Non-Pharmacological Treatments for Oral Carcinogenesis: From Oral Lichen Planus to Oral Squamous Cell Carcinoma

Oral lichen planus (OLP) is a chronic, immune-mediated inflammatory disorder of the oral mucosa recognized as an oral potentially malignant disorder, with a pooled malignant transformation rate of approximately 1–1.4% that is highest in atrophic-erosive and tongue lesions. Its most feared outcome, oral squamous cell carcinoma (OSCC), remains associated with a 5-year survival below 50% and a substantial clinical, functional, and economic burden. Because conventional management, like topical corticosteroids for OLP and surgery with or without radiotherapy for OSCC, entails cumulative toxicity and limited long-term efficacy, non-pharmacological strategies are attracting growing interest. This narrative review critically appraises the available evidence across the OLP-to-OSCC continuum, examining high-power ablative lasers, low-level laser therapy/photobiomodulation, photodynamic therapy, nutraceutical and phytotherapeutic agents (including melatonin, curcumin, aloe vera, coconut, zinc, and vitamin D), cryotherapy, ozone therapy, probiotics, and psychological interventions, alongside supportive measures in OSCC such as oral hygiene management, photobiomodulation for treatment-related toxicity, and post-treatment rehabilitation. Evidence is strongest and most consistent for photobiomodulation in OLP, whereas most other modalities remain promising but limited by small samples, heterogeneous protocols, and scarce placebo-controlled data. A multidisciplinary, evidence-graded approach is essential to optimize early detection, disease control, and quality of life.