Photo from healthline.com
Leukoplakia causes thicker, white spots on your gums, insides of your cheeks, the bottom of your mouth, and, in some cases, your tongue. These patches cannot be removed.
Doctors don't know what causes leukoplakia, but prolonged irritation from tobacco — whether smoked, dipped, or chewed — is thought to be the main cause.
The majority of leukoplakia patches are benign (noncancerous), however some exhibit early symptoms of malignancy. Cancers on the bottom of the mouth might develop near leukoplakia. Furthermore, white spots mixed in with red spots (speckled leukoplakia) may suggest the presence of malignancy. If you notice any unexpected or persistent changes in your mouth, consult your dentist or primary care physician.
Hairy leukoplakia, also known as oral hairy leukoplakia, typically affects patients whose immune systems have been impaired by disease, particularly HIV/AIDS.
WHAT ARE THE SYMPTOMS OF LEUKOPLAKIA?
Leukoplakia most commonly affects your gums, the insides of your cheeks, the bottom of your mouth (below the tongue), and, in rare cases, your tongue. It is usually not painful and may go unnoticed for some time.
Leukoplakia can manifest as follows:
- White or grey patches that cannot be removed
- erratic or flat-textured
- Thickened or toughened in some places
- In addition to elevated, red lesions (speckled leukoplakia or erythroplakia), which are more likely to indicate precancerous alterations.
Hairy leukoplakia
Hairy leukoplakia is characterized by fuzzy, white areas that mimic folds or ridges on the sides of your tongue. It's frequently confused with oral thrush, an infection characterized by creamy white patches that may be wiped away that's also common in people with compromised immune systems.
WHAT ARE THE CAUSES OF LEUKOPLAKIA?
Although the source of leukoplakia is uncertain, prolonged irritation, such as smoking and chewing tobacco, appears to be responsible for the majority of instances. Regular users of smokeless tobacco products frequently develop leukoplakia, which occurs when the tobacco is held against the cheeks.
Other possible reasons include prolonged inflammation from:
- Teeth that are jagged, fractured, or sharp rubbing on the tongue surfaces
- Dentures that are broken or ill-fitting
- Long-term alcohol consumption
Your dentist can discuss with you what may be causing your leukoplakia.
Hairy leukoplakia
Hairy leukoplakia is caused by Epstein-Barr virus infection (EBV). Once infected with EBV, the virus remains in your body for the rest of your life. The virus is normally dormant, but if your immune system is weakened, especially if you have HIV/AIDS, the virus can reactivate, resulting in disorders like hairy leukoplakia.
WHAT ARE THE RISK FACTORS FOR LEUKOPLAKIA?
Tobacco usage, especially smokeless tobacco, increases your risk of leukoplakia and oral cancer. Long-term alcohol usage raises your risk, and combining alcohol with smoking raises your risk even more.
Hairy leukoplakia
People living with HIV/AIDS are more likely to develop hairy leukoplakia. Despite the fact that the use of antiretroviral medications has reduced the frequency of instances, hairy leukoplakia continues to affect a number of HIV-positive people and may be one of the earliest symptoms of HIV infection.
WHAT ARE THE COMPLICATIONS OF LEUKOPLAKIA?
Leukoplakia does not usually result in permanent tissue damage in the mouth. However, leukoplakia raises your chances of developing oral cancer. Oral malignancies frequently develop near leukoplakia patches, and the patches themselves may be malignant. The risk of oral cancer persists even after leukoplakia patches are removed.
Hairy leukoplakia
Hairy leukoplakia is unlikely to progress to malignancy. However, it could be an indication of HIV/AIDS.
HOW IS LEUKOPLAKIA DIAGNOSED?
Your doctor will most likely diagnose leukoplakia by:
- Looking at the spots in your mouth
- Trying to remove the white patches
- Talking about your medical history and risk factors
- Excluding other possible causes
Testing for cancer
If you have leukoplakia, your doctor will most likely do the following tests to look for early symptoms of cancer:
- Oral brush biopsy: This entails removing cells from the lesion's surface with a tiny, spinning brush. Although this is a non-invasive process, it may not always yield a conclusive diagnosis.
- Excisional biopsy: This entails surgically removing tissue from the leukoplakia patch or, if the patch is small, removing the entire patch. An excision biopsy is more thorough and usually yields a clear diagnosis.
If the biopsy reveals malignancy and your doctor did an excisional biopsy that removed the entire leukoplakia patch, you may not require any additional treatment. If the patch is substantial, you may be referred for treatment to an oral surgeon or an ear, nose, and throat (ENT) specialist.
Hairy leukoplakia
If you have hairy leukoplakia, you will almost certainly be tested for disorders that may lead to a weaker immune system.
WHAT ARE THE TREATMENTS FOR LEUKOPLAKIA?
Treatment for leukoplakia is most effective when the lesion is discovered and treated early, when it is small. Regular checks are essential, as is routinely checking your mouth for abnormalities.
For most people, eliminating the source of irritation, such as smoking or drinking, cures the disease.
If this does not work or if the lesions exhibit early signs of malignancy, the treatment regimen may include:
- Removal of leukoplakia patches: A knife, a laser, or an extremely cold probe that freezes and destroys cancer cells can be used to remove patches (cryoprobe).
- Follow-up visits to inspect the area: Recurrences of leukoplakia are prevalent after you've had it.
Hairy leukoplakia treatment
Hairy leukoplakia usually does not require treatment. The disorder frequently generates no symptoms and is unlikely to result in oral cancer.
If your doctor suggests treatment, it could include:
- Medication: Antiviral drugs, for example, are examples of systemic pharmaceuticals. These drugs have the ability to suppress the Epstein-Barr virus, which causes hairy leukoplakia. Topical therapy is also an option.
- Follow-up appointments: When you stop taking the medication, the white spots of hairy leukoplakia may reappear. Your doctor may advise you to have regular check-ups to monitor changes in your mouth, as well as continued medication to prevent leukoplakia patches from recurring.
HOW CAN LEUKOPLAKIA BE PREVENTED?
If you eliminate all cigarette products and alcohol, you may be able to avoid leukoplakia. Consult your doctor about quitting techniques. Maintain regular dental checkups if you continue to smoke, chew tobacco, or consume alcohol. Because oral cancers are usually painless until they are advanced, stopping smoking and drinking alcohol is a superior preventative method.
Hairy leukoplakia
Hairy leukoplakia cannot be prevented if your immune system is compromised, but detecting it early can help you receive proper therapy.