Tobacco-associated lesions of the oral cavity: Part I. Nonmalignant lesions

The excessive use of tobacco products has been associated with various lesions in the oral cavity. Tobacco-associated lesions include tooth stains, abrasions, smoker's melanosis, acute necrotizing ulcerative gingivitis and other periodontal conditions, burns and keratotic patches, black hairy tongue, nicotinic stomatitis, palatal erosions, leukoplakia, epithelial dysplasia and squamous-cell carcinoma. A routine intraoral examination by a dental health professional can reveal most of these lesions at an early stage, and early intervention may prevent serious sequelae. Thus, detection of tobacco-associated lesions in conjunction with tobacco-use counselling by dental professionals has become the standard of care. The significance and treatment of nonmalignant tobacco-associated lesions are addressed in the first part of this two-part series. Malignant lesions, basic biopsy principles and prevention and intervention strategies are discussed in the subsequent part.