[Health lips beautiful smile: Conditions to know]

Diagnosis and management of lip pathologies should be part of the dentists' responsibilities. Lip pathologies might affect patient's function, appearance and quality of life. The routine clinical examination of the oral cavity includes lip examination--changes in lip color, size or texture should be recognized during the examination, as well as noticing any habit such as lip licking or mouth breathing.The aim of the review is to present common external lip lesions. Color changes--oral melanotic macule is a localized benign pigmented lesion. It might be similar to early melanoma therefore if it is a new lesion, growing or large it should be excised. White and red changes are usually seen at the lower lip which is exposed to the sun light mainly among light skin individuals. The color changes are showing epithelial and subepithlial permanent changes and is called Solar cheilitis. As a potentially malignant disorder the patient should be carefully examined and under follow- ups. These patients are also advised to reduce sun exposure and use sun screen lipsticks. Lichen planus of the lip can be seen as red and white changes the lips are less prevalent site of the disease and usually the patients will have in intra oral involvement as well. Size changes--angioedema is a quick enlargement of the lip sometimes the face as well. It is an allergic reaction to food drugs and other antigens and resolves spontaneously with 72 hours, but when the upper airway is involved an immediate emergency treatment should be given. A chronic swelling of the lip/lips may be a sign of orofacial granulomatosis--a complicated condition with an unknown etiology, diagnosed by a biopsy and elimination of other diagnoses. Treatment includes steroids in various forms or a combination of surgery. Changes of the epithelial surface of the lip can be a result of dry lips in a hot or dry environment or due to mouth breathing. Lip licking might worsen the situation by secondary infection. Angular cheilitis red and sometimes infected lesion of the commissures should be treated by antifungal and antibiotic and prevention of saliva drooling. Recurrent herpes labialis is a common condition that heals spontaneously but the dentist should be aware to local trauma or treatment that might trigger reactivation. In addition, contact of the vesicle fluid might spread the infection. Chronic ulcer or exophytic lesion is sign of lip carcinoma. The majority of patients in Israel are with lighter skin and sun exposure history. Most patients are over the age of 50. Risk groups should be examined carefully and routinely for any lip change. Israel is an endemic area of Leishmaniasis, and any chronic lip lesion among endemic areas residents or workers should be suspected as Leishmaniasis.