Common white lesions of the oral cavity: Review of clinical presentations and management

Objective: To provide primary care physicians with a review of common oral white lesions and a practical management algorithm.

Sources of information: Between January and April 2024 relevant literature and clinical guidelines were searched for using the PubMed MEDLINE database with no date limitation.

Main message: A broad differential diagnosis exists for white lesions of the oral cavity. Fungal infections; human papillomavirus-related proliferations; reactive lesions secondary to physical, thermal, or chemical injuries; and premalignant or malignant clinical entities can all present as white lesions. Prompt recognition and proper management are therefore important. In certain instances, short-term follow-up of nonsuspicious lesions may be considered to assess for regression, persistence, or progression. Other lesions require timely investigations and treatment. Furthermore, providing patients with adequate counselling for lifestyle risk factors, including tobacco and alcohol use, is of utmost importance.

Conclusion: White lesions of the oral cavity are prevalent and may be encountered routinely in primary care settings. Recognizing the most common conditions and becoming proficient in their clinical management enhances patient care. Primary care physicians can play a crucial role in early detection of oral pathology. Proper triage of suspicious lesions can subsequently help decrease the wait time to see a specialist and avoid unnecessary medical visits for patients.