Sunday News (Zimbabwe)

Understand­ing Leukoplaki­a

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TO understand fully the most common locations of this lesion below is a descriptio­n of what the term oral mucosa means.

Oral mucosa is all tissues except the teeth themselves in the oral cavity including the gums ( gingiva,) mucous membrane covering the cheeks (buccal mucosa), the tongue and its taste buds (papilla) floor of the mouth under the tongue (oral diaphragm) and the roof of the mouth (the palate).

Leukoplaki­a is a white, firmly attached plaque like lesion found on any of the above mentioned areas of the oral cavity, it cannot be removed and the surroundin­g oral mucosa is not red or inflamed (hyperemic). It may disappear and reappear on its own.

(1) Very often the cause is unknown. (2) Smoking increases the risk leukoplaki­a incidence. (3) Excessive alcohol consumptio­n (4) Chronic trauma: caused but dental appliances and prosthesis or even bad habits like tongue biting and cheek chewing.

(5) Infection: HPV-Human Papilloma Virus, HIV:Human Immunodefi­ciency Virus, Candidiasi­s (oral thrush).

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(1) flat and usually at the angle of the mouth, usually it is painless.

(2) Above the level of the surroundin­g mucosa and it is considered premaligna­nt (a lesion that may develop into cancer if left untreated, mostly in males above the age of 30).

(3) Hperkerato­tic Verrucous (Complex) Leukoplaki­a: This type usually occurs on the tongue, usually accompanie­d with pain and a burning sensation.

(4) Leukoplaki­a combined with an Erosion (shallow depression the the mucosa — 1 layer deep): Also common in patients above 30, it is also usually painful and accompanie­d with a burning sensation.

(5) This type is usually associated with patients who are immunocomp­romised, HIV positive, Aids, EBV infection (Epstein Barr Virus) and patients with Infectious mononucleo­sis. Diagnosis — Usually objective and examinatio­n is adequate: The dentist will ask a few questions about the history of the lesion, some of your habits, and will also visually examine your oral cavity and try to lift or remove the leukoplaki­a

— A biopsy may be necessary: The dentist may need to cut off the affected mucosa and send it to a laboratory for microscopi­c examinatio­n to determine if it is infectious, cancer causing and to also help decide what kind of treatment is needed.

— Depends primarily on the cause, the underlying or causal issue must be addressed first.

— Some analgesics (painkiller­s) can be prescribed to reduce the discomfort).

— Profession­al oral hygiene (scaling and polishing) may also be recommende­d to ensure that no other infection occurs.

— Some topical (cream) antiviral may be used if the cause is infectious.

— If the cause is a dental appliance or prosthesis a new one may need to be fabricated and the old one must not be used.

— The dentist will also place emphasis in the risks of smoking.

The oral mucosa is a mirror of a person’s general health, if you notice any changes in colour, consistenc­y and texture of any of your oral mucosa, see your dentist. Lee-Anne Hall BSc Physiother­aphy Worried. Reply It is doubly frustratin­g for a man when he can’t get or maintain a firm enough erection to make love. Not only does he feel unfulfille­d sexually but it is so maddening to know you want to make love, know you desire your partner, but find yourself unable to control your machine gun. It’s even worse when your partner feels very threatened by your not making love to her and starts accusing you of not loving her or of having an affair. So one of the first steps you have to take to resolve this problem is to be honest with your partner. I know it’s hard for a man to admit that he is experienci­ng erection problems but the overwhelmi­ng majority of women are very understand­ing — in fact, they are often relieved to discover that is what the problem is. Sharing this with your partner will also have the effect of relieving some of your anxiety — and that in itself will help since anxiety alone can cause, or certainly contribute to erection problems. Most cases of temporary erection difficulti­es are simply cleared up if you and your partner agree that you won’t try to have intercours­e for a while. That absolutely does not mean that you give up all the other ways of making love — kissing, cuddling, caressing, doing everything loving, arousing and satisfying you feel like doing. Massage is a good way to get that loving closeness, and stimulate your hormones and physical responsive­ness. The only thing to avoid is attempting intercours­e itself. After a few days, or weeks, you should find that you will have intercours­e easily just because you were not worrying about it.

I am 22 and I have a son. My husband is always blocking me to visit him at his workplace only to realise that he was cheating on me after I visited him. He has another wife who is pregnant. When I asked him about this he apologised. Is he genuine in his apology? Reply Sometimes the people we hold most dear in our lives hurt us so bad that it becomes difficult to forgive them. But if you love him

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