Leukoplakia

Leukoplakia: Overview

Leukoplakia is a condition in which thick, whitish patches form on the gums, tongue or inside of the cheeks.  It is the most common of all chronic mouth lesions.

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Causes and Development; Contributing Risk Factors

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:

  • tobacco use
  • alcohol use
  • being male
  • being older
  • having a weakened immune system

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.

Signs and Symptoms

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 and Prevention

Treatment starts with removing the causes if possible, for example:

  • quitting tobacco and/or alcohol use
  • replacing ill-fitting dentures or bridges
  • stopping biting the insides of the cheeks

Prognosis; Complications; Seek medical attention if...

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.

Signs, symptoms & indicators of Leukoplakia:

Symptoms - Head - Mouth/Oral

Counter-indicators

Risk factors for Leukoplakia:

Immunity

HIV/AIDS

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.

Symptoms - Environment

Chewing tobacco use

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.

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Leukoplakia suggests the following may be present:

Tumors, Malignant

Mouth Cancer

A small percentage of leukoplakia patches show early signs of cancer, and many cancers of the mouth occur next to these white patches.  Precancerous leukoplakia often includes raised red lesions.

Recommendations for Leukoplakia:

Habits

Tobacco Avoidance

The vast majority of people who develop leukoplakia are smokers, and most leukoplakic patches either improve or disappear within a year of stopping smoking.

Surgery/Invasive

Surgery

The treatment of choice is removing the irritants that are causing leukoplakia.  If this doesn't work, or the lesions are precancerous, your dentist may decide to remove the leukoplakic patches using a scalpel, laser or cryoprobe (freezing probe.)

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