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Leukoplakia is a potentially malignant disorder affecting the mouth. It causes a white patch or plaque to form on the gums, tongue, or oral mucosa. It may resemble oral thrush, a yeast infection of the oral cavity.
However, unlike oral thrush or lichen planus, which also cause oral mucosal lesions, leukoplakia can turn into mouth cancer. Around 3 to 17.5% of people with leukoplakia develop squamous cell carcinoma, the most common type of oral cancer, within 15 years.1
There are different types of leukoplakia:
What Causes Leukoplakia?
The cause of leukoplakia is unknown, but it's thought to be related to chronic irritation or inflammation of the mucous membranes.
Chewing and smoking tobacco are significant risk factors for developing leukoplakia, as are snuff (finely ground tobacco leaves that’s inhaled through the nose) and other forms of smokeless tobacco.2
In some parts of the world, chewing betel is a common practice that can increase the risk of leukoplakia. It can also happen because of wearing ill-fitting dentures or having broken or sharp teeth that rub against the cheeks or tongue.
Other risk factors include:
Age seems to play a role as fewer than 1% of leukoplakia cases occur in people under 30, and most cases occur in men between 50 and 70.1
Although there seems to be a link between human papillomavirus (HPV) and oral leukoplakia, it’s not fully understood. However, some research shows a strong association between HPV infection and leukoplakia.3
If the doctor cannot find the cause for leukoplakia, they term it idiopathic leukoplakia. This type of leukoplakia is rare and usually forms on the tongue. It has an increased risk of malignant transformation compared to the tobacco-associated form.
Leukoplakia patches are usually painless, and you cannot wipe them away. They may appear:
Doctors associate raised and speckled leukoplakia with an increased risk of malignant transformation, meaning the development of oral cancer.
Doctors diagnose leukoplakia by:
If it cannot be characterized clinically or histologically as any other condition, your doctor may diagnose leukoplakia. They may then recommend further testing to rule out oral cancer and request the following biopsies:
If the biopsies show there are precancerous or cancerous changes, you may need further tests. But if the doctor removed the entire leukoplakia patch during a biopsy, you may not require additional treatment.
A hairy leukoplakia diagnosis may mean you have underlying health causes, so your doctor may also evaluate you for conditions that could weaken your immune system.4
Treatment aims to prevent leukoplakia patches from becoming cancerous and is most successful when started early and the patch is small. It may involve lifestyle changes or surgery.
It's essential to remove all contributing factors, meaning you shouldn’t use tobacco products or drink alcohol. In addition, any dental causes such as rough teeth, fillings, or dentures should be addressed as soon as possible.
Your doctor may also suggest the following:
If the above treatments are ineffective, or the plaques show early signs of cancer, your doctor may suggest surgical options, including:
Your doctor will arrange regular follow-up visits with you as recurrences are common.
You usually don't require treatment if you have oral hairy leukoplakia, as it isn't likely to lead to cancerous changes and causes no symptoms. Instead, your doctor may recommend antiviral medications and topical treatments.
Your doctor may also arrange follow-up visits to monitor your mouth or ongoing medication to prevent the patches from returning.
An overwhelming number of cases of oral leukoplakia are related to smoking, so one of the easiest ways to prevent the condition is by avoiding tobacco use. Likewise, because of the links with alcohol use, reducing or stopping drinking can help.6
Good nutrition is another critical factor in preventing diseases and poor health. Therefore, follow a healthy, balanced diet rich in antioxidant foods to optimize your health and well-being and minimize the chances of developing health problems such as leukoplakia.
Remember, if you notice any changes in your mouth or think you have oral leukoplakia, contact your doctor or another healthcare provider for advice.
Usually, leukoplakia doesn't damage the oral cavity or cause pain. But there’s an increased risk of oral cancer forming near the patches or within the lesions themselves, so it's sensible to attend regular check-ups so your doctor can monitor the patches.
No, leukoplakia isn't an emergency, but it's a good idea to make an appointment with your doctor or dentist. They can assess the oral lesions and advise you on treatment or management options.
Leukoplakia patches typically clear up within a few weeks or months once you remove the chronic irritation. Despite that, there's still a chance that it can return, even if you have surgery to remove the oral lesions.7
You'll need to follow up with your doctor every 3 to 6 months so they can monitor the condition and take biopsies as necessary.
If you have patches surgically removed, you should still have an examination every 6 to 12 months as leukoplakia often returns. The good news is that if a treated site remains clear of any changes for 3 years, you may not need further follow-up appointments.1
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