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O papel do médico dentista no diagnóstico e evolução das lesões potencialmente malignas da cavidade oral
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Abstract(s)
Ao longo dos anos tem existido um aumento de patologias malignas na cavidade oral, não só em Portugal, como em todo o mundo. A maioria das doenças encontradas na cavidade oral estão em estado muito avançado de desenvolvimento, o que dificulta o tratamento e reduz a qualidade de vida dos pacientes e consequentemente a redução do tempo sobrevida.
As lesões potencialmente malignas, são uma condição pré-cancerígena, que quando não identificada e tratada a tempo, pode progredir para cancro oral invasivo. É fundamental que os médicos-dentistas, que têm uma posição privilegiada na deteção e identificação destas lesões, dominem as características clínicas dos diferentes tipos de lesões, bem como, as patologias subjacentes para interceptar/ reduzir a sua progressão diminuindo a mortalidade.
As lesões potencialmente malignas abordadas são principalmente a Leucoplasia Oral, Líquen Plano Oral, Eritroplasia, Lupus Eritematoso Discoide, Disqueratose Congênita, Queilite Actínica, Fibrose Submucosa, Tabagismo Reverso e outras mais.
Os médicos dentistas desempenham um papel fundamental na educação da saúde oral, alertando os pacientes sobre os riscos e os fatores associados às lesões potencialmente malignas, como podem ser tabaco álcool, exposição excessiva ao sol. O diagnóstico clínico deve ser acompanhado do exame histológico, por isso é obrigatório fazer biópsias às alterações suspeitas.
O acompanhamento faz-se desde idades precoces, sendo muito importante para avaliar a eficácia do tratamento e qualquer sinal de recorrência ou progressão da lesão. Verificámos que estas doenças potencialmente malignas, não têm grande incidência em crianças, adultos jovens e de meia-idade, atingindo sobretudo doentes mais idosos. No entanto as mais frequentes nas crianças e adolescentes são: Disqueratose Congénita, Herpes Virus, Candidíase Oral e Papiloma Vírus Humano (HPV).
Over the years there has been an increase in malignant pathologies in the oral cavity, not only in Portugal, but all over the world. Most diseases found in the oral cavity are in a very advanced stage of development, which makes treatment difficult and reduces the quality of life of patients and consequently reduces survival time. Potentially malignant lesions are a precancerous condition, which when not identified and treated in time, may progress to invasive oral cancer. It is essential that dentists, who have a privileged position in the detection and identification of these lesions, master the clinical characteristics of the different types of lesions, as well as their underlying pathology to intercept/reduce their progression reducing mortality. The potentially malignant lesions addressed are mainly Oral Leukoplakia, Oral Lichen Planus, Erythroplakia, Discoid Lupus Erythematosus, Congenital Dyskeratosis, Actinic Cheilitis, Submucosal Fibrosis, Reverse Smoking and others. Dental doctors play a key role in oral health education, warning patients about the risks and factors associated with potentially malignant lesions, as can be tobacco alcohol, excessive sun exposure. The clinical diagnosis must be accompanied by histological examination, which is why it is obligatory to perform biopsies on suspicious alterations. Follow-up from an early age is very important to assess the effectiveness of treatment and any signs of recurrence or progression of the lesion. We have found that these potentially malignant diseases do not have a high incidence in children, young and middle-aged adults, affecting mostly older patients. However, the most frequent in children and adolescents are: Congenital Dyskeratosis, Herpes Virus, Oral Candidiasis and Human Papilloma Virus (HPV).
Over the years there has been an increase in malignant pathologies in the oral cavity, not only in Portugal, but all over the world. Most diseases found in the oral cavity are in a very advanced stage of development, which makes treatment difficult and reduces the quality of life of patients and consequently reduces survival time. Potentially malignant lesions are a precancerous condition, which when not identified and treated in time, may progress to invasive oral cancer. It is essential that dentists, who have a privileged position in the detection and identification of these lesions, master the clinical characteristics of the different types of lesions, as well as their underlying pathology to intercept/reduce their progression reducing mortality. The potentially malignant lesions addressed are mainly Oral Leukoplakia, Oral Lichen Planus, Erythroplakia, Discoid Lupus Erythematosus, Congenital Dyskeratosis, Actinic Cheilitis, Submucosal Fibrosis, Reverse Smoking and others. Dental doctors play a key role in oral health education, warning patients about the risks and factors associated with potentially malignant lesions, as can be tobacco alcohol, excessive sun exposure. The clinical diagnosis must be accompanied by histological examination, which is why it is obligatory to perform biopsies on suspicious alterations. Follow-up from an early age is very important to assess the effectiveness of treatment and any signs of recurrence or progression of the lesion. We have found that these potentially malignant diseases do not have a high incidence in children, young and middle-aged adults, affecting mostly older patients. However, the most frequent in children and adolescents are: Congenital Dyskeratosis, Herpes Virus, Oral Candidiasis and Human Papilloma Virus (HPV).
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Patologia oral Patologia maligna Patologia benigna Lesões orais