Do you have red spots inside your mouth? You don't know that it's erythroplakia! Let's talk about this.

Have you ever noticed in the mirror while brushing your teeth or rinsing your mouth, a red spot or patch inside your mouth, perhaps on your tongue, inside your cheeks, or under your tongue? Sometimes these may not be so common. But my friend, some red spots like this, if we medically speak, may be due to a condition called erythroplakia . This is something that you should be a little concerned about sometimes.

What is Erythroplakia, friend?

Simply put, erythroplakia is a condition where red patches or patches develop on the delicate lining of your mouth (called the oral mucosa). These can appear on your tongue, the inside of your cheeks, under your tongue, or even in your throat.

Think about it, the skin inside our mouth is very delicate, isn't it? That's where these red spots form. Most of the time, these erythroplakia spots are harmless. However, the most important thing is that some of them can be cancerous conditions, or they can be precancerous. That's why it's important to tell a doctor if you notice anything unusual inside your mouth.

Who is most likely to get this?

Erythroplakia can actually develop in anyone. However, some people are more prone to developing it.

• Smokers: People who smoke cigarettes are more likely to develop this condition.
• Tobacco smokers (chewing tobacco users): People who chew tobacco with betel leaves are also at risk.
• People over 40 years of age: This condition generally becomes more common with age.

In Sri Lanka, betel nut eating and tobacco use are a bit high, aren't they? So it's good for those who have such habits to be especially aware of this.

How common is Erythroplakia?

It's not as common as leukoplakia (a condition that causes white patches in the mouth). Roughly speaking, it's said that about 1 in 2,500 adults in the United States has it. But just because it's not common doesn't mean we can't get it too.

Is Erythroplakia dangerous? Should we be concerned?

Here's the important thing. Doctors consider erythroplakia a precancerous condition . This means that some of these spots can become cancerous, or turn into cancer.

But don't worry! Most erythroplakia spots are harmless. However, to know for sure, you need to see a doctor and get checked out.

If you notice any unusual spots or patches in your mouth, see a doctor or dentist right away. They can do a biopsy (a small piece of tissue taken for examination) if necessary to see if it is cancerous.

What are the symptoms of this? How do you recognize it?

Most people with erythroplakia don't experience pain or other obvious symptoms at first. That's why you may not even know you have it. However, you may notice things like:

• One or more red, patchy spots inside the mouth .
• These spots may be slightly raised or flat .
• The tissue where the spots are located may be smooth like velvet or may take on a granular appearance.
• Sometimes, when you scrape under these spots, blood may come out .

If you see something like this, you should definitely show it to a doctor.

Why does erythroplakia develop? What are the causes?

There are several main reasons for this:

• Smoking: This is the main enemy.
• Chewing tobacco: Chewing tobacco along with betel leaves is also a major cause.
• Excessive alcohol use: Like anything, alcohol can cause problems when consumed in excess.
• Ill-fitting dentures: Sometimes the dentures our grandparents gave us don't fit properly and can cause damage to the mouth. This long-term damage can also be a cause.

Additionally, sometimes erythroplakia can occur as a secondary infection with a fungal infection in the mouth (candidiasis or thrush). Surprisingly, sometimes this condition occurs for no apparent reason .

Other factors that increase risk:

• Poor oral hygiene: People who do not brush their teeth properly or rinse their mouths are also at higher risk.
• Over 40 years of age.
• Having a Human Papillomavirus (HPV) infection .

How does a doctor diagnose this?

Erythroplakia is often painless, so it's usually discovered during a routine checkup when you go to the dentist. If a doctor suspects something is wrong, they'll likely do a biopsy . This involves taking a small piece of tissue from the area where the red spot is and sending it to a lab to examine the cells.

This biopsy can help determine whether a mole is cancerous, precancerous, or benign. It can also help rule out other conditions that may have similar symptoms (such as lichen planus, acute atrophic candidiasis, hemangioma, lupus, and pemphigus).

What are the treatments for erythroplakia?

The treatment method is determined based on the results of the biopsy.

