There are nearly 263,020 oral cancers and 127,654 oral cancer deaths worldwide every year1. As of January 1, 2010, there were approximately 275,193 women and men alive in the United States with a history of oral and pharyngeal cancer (181,084 men and 94,109 women)2. The 5-year survival rate of oral cancer patients remains virtually unchanged despite various therapeutic improvements over the past three decades3. Individuals at high risk of developing oral cancer (OC) are primarily older, male, heavy consumers of alcohol and tobacco, have a poor diet, and low socioeconomic status 4, 5. Recent studies have implicated HPV infection as a factor of independent risk for oral cancer (OC) pharyngeal tumors6, 7. For oral squamous cell carcinoma (OSCC), the role of HPV remains controversial8. OSCC begins in a multistep process in which normal cells are transformed into preneoplastic cells and then into cancer9. During this process, a sequential accumulation of genetic and molecular changes occurs10. Most oral cancers are preceded by visible changes in the oral mucosa. Within the oral cavity, lesions such as leukoplakia, erythroplakia, lichen planus and submucosal fibrosis have a propensity for malignancy11. Oral potentially malignant disorders (OPMDs) transform into oral tumors through various histopathological stages from hyperkeratosis/hyperplasia, to varying degrees of dysplasia (classified as mild, moderate or severe based on the presence and severity of cellular atypia and other structural aspects of the epithelium), to carcinoma in situ (CIS) and finally to invasive cancer12. Histopathological evaluation for the degree of epithelial dysplasia is the most common method to determine the malignant potential of patients with oral precancerous lesions... middle of paper... association between tobacco smoking, alcohol consumption and OPMD. Second, our findings may not be generalizable to the general population, as only dental patients were included. Randomized controlled trials may be useful to further investigate the sensitivity and specificity of oral visual examination in the context of OPMDs. Optimal oral visual screening for OC remains a simple and essential tool to identify any suspicious lesions and potentially increase survival. A thorough visual and tactile examination is warranted in dental patients, particularly those with a history of smoking and the elderly. Dentists should be alert for signs of potential oral malignancy and counsel their patients about risk factors for oral cancer. Although OPMDs were rare, our findings confirm the importance of thorough chairside screening by dentists to detect mucosal changes.