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 Table of Contents  
SHORT COMMUNICATION
Year : 2022  |  Volume : 34  |  Issue : 4  |  Page : 479-480

Novel classification system based on mental attitude for patients with oral leukoplakia: A proposal


1 Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India
2 Department of Oral Medicine and Radiology, Government Dental College and Hospital, Mumbai, Maharashtra, India

Date of Submission18-May-2022
Date of Decision09-Aug-2022
Date of Acceptance26-Oct-2022
Date of Web Publication09-Dec-2022

Correspondence Address:
Sanpreet S Sachdev
301, Department of Oral Pathology and Microbiology, Government Dental College and Hospital, P D' Mello Road, Fort, Mumbai - 400 001, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaomr.jiaomr_147_22

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   Abstract 


The patient's mental attitude is crucial in accepting the condition and compliance with tobacco cessation counseling. Even so, it was not considered a contributory factor in any of the earlier risk assessment systems. In this context, we have proposed a classification system to categorize patients with leukoplakia based on their mental attitude about understanding the risk associated with the disease and their motivation toward tobacco cessation.

Keywords: Oral potentially malignant disorders, patient psychology, tobacco cessation


How to cite this article:
Sachdev SS, Chettiankandy TJ, Kadam S, Nimma V. Novel classification system based on mental attitude for patients with oral leukoplakia: A proposal. J Indian Acad Oral Med Radiol 2022;34:479-80

How to cite this URL:
Sachdev SS, Chettiankandy TJ, Kadam S, Nimma V. Novel classification system based on mental attitude for patients with oral leukoplakia: A proposal. J Indian Acad Oral Med Radiol [serial online] 2022 [cited 2023 Jan 28];34:479-80. Available from: http://www.jiaomr.in/text.asp?2022/34/4/479/363016




   Introduction Top


Behavioral interventions have been proven to be most efficacious in tobacco cessation therapies, the basis of which is patient counseling.[1] Therefore, the patient's mental attitude plays a significant role in compliance with the therapy protocol. Even so, the patient's mental attitude was never considered a possible contributory factor in the malignant transformation or, more specifically, the outcome of treatment of oral leukoplakia (OL).[2] In this context, we have proposed a classification system to categorize patients with OL based on their mental attitude about understanding the risk associated with the disease and their motivation toward tobacco cessation.

The proposed classification system

The classification system was developed after the observation of 330 patients with OL. The patients were categorized only after informing them about the diagnosis of OL and the possibility of its resolution with adequate intervention. The patients were then categorized based on their acceptance of the risk carried by the condition and motivation toward quitting tobacco, along with a tentative counseling strategy for each category [Table 1].
Table 1: Proposed classification system for patients with oral leukoplakia

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Several classifications were proposed for denture patients in prosthodontics by various authors.[3],[4] The concept is similarly applicable to patients with OL in which patients of certain categories listed in these classifications, such as reluctant, indifferent, apprehensive, and hysterical, were noted; these were adopted from the existing classifications.

The “Optimistic” category corresponds to the “Philosophical” type of patients described by House. On the other hand, reluctant Patients were described by Gamer as those who doubt the dentist and are skeptical of the treatment plan.[3],[4]. In the case of OL, the patient's reluctance may be associated with accepting the condition or doubt about one's ability to quit tobacco. A portion of patients, especially those in elder age groups, occasionally exhibited indifference toward the possibility of an unfavorable outcome of OL in the future. They did not heed the clinician's advice to exercise caution about their tobacco habit. Consequently, there was no effort to comply with the treatment from their side.

Two special categories, apprehensive and hysterical, were incorporated into the system separately because of the uncertainty of prognosis in a mentally unstable state. Excessive apprehensiveness and emotional instability may hamper the normal thought process of an individual, and their same attitude may not be revealed.[5] They can be included in one of the primary categories once their attitude is stabilized.


   Conclusion Top


The proposed classification system can be an eye-opener leading to greater success rates in managing patients with OL. Clinical trials with adequate long-term follow-up would serve to validate the classification or suggest possible modifications that would be required in the future.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Patnode CD, Henderson JT, Coppola EL, Melnikow J, Durbin S, Thomas RG. Interventions for tobacco cessation in adults, including pregnant persons: updated evidence report and systematic review for the US Preventive Services Task Force. J Am Med Assoc 2021;325:280-98.  Back to cited text no. 1
    
2.
Martin GC, Brown JP, Eifler CW, Houston GD. Oral leukoplakia status six weeks after cessation of smokeless tobacco use. J Am Dent Assoc 1999;130:945-54.  Back to cited text no. 2
    
3.
Jubhari EH, Rachellea K. Patient mental attitude: A systematic review. J Dentomaxillofac Sci 2020;5:69-73.  Back to cited text no. 3
    
4.
Choudhary S, Kumar A, Arora H. Correlation of patient's mental attitude with age, sex, and educational level: A survey. Eur J Dent 2016;10:23-8.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
Avis KA, Stroebe M, Schut H. Stages of grief portrayed on the internet: A systematic analysis and critical appraisal. Front Psychol 2021;12:772696.  Back to cited text no. 5
    



 
 
    Tables

  [Table 1]



 

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