This is a health condition that causes thick and white patches to form on the gums. Sometimes, these patches can appear inside the cheeks, bottom of the mouth, and tongue. Usually, these patches cannot be scraped off. This condition is called leukoplakia and experts do not fully understand why it happens. However, certain bad habits can provoke this condition (such as smoking, misuse of alcoholic beverages, and others).
While most patches caused by this condition are noncancerous, some of them can be a symptom of cancer. When it happens cancer appears near the leukoplakia patches. Physicians call mixed regions with red and white areas speckled leukoplakia. If you have any differences in the mouth that do not disappear, it is recommended to visit a dentist.
There is a leukoplakia type that often negatively affects people with weakened immune systems due to different diseases such as HIV/AIDS and it is called hairy leukoplakia.
Symptoms
Commonly, symptoms appear on the gums, inside the cheeks, tongue, and bottom of the mouth (under the tongue). These symptoms are painless and often noticed after a while. Check below some leukoplakia symptoms:
- Thick or hard patches
- Patches that have a rough, ridged, wrinkled, or smooth surface
- Gray or white patches that cannot be removed
- In some cases, leukoplakia patches can appear with abnormal shapes and edges
Hairy leukoplakia provokes fuzzy, white patches that look like ridges or folds and appear on both sides of the tongue. In most cases, this leukoplakia type is mistaken as oral thrush, which also provokes white patches. In addition, oral thrush usually happens in people with a weakened immune system.
Mostly, this condition does not provoke discomfort but sometimes it may be a sign of a more serious health problem. Thus, you should immediately contact your healthcare professional if any of the following symptoms occur. Examples include:
- Mouth lumps
- Ear pain
- Swallowing or opening jaw problems
- Long-term changes in the mouth
- Red, dark, or white patches in the mouth
- Mouth sores that do not heal for more than 2 weeks
Causes
Experts do not know the exact leukoplakia cause but they suspect long-term irritation caused by smoking, secondhand smoke, and misuse of alcoholic beverages are closely linked with this condition. Check below for other potential leukoplakia causes:
- The use of betel nut (also known as areca nut)
- Broken, jagged, or sharp teeth that rub tongue surfaces
- Broken dentures
However, hairy leukoplakia is often provoked by the Epstein-Barr virus (EBV). For people who are infected with this virus, it remains in the body for life but it is usually not active and does not cause any symptoms. It usually activates when a person has a weakened immune system (HIV/AIDS).
Risk Factors
Alcoholic beverages and tobacco use (either smoked or smokeless) increase your risk of developing this condition. Moreover, if you drink alcohol along with smoking the risk of getting this condition elevates significantly.
Complications
This health condition does not provoke permanent damage to the mouth but once you experience this disease, it increases your risk of mouth cancer. When it happens, red patches appear near leukoplakia patches. Unfortunately, if the patches of leukoplakia are removed the risk of cancer also remains.
Hairy leukoplakia commonly do not provoke cancer but may be an early symptom of HIV/AIDS.
How to Prevent Leukoplakia?
The only way to prevent this condition is to quit smoking and limit or avoid alcoholic beverages. If you face problems with quitting, discuss it with your doctor about an effective strategy for smoking cessation. Additionally, people with weakened immune systems cannot prevent hairy leukoplakia.
Diagnosis
Healthcare providers usually diagnose this condition based on the following factors. For example:
- Analyzing the patches in the mouth and trying to clear them
- Doctors will ask you questions about symptoms and medical history
- Exclude other health conditions that provoke similar symptoms
If your healthcare professional suspects you may have mouth cancer, you may need to do additional tests. For example:
- Oral brush biopsy – During this test, doctors remove a sample from the surface of the patch and send it to the laboratory to be checked for cancer cells.
- Excisional biopsy – This test involves the removal of a part of a complete patch (if it is a small one) to check for cancer cells. Excisional biopsy is considered the most accurate test to get a definite diagnosis.
In case tests show cancer and your doctor uses excisional biopsy and the patch is removed thoroughly, you may not need treatment. However, if the patch is large or cannot be removed, your doctor may direct you to an oral surgeon.
People with hairy leukoplakia commonly are checked for health conditions that lead to a weakened immune system.
Treatment
Commonly, the treatment is successful with early diagnosis and treatment. In such cases, the patches are very small and can be removed. That’s why it is advised to have regular checkups for changes to the gums, tongue, or cheeks. Sometimes, lifestyle changes (such as quitting smoking and limiting or avoiding alcoholic drinks) are enough to get rid of leukoplakia.
However, if lifestyle changes do not work or doctors suspect the patches are cancerous, you may need the following treatment options. Examples include:
- Surgery to remove leukoplakia patches – Surgeons usually remove these patches using a surgical knife, a laser, or tools that heat or cold the patches, which help to destroy cancerous cells.
However, once you develop leukoplakia it is common for it to return. So, you should have regular appointments with your doctor to prevent any potential complications.
Most people with hairy leukoplakia do not require treatment because it does not provoke any symptoms. Moreover, the risk of mouth cancer is very low in people with hairy leukoplakia. In any case, doctors may prescribe some medicines (antiviral drugs) that will help to control the Epstein-Barr virus.
Frequently Asked Questions
What is the primary cause of leukoplakia?
Healthcare professionals do not fully understand why this condition happens. However, they suspect long-term irritation caused by misuse of alcoholic drinks and use of tobacco products could play a role.
When doctors perform a biopsy on people with leukoplakia?
Doctors usually perform this test when they suspect patches provoked by leukoplakia are cancerous. They commonly perform an oral brush biopsy or excisional biopsy. Do not take any medications without a doctor’s recommendation because it may lead to unpleasant results.
How common is leukoplakia?
Approximately 1-2% of the population experience oral leukoplakia. Furthermore, most of the patients are over 40 years old. If you have additional questions, ask your physician.
