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Because frictional injury is very common in the oral cavity and usually presents as a hyperkeratosis, it is likely that many so-called leukoplakias actually represent nonspecific frictional keratoses that are not MMO or BARK

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Theyre especially difficult to overcome, because they provide a physical barrier against the host immune response, can be impermeable to antibiotics and act as a reservoir for persistent infection, the authors write in an accompanying blog post