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Q. Are the white lines on my inner cheek a precancerous lesion?

Answered by
Dr. Krishna Swaroop Achanta
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 05, 2022

Hi doctor,

I have some white lines on my cheeks and would like to ask your opinion. Is biopsy required? My first dentist thought it was a pre-cancerous spot, but I went for a second opinion, and the doctor said it was nothing. So now I am confused. Kindly help.

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Hello,

Welcome to icliniq.com.

I understand your concern. I have seen the image (attachment removed to protect the patient's identity) you have enclosed. I am a maxillofacial surgeon too. I do not think a biopsy would be required based on what pictures you have uploaded. The lines seem quite faint on the buccal mucosa. Indeed, dentists usually warn of the state of precancer lesions. But to even develop into cancer, it takes months to years again. That is again dependent on the clinical extent of the lesion. Are you feeling any pain or oral discomfort because of these lines? I suggest you the following as precautionary steps,

1) Lukewarm saltwater rinsing multiple times a day for a week whenever your infection gets prominent.

2) Use a Chlorhexidine mouthwash daily at night time.

3) Regular oral prophylaxis every six months to one year.

If it is not causing any oral discomfort to you, then do not worry; these lesions will be self-limiting. I suggest you avoid hot, hard, and spicy foods and follow the hygiene instructions. A biopsy is required when you feel a painless lump or a, hardened tissue or continuously aggravating lesion. Even mildly precancerous, it will not transform overnight into a cancer lesion. Ensure that these lines vanish by following proper oral hygiene for a month. Usually, when you limit the cause of friction or grinding or sharp tooth or any other cause causing these lines, the lesions will self heal. If they do not heal even past a month, I suggest you go for an in-clinic examination by the maxillofacial surgeon, who will examine the texture of the lesion and then suggest you get the biopsy done. In my opinion, you may not need it right now.

I hope you understand.

Hi doctor,

Thank you for the reply. I did not feel any pain or oral discomfort. When I did a self-check on the lesions, it was gone when I stretched them outwards. Can it be a leukoedema? Also, I applied Bonjela gel and Orrepaste in that two regions. Could that be the reason? Kindly help.

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Hi,

Welcome back to icliniq.com.

There are possibilities of leukoedema. I need to examine these lesions physically to find out the diagnosis. I suggest applying Bonjela gel (Choline salicylate, Cetalkonium chloride) to reduce irritation. But Orrepaste (Triamcinolone Acetonide) is not required. In your case, I am not sure if it is precancerous. It looks fine to me. Just follow the oral hygiene instruction, and I suggest you take Omega-3 and Omega-6 fatty acid supplements at least thrice a week. Antioxidants will boost immunity and gingival health both by supplements and dietary intake of leafy veggies, eggs, berries, milk products, etc. So do not worry at all. Just focus on boosting immunity, good oral hygiene, and regular mouth washing. If you still suspect it past a month that these lines on stretching are not disappearing and are a concern to you, I suggest you get it checked physically by a maxillofacial surgeon.

Kindly revert in case of further queries.

Hi doctor,

Thank you for the information.

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Hi,

Welcome back to icliniq.com.

I hope you get well soon.

Hi doctor,

Thank you for the reply. How do I leave feedback?

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Hi,

Welcome back to icliniq.com.

No worries. I suggest you follow the supplements and hygiene instructions. Strictly avoid smoking and alcoholism. If it persists past a month, please reconsult me before you think of a biopsy.

Kindly revert in case of further queries.

Thank you.


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