonları; displastik değişimler, karsinoma in-situ ya da oral kanserler konusunda ciddi malign dönüşüm riskine sahiptir. Oral liken planus, oral lökoplaki, oral eritroplaki, oral submüköz fibrozis, diskeratosis kongenita ve epidermolizis büllosa çocuklarda değişken görülme sıklığı ile beraber, en çok görülen prekanseröz lezyonlardır. Bu lezyonların etiyolojik faktörleri tam olarak anlaşılamamış olsa da; ana faktörler sigara kullanımı, alkol tüketimi ya da areca nut çiğneme gibi bağımlılık yapan alışkanlıklardır. Dahası; bu zararlı alışkanlıklar çocuklarda özellikle erken yaşlarda dramatik olarak artmakta ve halk sağlığı konusunda sorun olmaktadır. Çocukluk çağında oral kanserlere ya da prekanseröz lezyonlara nadiren rastlanmasına rağmen, bu lezyonların erken tanı ve tedavisi; çocuklarda tedavi prosedürlerindeki farklılıklar, bu lezyonlara neden olabilecek zararlı alışkanlıkların giderilmesi ve düzenli takiplerin sağlanması açısından önemlidir. Bu nedenle, pediyatrik hastaları konu alan farklı disiplinlerdeki uzmanların bilgilendirilmesi ve farkındalığının artırılması gerektiği düşünülmektedir. Bu derlemenin amacı, pediyatrik hastalarda yaygın görülen oral prekanseröz lezyonların klinik özelliklerini, patogenezini, etiyolojik faktörlerini, güncel tedavi yaklaşımlarını ve önleyici prosedürlerini özetlemektir.

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