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Understanding Leukoplakia

What is leukoplakia?

Leukoplakia is a condition in which thick, white patches form on your tongue and the lining of your mouth. Smoking is the most common cause. But other irritants can result in this condition as well.

Mild leukoplakia is usually harmless and often goes away on its own. More serious cases may be linked to oral cancer. These must be treated promptly.

Regular dental care can help prevent recurrences.

What are the symptoms of leukoplakia?

Leukoplakia is marked by unusual-looking patches inside your mouth. These patches can vary in appearance and may have the following features:

  • white or gray color
  • thick, hard, raised surface
  • hairy (hairy leukoplakia only)
  • red spots (rare)

Redness may be a sign of cancer. See your doctor right away if you have patches with red spots.

Leukoplakia most often occurs on your tongue. It can also appear inside your cheeks and on your gums. The patches may take several weeks to develop, and they’re rarely painful.

Some women may develop leukoplakia on the outside of their genitals in the vulva area.

What are the causes of leukoplakia?

The exact cause of leukoplakia is unknown. It’s primarily linked to tobacco use. Smoking is the most common cause. But chewing tobacco can also cause leukoplakia.

Other causes include:

  • injury to the inside of your cheek, such as from biting
  • rough, uneven teeth
  • dentures, especially if improperly fitted
  • inflammatory conditions of the body

Research suggests there may be a link between leukoplakia and the human papilloma virus.

Hairy leukoplakia

The Epstein-Barr virus (EBV) is the main cause of hairy leukoplakia. Once you get this virus, it remains in your body permanently. EBV is usually dormant. However, it can cause hairy leukoplakia patches to develop at any time. Outbreaks are more common in people with HIV or other immune problems.

How is leukoplakia diagnosed?

Leukoplakia is usually diagnosed with an oral exam. During a physical exam, your dentist or primary care doctor can confirm if the patches are leukoplakia. You might mistake the condition for oral thrush. Thrush is a yeast infection of the mouth. The patches it causes are usually softer than leukoplakia patches. They may bleed more easily.

Your dentist or doctor may need to do other tests to confirm the cause of your spots. This helps them suggest a treatment that may prevent future patches from developing.

If a patch looks suspicious, your dentist or doctor will do a biopsy. To do a biopsy, they remove a small piece of tissue from one or more of your spots. They then send that tissue sample to a pathologist for diagnosis. The goal is to look for signs of oral cancer.

What are the treatment options for leukoplakia?

Most patches improve on their own and don’t require any treatment. It’s important to avoid any trigger that may have caused your leukoplakia, such as tobacco use. If it’s related to irritation from a dental problem, your dentist may be able to address this.

If a biopsy comes back positive for oral cancer, the patch must be removed immediately. This can help prevent the spread of the cancer.

Small patches can be removed by a more extensive biopsy using laser therapy or a scalpel. Large leukoplakia patches require oral surgery.

Hairy leukoplakia may not require removal. Your dentist or doctor might prescribe antiviral medications to help stop the patches from growing. Topical ointments containing retinoic acid can also be used to reduce patch size.

How can leukoplakia be prevented?

Many cases of leukoplakia can be prevented with lifestyle changes:

  • Stop smoking or chewing tobacco.
  • Reduce alcohol use.
  • Eat antioxidant-rich foods such as spinach and carrots. Antioxidants may help deactivate irritants that cause patches.

Contact your dentist or doctor immediately if you suspect leukoplakia. This can help keep the patches from getting worse.

Follow-up appointments are crucial. Once you develop leukoplakia, you have an increased risk of developing it again in the future.

What is the long-term outlook for leukoplakia?

In most cases, leukoplakia isn’t life threatening. The patches don’t cause permanent damage to your mouth. Lesions usually clear on their own within a few weeks after the source of irritation is removed. However, if your patch is particularly painful or looks suspicious, your dentist may order tests to rule out:

A history of leukoplakia can increase your risk for oral cancer, so let your doctor know if you’ve noticed irregular patches in your mouth. Many of the risk factors for leukoplakia are also risk factors for oral cancer. Oral cancer can form alongside leukoplakia.

Content licensed from:

Written by: Kristeen Moore
Medically reviewed on: Nov 23, 2016: Nancy Choi, MD

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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