Oral squamous cell carcinoma (OSCC) is one of the most prevalent cancers worldwide, leading to significant illness and death, particularly in low- and middle-income countries. In addition to tobacco, alcohol, and human papillomavirus (HPV), several culturally ingrained practices, such as areca nut chewing, toombak, khat, reverse smoking, and hot mate drinking, remain underrecognized but important cultural factors contributing to OSCC globally. These exposures operate through the formation of nitrosamine-induced DNA adducts, oxidative stress, chronic inflammation, and thermal injury. Areca nut and toombak are associated with oral submucous fibrosis and carcinoma, while reverse smoking and mate are linked to thermal and polycyclic aromatic hydrocarbon-related effects. Khat is connected to oxidative and cytogenetic damage. This narrative review combines epidemiological, mechanistic, and public health evidence on cultural carcinogens in OSCC, emphasizing prevention strategies that honor cultural identity through education, harm reduction, and community involvement. Dermatologists specializing in mucocutaneous oncology can detect early lesions like leukoplakia, erythroplakia, and oral submucous fibrosis. Including oral mucosal screening in routine care provides an effective, affordable way to prevent diseases in high-risk populations. Culturally sensitive, dermatology-focused prevention can help reduce OSCC incidence and disparities while respecting community identity.

BACKGROUND: Oral potentially malignant disorders (OPMDs) are a group of oral diseases that have the potential for malignant transformation. A significant proportion of oral squamous cell carcinomas arise from OPMDs. Thus, their early detection contributes to the prevention of oral cancer. An investigation of the public’s awareness and intended behavioral responses to OPMDs helps identify health-seeking patterns, underscoring risk factors that are associated with poor awareness of OPMDs management. OBJECTIVES: This study aims to investigate overall awareness of OPMDs among the public, and to understand the public’s behaviors as a response to different clinical subtypes of OPMDs. METHODS: A total of 528 patients attending a two-center dental institution in northern Jordan agreed to participate in this study. A researcher-administered questionnaire was employed to capture the responses of the participants to selected clinical images of OPMDs. Fifteen clinical image-based scenarios of OPMDs representing three lesion types—white, red, and erosive—in five oral locations—buccal, tongue, floor of the mouth, palate, and lips—were employed. RESULTS: Age and sex influenced overall OPMDs awareness (p < 0.001 and p = 0.006, respectively). Three behavioral phenotypes were identified among the study participants as follows: active/high awareness, moderately active/self-managing, and passive/low awareness. Lesion characteristics, including color and location, significantly influenced the response behaviors of participants. CONCLUSION: The findings of this study reveal moderate public awareness of OPMDs, with variations according to age group and sex. Distinct behavioral patterns were identified, influenced by the clinical characteristics of OPMDs. The findings of this study indicate a previously unrecognized and latent awareness level of OPMDs clinical variants that necessitates educational interventions to increase OPMDs awareness.

Ki67 is one of the preferred markers to provide standardization in the diagnosis/grading of oral potentially malignant disorder (OPMD) and oral squamous cell carcinoma (OSCC) in histopathological examinations. The aim of this systematic review is to evaluate the methodologies, findings and interpretations of Ki67 expression studies used in histopathological examinations for the diagnosis and grading of oral epithelial dysplasia (OED), OPMD (oral lichen planus, oral leukoplakia, erythroplakia, oral submucous fibrosis, and oral epithelial dysplasia) and OSCC cases in the literature. Articles in the Web of Science, Pubmed and Scopus databases within the last 5 years (2020-2024) were searched with the related keywords. The modified Quality in Prognosis Studies (QUIPS) tool was used to assess the "risk of bias" of the articles included. 50 articles were included in the systematic review. General risk of bias assessment of the articles included in the review, it was determined that the studies were high risk in terms of selection bias and performance bias, medium risk in terms of detection bias, and low risk in terms of attrition bias and reporting bias. Although it is generally possible to distinguish NM & OED with Ki67 expression, it may be more challenging than comparing NM & OSCC. Ki67 expression is not considered successful in determining the metastatic and recurrence potential of OSCC and OPMD. Ki67 expression may be lower in oral submucous fibrosis (OSMF) than in other types of OPMD, and the most important reason for this may be the proliferative activity change characterized by the typical atrophic epithelium of OSMF.

This article explores the etiopathogenesis and clinical spectrum of oral potentially malignant disorders (OPMDs), with a focus on 3 high-risk entities: leukoplakia, erythroplakia, and oral submucous fibrosis (OSMF). Oral cancer, predominantly squamous cell carcinoma, is strongly influenced by lifestyle habits such as tobacco use, betel nut chewing, and alcohol consumption. Leukoplakia, the most common OPMD, presents as a persistent white patch with variable potential for dysplasia. OSMF is a chronic, progressive fibrotic condition associated with areca nut use, leading to mucosal rigidity. The article emphasizes the importance of early diagnosis, histopathological evaluation, management, and the reduction of oral cancer incidence.

