Follow-up
Deterrence/Prevention
Removing the frictional irritant resolves the condition. Irritants include tissue chewing or sucking, ill-fitting or irregularly surfaced dentures, jagged teeth, poorly adapted dental restorations, and constant mastication on edentulous alveolar ridges.
If dental prostheses fit poorly or are broken, relining or fabricating new removable partial and full dentures decreases the development of frictional keratosis. Wearing an occlusal splint may be useful for decreasing or eliminating cheek and lip biting.
The patient should receive follow-up care to ensure the frictional area is resolving.
Media Gallery
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The white line observed on the cheek is level with the biting plane of the teeth. The wear on the occlusal surfaces of the molar teeth suggests that the patient had a habit of bruxism. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS.
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Prominent linea alba with evidence of cheek biting. The white line shows a slightly scalloped appearance, which correlates with the buccal surfaces of the teeth against which the mucosa is rubbed. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS.
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This wider area of roughened mucosa is typical of those produced by the habit of cheek biting or nibbling. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS.
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This frictional keratotic line shows a roughened surface. A thicker patch of mucosa is at the anterior end (under the tongue blade edge). This area is exactly level with the occlusal plane and was being chewed constantly by the patient. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS.
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Anterior rough surface area at the occlusal plane of the teeth. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS.
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Oral frictional hyperkeratosis of the lateral border of the tongue from chronic biting habit. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS.
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Oral frictional hyperkeratosis of the attached maxillary gingiva from inappropriate toothbrushing technique. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS.
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Oral frictional hyperkeratosis of the retromolar pad is also referred to as a ridge callus. This lesion is caused by masticatory irritation. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS.
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Low-power view of stratified squamous epithelium with marked hyperkeratinization, acanthosis, and a prominent granular cell layer. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS.
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High-power view of the surface keratin layer and a prominent granular cell layer. Courtesy of Catherine M. Flaitz, DDS and Alfredo Aguirre, DDS.
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