Nearly 263,020 oral cancers and 127,654 oral cancer deaths occur worldwide each year1. As of January 1, 2010, there were approximately 275,193 living women and men in the United States with a history of oral cavity and pharyngeal cancer (181,084 men and 94,109 women)2. The 5-year survival rate of patients with oral cancer remains almost unchanged despite various therapeutic improvements over the past three decades3. People at high risk of developing oral cancer (OC) are mainly older men, heavy consumers of alcohol and tobacco, poor diet and low socioeconomic status4, 5. Recent studies have implicated HPV infection as an independent risk factor for oral cancer. pharyngeal cancers6, 7. For oral squamous cell carcinoma (OSCC), the role of HPV remains controversial8. OSCC initiates a multistep process in which normal cells are transformed into preneoplastic cells and then cancer9. During this process, a sequential accumulation of genetic and molecular changes occurs10. The majority of oral cancers are preceded by visible changes in the oral mucosa. In the oral cavity, lesions such as leukoplakia, erythroplakia, lichen planus and submucosal fibrosis have a propensity for malignancy11. Oral potentially malignant disorders (OPMD) develop into oral cancers through various histopathological stages ranging from hyperkeratosis/hyperplasia to varying degrees of dysplasia (classified as mild, moderate or severe depending 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 assessment of epithelial dysplasia grade is the most common method to determine the malignant potential of patients with oral precancerous lesion... middle of article ...... association between smoking, alcohol consumption alcohol and OPMDs. Second, our results may not be generalizable to the population as a whole because 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 OPMD. Optimal oral visual screening for OCs remains a simple and essential tool to identify any suspicious lesions and potentially increase survival. A thorough visual and tactile examination of dental patients, especially those with a history of smoking and the elderly, is warranted. Dentists should remain alert for signs of potential oral malignancy and counsel their patients about risk factors for oral cancer. Although OPMDs are rare, our results support the importance of a thorough chairside examination by dentists to detect any changes in the mucosa..