Objective: To learn the long-term treatment outcome of oral leuko- and erythroplakia. Method: A total of 271 lesions (69.8% homogenous and 24.7% non-homogenous leukoplakias and 5.5% erythroplakias) in 218 patients (122 women; mean age: 63.1 yrs. range: 23.3 - 92.4 and 96 men; mean age: 58.3 yrs. range: 28.1 - 82.9) were included. The mean follow-up period was 5.9 yrs. (range: 1-20). Biopsies from 194 lesions showed carcinoma in situ in 3.1%, severe dysplasia in 6.2%, moderate dysplasia in 11.9%, slight dysplasia in 20.1% and no dysplasia in 58.7%. 77 lesions were not biopsied because patients refused or dentists desisted from doing it, because the lesions were considered as having a low risk of premalignant changes based on the clinical features. 96 lesions (35.4%) (40 homogenous and 47 non-homogenous leukoplakias and 9 erythroplakias)were surgically removed. The remaining 175 lesions (64.6%)(128 homogenous and 47 non-homogenous leukoplakias and 9 erythroplakias) had no surgical intervention because patients refused or the lesions were considered as having a low risk of malignant development. Results: Among surgically treated lesions (1 erythroplakia, 11 non-homogenous and 1 homogenous leukoplakia), 13 (13.5%) developed carcinoma. Among non-surgically treated lesions 7 (4.0%) including 3 non-homogenous and 4 homogenous leukoplakias developed carcinoma. Conclusion: This study confirms that surgical intervention does not prevent malignant development of oral leukoplakia and erythroplakia in all cases. Moreover, there appears to be no obvious clinical or histological characteristics of lesions, which allows a safe prediction of future malignant development.

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