The exact cause of leukoplakia is not known, but it appears to be due to excess cell growth resulting from chronic irritation. Common irritations include smoking, long-term alcohol use, and possibly ill-fitting dentures or the habit of chewing the inside of the cheek. Tobacco use appears to be responsible for most cases of leukoplakia.
Oral hairy leukoplakia can occur in those who have been infected with the Epstein-Barr virus, which normally lies dormant but can be reactivated by a weakened immune system.
Risk factors for leukoplakia include:
Those with weakened immune systems sometimes develop a form of the disease called hairy leukoplakia. Combining tobacco with alcohol further increases risk; men are more likely to drink and smoke so this may explain why they are at higher risk. However, women with leukoplakia tend to show more cancerous changes in their mouth tissues than men.
Leukoplakia starts as flat, gray or gray-white sores on the gums, inside of the cheeks, and sometimes the tongue. Over weeks or months these sores become whiter, thicker/rougher/wrinkled, with a harder surface. These patches can't be scraped off easily and are generally not painful, but may be irritated by touch or spicy foods.
Treatment starts with removing the causes if possible, for example:
Leukoplakia doesn't usually cause permanent damage and often disappears once the irritants have been removed.
Leukoplakia is sometimes associated with oral cancer.
Consult a dentist if you have sores in your mouth that don't heal within a couple of weeks, or you develop lumps or red/white/dark patches in your mouth, or you notice any tissue changes taking place on the insides of your mouth.
HIV or AIDS patients are especially likely to develop hairy leukoplakia. Although modern drugs have reduced its incidence, as many as 25% of HIV-positive people still develop hairy leukoplakia. It can be one of the first signs of HIV infection.
Chewing tobacco and snuff play a key role in the development of leukoplakia: Up to 75% of regular users of "smokeless tobacco" products eventually develop leukoplakia where they hold the tobacco against their cheeks.
Leukoplakia is common among tobacco users.
The vast majority of people who develop leukoplakia are smokers, and most leukoplakic patches either improve or disappear within a year of stopping smoking.
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