Dysplastic changes require referral

Patients older than 60, especially smokers or those who drink excess alcohol, are at an increased risk of oral cancer. Oral cancer can present as an area of leukoplakia, erythroplakia, ulceration, pigmentation or as a lump.

The image shows an area of homogeneous leukoplakia in the floor of the mouth extending on to the under surface of the tongue. Leukoplakia can be just a hyperplastic benign thickening of the mucosal lining or show dysplastic changes on biopsy. If moderate to severe dysplasia, then