Leukoplakia – What Should You Know About It?

Leukoplakia is a condition that is characterized by the formation of white long-lasting patches that appear like resistant plaques on the gums, tongue and the lining of the mouth. Oral membrane irritating activities like smoking may serve as a contributing factor. Usually the symptoms associated with white patches disappear on their own without any treatment; however, in case of leukoplakia this may not be the case.

According to World Health Organization, this disease is described as white oral lesions with potential risk which may not be related to any non-serious condition. For the correct diagnosis of leukoplakia, various tests are considered mandatory to rule out serious malignant lesions.

Symptoms Of Leukoplakia

The thick patches caused by leukoplakia may appear gray or transparent with or without cracking. These patches are often painless and may usually appear in the following regions:

• Tongue
• The bottom part of the mouth i.e. below the tongue
• Gums
• Inner lining of cheeks

The patches may at times also appear on the other parts of the body particularly on the genital region.

Leukoplakia does not result due to cancer but it accelerates the risk of developing oral cancer. Severe or persistent leukoplakia may be found as precancerous in some cases. Following signs suggest an immediate consultation with the doctor:

• Popping sensation or pain in the ear while swallowing
• Sores that do not disappear within 2 weeks
• Difficulty in swallowing, eating or even jaw movement
• Appearance of white lumps with reddish patches
• Appearance of white patches with reddish raised regions

Causes

Chronic mouth irritation in particular plays a significant role in majority of the leukoplakia cases. The persistent damage to the oral tissues makes them thickened and enlarged and facilitates the formation of a substance known as keratin, a protein which is very important for the health of skin and protects it from stress and injury. Given below are the factors that contribute to leukoplakia:

• Persistent or excess use of tobacco
• Human papillomavirus (HPV)
• Immune weakening conditions such as HIV, organ surgery and chemotherapy
• Ulcerative or related conditions
• Prolong or excessive use of oral products that are abrasive in nature like polishing devices and teeth whiteners
• Braces, poorly fitted dentures, retainers or bite plates
• Rough or jagged surface of the teeth
• Inadequate oral hygiene
• Tongue or cheek biting
• Excess intake of alcohol

Some people suffer from hairy leukoplakia, a type of leukoplakia that occurs in people with weak immunity. The lesions in this care are rather painless and have a fuzzy appearance. It can serve as an initial physical red flag for AIDS and HIV.

Diagnosis

The biopsies commonly carried out for the diagnosis of leukoplakia are given as following:

• Oral brush biopsy
• Excisional biopsy

If there are no obvious signs of an ongoing malignant lesion, the basic treatment begins with abstinence from the causative factors such as smoking. If the plaque doesn’t disappear on its own, the doctor may remove it by using a scalpel.

Prevention

• Avoiding tobacco
• Maintaining good oral hygiene
• Minimizing or avoiding alcohol intake
• Avoiding the use of abrasive dental products or devices
• Routine dental examination
• Avoiding food that may cause allergy
• Practicing safe oral sex
• Avoiding candies with rough edges

References

• Brouns, E. R. E. A., Baart, J. A., Karagozoglu, K. H., Aartman, I. H. A., Bloemena, E., & Waal, I. (2014). Malignant transformation of oral leukoplakia in a well‐defined cohort of 144 patients. Oral diseases, 20(3), e19-e24.