Photodynamic therapy (PDT) utilising 5-aminolevulinic acid (5-ALA) has emerged as a signifi-cant non-invasive treatment for oral potentially malignant disorders (OPMDs). PDT involves the use of a photosensitiser (5-ALA), light and oxygen to selectively target and destroy diseased tissues via photochemical reactions. This therapy has shown promising results in treating vari-ous OPMDs, such as oral leucoplakia, oral erythroplakia and oral lichen planus. This consensus document outlines the clinical application of 5-ALA-PDT, providing a comprehensive guide for oral mucosal specialists and stomatology departments. The consensus includes detailed recommendations on irradiation dose, irradiation time, light source selection, pre-treatment preparation, clinical diagnosis, treatment protocols, efficacy evaluation and management of post-treatment adverse events. The goal is to standardise 5-ALA-PDT procedures to improve clinical outcomes and provide a scientific basis for the treatment of OPMDs. By offering guid-ance on patient selection, lesion assessment and therapeutic strategies, this document aims to address current clinical challenges and enhance the effectiveness of PDT in managing oral mucosal diseases.

Oral cancer, particularly oral squamous cell carcinoma, remains a serious health concern, with a poor prognosis and a late diagnosis. Leukoplakia, erythroplakia, lichen planus, and submucous fibrosis are examples of oral potentially malignant disorders that must be detected early but are not always so by traditional, laborious, and subjective diagnostic techniques. In oral cancer, artificial intelligence (AI) and precision medicine are becoming game-changing technologies that enhance individualized care, treatment planning, and diagnostic precision. Complex imaging and histopathology data may be analyzed using machine learning and deep learning algorithms, particularly convolutional neural networks, which can identify patterns that are invisible to the human eye. AI systems based on smartphones have demonstrated expert-level accuracy in identifying oral lesions in recent experiments. Through the discovery of biomarkers and the integration of several omics, AI-driven precision medicine also makes customized treatments possible. Nonetheless, issues with patient privacy, data bias, and the opaque "black box" nature of AI systems persist. The future of proactive, individualized oral cancer care will be shaped by the development of Explainable AI and robust ethical frameworks, both of which are necessary to ensure transparency, trust, and equitable integration.

Oral cancer, particularly oral squamous cell carcinoma, remains a serious health concern, with a poor prognosis and a late diagnosis. Leukoplakia, erythroplakia, lichen planus, and submucous fibrosis are examples of oral potentially malignant illnesses. However, traditional diagnostic approaches are typically laborious, subjective, and unreliable, leading to delayed diagnosis - when therapy options are limited and survival is compromised. In oral cancer, artificial intelligence (AI) and precision medicine are becoming game-changing technologies that enhance individualized care, treatment planning, and diagnostic precision. Machine learning and deep learning algorithms, particularly convolutional neural networks, can analyze massive, complex datasets from fluorescence to hyperspectral imaging, revealing patterns that are beyond human detection. Recent trials have shown AI systems based on smartphones have demonstrated expert-level accuracy in identifying oral lesions in recent experiments. Through the discovery of biomarkers and the integration of several omics, AI-driven precision medicine also makes customized treatments possible. Nonetheless, issues with patient privacy, data bias, and the opaque "black box" nature of AI systems persist. The future of proactive and individualized oral cancer therapy relies on creating Explainable AI and strong ethical frameworks that encourage transparency, trust, and equitable integration.

Traumatic and reactive lesions of the oral mucosa, caused unintentionally by mechanical, thermal, or chemical irritation, may develop either acutely or chronically. In most cases, traumatic ulcerations heal within two weeks once the causative irritant is removed. However, persistent irritation can lead to chronic hyperkeratosis or mimic oral potentially malignant disorders (OPMDs). According to the World Health Organization (WHO), OPMDs such as leukoplakia, erythroplakia, proliferative verrucous leukoplakia, and oral submucous fibrosis carry an increased risk of malignant transformation into oral squamous cell carcinoma (OSCC). Clinically, reactive and potentially malignant lesions often present with overlapping features, rendering biopsy with histopathological evaluation essential for accurate diagnosis. This article presents two clinical cases that were initially misdiagnosed as lesions resulting from chronic mechanical trauma (CMT). Histopathological examination revealed high-grade epithelial dysplasia (carcinoma in situ) in one patient and a moderately differentiated OSCC in the other. These cases highlight the importance of a structured diagnostic approach—including removal of mechanical irritants, histopathological assessment, and regular clinical follow-up—to ensure early detection and appropriate management of suspicious lesions of the oral mucosa.