Leukoplakia

Written by Kristeen Moore
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What is Leukoplakia?

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

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

Regular dental care can help prevent recurrences.

Symptoms of Leukoplakia

This condition is marked by unusual looking patches inside the mouth. These patches can vary in appearance. Generally, patches resulting from leukoplakia have the following features:

  • white or grey color
  • thick, hard, and raised surface
  • hairy (hairy leukoplakia only)

Rarely, the patches have red spots. Redness may be a sign of cancer.

Leukoplakia most often occurs on the tongue. However, cheeks and gums are also vulnerable. The patches may take several weeks to develop, but they are rarely painful.

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

Causes of Leukoplakia

The exact cause of leukoplakia is unknown. However, it is primarily linked to tobacco use. Smoking is the most common cause. Chewing tobacco can also cause leukoplakia. According to the Mayo Clinic, three out of four tobacco users will develop leukoplakia at some point during their lives. (Mayo Clinic, 2010)

Other causes include:

  • biting the cheek
  • rough, uneven teeth
  • dentures (especially if improperly fitted)

Hairy Leukoplakia

The Epstein-Barr virus (EBV) is the main cause of hairy leukoplakia. Once you get this virus, it permanently remains in your body. 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.

Diagnosing Leukoplakia

Leukoplakia is generally diagnosed with an oral exam. Many patients 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.

During a physical exam, your dentist can confirm if the patches are leukoplakia. Other tests may be needed to confirm the cause. With treatment, you may be able to prevent future patches from developing.

If a patch looks suspicious, your dentist will do a biopsy. A small tissue sample is sent to a pathologist for diagnosis. The goal is to rule out the possibility of oral cancer.

Treating Leukoplakia

Most patches improve on their own. However, if a biopsy comes back positive for oral cancer, the patch must be removed immediately. This can help prevent its spread.

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

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

Long-Term Outlook for Leukoplakia

In most cases, leukoplakia isn’t life threatening. The patches don’t cause permanent damage to the 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:

  • oral cancer
  • HIV
  • AIDS

According to the Mayo Clinic, your risk of oral cancer is increased even after the patches have been removed. Many of the risk factors for leukoplakia are also risk factors for oral cancer. Oral cancer can form alongside leukoplakia. (Mayo Clinic, 2010)

Leukoplakia Prevention

Many cases of leukoplakia can be prevented with behavioral changes.

  • Stop smoking or chewing tobacco
  • Reduce alcohol use
  • Eat antioxidant-rich foods. Antioxidants can help deactivate irritants that may cause patches. Antioxidant-rich foods include spinach, pumpkin, and carrots.

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

Follow-up appointments are crucial. Once you develop leukoplakia, the chances of a recurrence are high.

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