Analysis of Oral Mucosal Alterations in Orthodontic Patients: Implications for Carcinogenesis

Abstract

Background: Orthodontic treatment is widely employed to correct malocclusion and improve aesthetics and function. However, long-term appliance wear may induce chronic irritation and mucosal changes, potentially contributing to carcinogenic risk.

Objective: To analyze the prevalence and nature of oral mucosal alterations in orthodontic patients and explore their implications in the pathogenesis of oral carcinogenesis.

Materials and Methods: A descriptive cross-sectional study was conducted among orthodontic patients (n=250; aged 12–35 years) attending the Department of Orthodontics and Dentofacial Orthopaedics of a dental college. Patients with systemic illness, prior history of oral premalignant lesions, or tobacco use were excluded. Clinical examination was carried out under artificial illumination using mouth mirrors and explorers. Mucosal changes were recorded, including ulcerations, frictional keratosis, erythema, hyperpigmentation, and other lesions. Data were tabulated and analyzed descriptively to assess the distribution of lesions with respect to age, sex, and type of orthodontic appliance.

Results: Among 250 patients, mucosal alterations were observed in 118 cases (47.2%). The most common alteration was traumatic ulceration (52.5%), followed by frictional keratosis (31.4%), erythematous patches (10.1%), and hyperpigmentation (6%). Alterations were more prevalent in patients wearing fixed appliances (55.4%) compared to removable appliances (22.7%). Buccal mucosa and labial mucosa were the most frequently affected sites. Females showed slightly higher prevalence (49.6%) compared to males (44.3%). Though reversible in most cases, chronic keratotic lesions highlight potential pathways for epithelial dysplasia and oral carcinogenesis.

Conclusion: Orthodontic appliances are associated with clinically detectable oral mucosal alterations, primarily traumatic and keratotic in nature. While most are benign and reversible, persistent irritation may create a microenvironment conducive to malignant transformation. Regular monitoring and patient education are critical to mitigate long-term carcinogenic risk