• If the condition is harmless and mild: Your doctor will likely monitor you with regular follow-up visits. No other treatment may be needed.
• If the condition is severe, reoccurs, or contains cancerous cells: A doctor may suggest treatments such as:
• Laser surgery: This involves using laser beams to destroy the problematic cells. The damage to the surrounding healthy tissue is minimal.
• Cryosurgery: This involves using extreme cold (such as liquid nitrogen) to destroy the affected tissue.
• Cancer treatment: If the biopsy results show cancer, your doctor will refer you to an oncologist, who may recommend treatments such as radiation therapy, chemotherapy, or immunotherapy .

How long does it take to recover after treatment?

This varies from person to person. It depends on many factors, including the type of surgery, the size of the scar, and your body's ability to heal. Typically, you can expect to recover completely in three to four weeks after laser therapy or cryotherapy. However, for someone undergoing cancer treatment, it can take weeks or months to fully recover. Ask your doctor how long it will take depending on your condition.

Can we prevent this from happening?

Because erythroplakia sometimes develops for no apparent reason, it may not be possible to completely prevent it. However, there are things we can do to reduce our risk:

• Avoid all tobacco products: cigarettes, bidis, cigars, chewing tobacco.
• Reduce or completely stop alcohol consumption.
• Maintain good oral health: Brush your teeth twice a day and rinse your mouth thoroughly.
• See a dentist regularly: Visit a dentist at least once a year for a check-up.
• If you wear dentures: Have them checked every two to three years and relined if necessary. This is because the gums in your mouth change over time, which can cause your dentures to not fit properly.

What happens if you have erythroplakia? Should you be worried?

Erythroplakia is a condition that can lead to cancer. However, most people do not develop cancer from it. So don't worry unnecessarily. However, the most important thing is to see a doctor, get an accurate diagnosis, and develop a treatment plan if necessary.

Sometimes erythroplakia will go away on its own. However, if it is severe or occurs frequently, your doctor may recommend something like laser treatment or cryotherapy.

Most importantly, if the biopsy results confirm cancer, the doctor will refer you to an oncologist for further testing and treatment. Early detection is easier to treat.

Do you need to be careful with food and drink?

Although most people do not experience any pain from erythroplakia, some may experience a sore mouth or a burning sensation when eating spicy or hot foods. So if you feel the same way, it is best to stay away from such foods and drinks for a while.

When should I see a doctor?

If you notice any unusual sores, spots, lumps, or bumps inside your mouth, see a dentist or general practitioner immediately. You should definitely get a medical checkup to find out if this is something minor or serious. They can then check for other serious illnesses and tell you exactly what's wrong with you.

What are the important questions to ask the doctor?

If you find out you have erythroplakia, you can ask your doctor questions like these:

• Do you know what causes this?
• What changes do I need to make in my lifestyle?
• Do I also have leukoplakia (white spots)?
• Do I need treatment? If so, what kind of treatment?
• How long do you think it will take to recover?
• What are the chances of this erythroplakia recurring?

It is very important to ask questions like these to gain a better understanding of your situation.

What is the difference between Erythroplakia and Leukoplakia?

Sometimes, along with red patches (erythroplakia) in your mouth, you may also see white patches. Those white patches are called leukoplakia . This is another condition that occurs in the delicate membranes of the mouth.

Simply put:

• Erythroplakia is a condition in which red patches or patches develop in the mouth. These can be raised or flat. Sometimes they may bleed when touched or scratched.
• Leukoplakia is a condition that causes white patches or spots in the mouth. These cannot be removed by scratching.

It is important to take care of both of these.

Finally, things to remember (Take-Home Message)

Okay, so we've talked a lot about erythroplakia, haven't we? Here are some key things to remember:

• Erythroplakia is a condition where red patches or spots develop inside your mouth or throat.
• Although these are mostly harmless, it is important to be aware of them as some can become cancerous (precancerous) .
• If you notice any unusual spots or sores in your mouth, see a dentist or general practitioner immediately.
• Smoking and chewing tobacco are the main causes of this condition.
• If identified and treated early, very good results can be achieved.

So, be careful about your oral health, because there's a saying that goes, "The mouth is the mirror of the body"!

I hope this information is useful to you. Stay healthy!

` Erythroplekia, red spots in the mouth, oral cancer, smoking, betel nut, dental health, leukoplakia