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The diagnosis and treatment of lesions are currently based on histopathology, which is the gold standard for the diagnosis of cancer and dysplasia at the molecular level. Recently, there has been an increasing trend of optical spectroscopy methods for the detection of oral premalignant and malignant lesions and the same is highlighted in this paper. It depends on the optical spectrum derived from any tissue that contains information about the histological and biochemical make-up of that tissue. It provides tissue diagnosis in real-time, non-invasively, and in situ.