Palatal perforation: A visible or non-visible deformity in leprosy

Leprosy is caused by Mycobacterium leprae. It is a chronic granulomatous systemic infection that affects the skin and peripheral nerves. Oral lesions as palatal perforation tend to appear in the later stages of leprosy and often reflect a significant disease burden in the community. Early diagnosis and treatment of leprosy are essential to halt disease transmission and reduce the risk of disability. Oral examination is often overlooked in leprosy patients, but it is essential to assess the oral cavity in all cases, as lesions or abnormalities can go unnoticed, especially if the patient is unaware of their presence. This invisible oral lesion is only visible in few research papers as case reports. Palatal perforation are successfully reconstructed using lateral nasal and rotated palatal mucosal flaps, achieving favorable anatomical and functional results following effective antileprosy therapy for the underlying condition. Maintaining good oral hygiene in leprosy patients is important, as early identification and management of oral lesions can help reduce the risk of disease transmission. There is also missed opportunity in integration of National Leprosy Eradication Programme (NLEP) with National Oral Health Programme (NOHP). Multidisciplinary approach of Oral Medicine and Radiology, Oral Maxillofacial Surgery, Prosthodontic, Public health Dentistry, Dermatology and Otorhinolaryngology departments is significantly required at all levels of prevention of leprosy. Further, the programmatic management ensures its incorporation into national health programmes with defined roles and responsibilities during training for effective translation and implementation of multidisciplinary approach for effective functional and structural rehabilitation in leprosy.