Leukoplakia is a white or gray patch that develops on the tongue, inside of the cheeks, gums, or floor of the mouth. These patches cannot be scraped off and do not have a specific cause, but they are often linked to chronic irritation. While most cases of leukoplakia are benign, some may be precancerous, requiring careful monitoring.
Causes of Leukoplakia
Leukoplakia develops due to persistent irritation or damage to the oral mucosa. Common causes include:
- Tobacco Use: Smoking or chewing tobacco is the most common risk factor.
- Alcohol Consumption: Excessive alcohol can irritate the oral tissues.
- Poorly Fitted Dentures or Dental Appliances: Rough edges of dentures or fillings can create chronic irritation.
- Chronic Biting or Chewing of the Cheeks or Lips: Repeated trauma can trigger the formation of white patches.
- Human Papillomavirus (HPV) Infection: Some cases of leukoplakia may be associated with HPV.
- Sun Exposure: Actinic leukoplakia affects the lips due to prolonged sun exposure.
Symptoms of Leukoplakia
- White or gray patches on the tongue, gums, or inner cheeks.
- Thickened, hardened, or slightly raised lesions.
- Painless patches, though some irritation may occur.
- In some cases, red spots (erythroplakia) within leukoplakia, which may indicate a higher risk of cancer.
Types of Leukoplakia
- Homogeneous Leukoplakia: Uniform, smooth, or slightly wrinkled white patches.
- Non-Homogeneous Leukoplakia: Irregular, nodular, or speckled patches that may have red areas (erythroleukoplakia), which have a higher risk of malignancy.
- Proliferative Verrucous Leukoplakia (PVL): A rare but aggressive form with a higher risk of cancer development.
Diagnosis of Leukoplakia
A dentist will typically:
- Perform a visual examination of the lesion.
- Recommend a biopsy if the lesion appears irregular, persistent, or suspicious.
- Use additional tests, such as exfoliative cytology or toluidine blue staining, to assess cancer risk.
Treatment and Management
- Eliminating Irritants: Quitting smoking, reducing alcohol intake, and adjusting ill-fitting dentures can help resolve mild cases.
- Medical Treatment:
- Prescription mouth rinses or topical medications may help in some cases.
- Antiviral therapy if associated with HPV.
- Surgical Removal:
- If the lesion persists, grows, or shows precancerous changes, removal via laser surgery, cryotherapy, or scalpel excision may be necessary.
- Regular Monitoring:
- Follow-up visits are essential to monitor changes in the lesion and detect early signs of malignancy.
Is Leukoplakia Cancerous?
Most leukoplakia cases are benign, but some may develop into oral squamous cell carcinoma (OSCC) over time. The presence of red patches (erythroplakia), non-homogeneous texture, or dysplasia on biopsy increases the risk.
Prevention of Leukoplakia
- Quit Smoking and Tobacco Use.
- Reduce Alcohol Consumption.
- Maintain Proper Oral Hygiene and Get Regular Dental Checkups.
- Address Chronic Irritations from Dentures or Dental Appliances.