Reliability and validity of light-based screening techniques in detection of oral premalignant lesions

Objective: To assess and create awareness towards risk factors like Kath chewing and other tobacco related habits and prevalence of premalignant lesions and early detection through light based Screening tool. Methodology: -First stage comprised of an interview to get demographic and preliminary data for the study. In the second stage, the entire recruited participants underwent an oral examination, and suspected lesions were further seen by specialist dental surgeon. Exclusion is done by a specialist dentist to group them into clinical types based on clinical provisional diagnosis and are referred for histopathologic examination for further management. Third stage all suspected red and white lesions, inconspicuous lesions are screened by Acetic acid and VElscope to identify & confirm visible changes which required histopathological examination for further definitive treatment options. Result: 75% study subjects showed Aceto-whitening, 9.3% subjects showed negative result and 11.4% subjects showed false positive results and 2.8% projected as No Abnormality Detected in acetic acid test. In VElscope examination, 65.6% Showed Positive Dark areas, followed by 34.3 % False Positive results. There were no negative finding. Positive Predictive Value stands more with age old Acetic acid test (75%) when compared with advance methods like VELscope (65.6%). Conclusion: The oral cavity should be carefully examined in tobacco users. Any changes in color or texture of oral mucosa should arouse suspicion of the presence pre malignant lesions and/or oral cancer. Devices like VELscope can be used as a diagnostic aid for identification of these lesions. However, we have to realize that still the histopathological examination is the most accurate method to confirm the diagnosis.