Leukoplakia is an oral condition which is chiefly characterized by thick, white or grayish patches in the inside of the mouth (i.e., on the gums, inner portions of the cheeks, the bottom of the mouth and, sometimes, on the tongue as well). Unlike other oral patches, these cannot be scraped off.
Although most leukoplakia patches are generally noncancerous (benign) in nature, yet some show early signs of cancer. These cancerous lumps are found at the bottom of the mouth next to areas of leukoplakia. Sometimes, white areas mixed in with red areas (speckled leukoplakia) may indicate the potential for cancer in the later stages. While a milder condition is usually harmless and often goes away on its own, a chronic condition requires prompt treatment as in some cases it may lead to oral cancer.
In some cases, a type of leukoplakia called hairy leukoplakia or oral hairy leukoplakia, are generally diagnosed in people with compromised immune systems due to diseased conditions like HIV/AIDS.
In some very rare case scenarios, leukoplakia can even be noticed on the outside of the genitals in the vulva area as well as inside the vagina in some post-menopausal women.
There is still ongoing research regarding the exact cause of leukoplakia but several cases indicate the link of this greyish patchy condition with chronic irritation caused due to the extensive use of tobacco (be it smoked, dipped or chewed). In some cases, even regular users of smokeless tobacco products, where they hold the tobacco against their cheeks can eventually develop into leukoplakia.
Another form of leukoplakia known as Hairy Leukoplakia chiefly results from infection due to the Epstein-Barr virus (EBV). Once a person is infected with this specific virus, it usually stays dormant in your body but in case the person develops a weakened immune system due to HIV or AIDS, the virus can gradually get reactivated and show characteristic symptoms.
Certain causative factors that increase the risk of Leukoplakia include:
Poorly Fitted Dentures: People having dental procedures where the dentures are either ill-fitted or broken may be prone to leukoplakia.
Broken Tooth: A jagged, broken or sharp tooth may cause severe irritation and inflammation within the oral cavities increasing the chances of developing this condition.
Injury: An injury inside the mouth from biting or other causes may lead to inflammation which may ultimately cause leukoplakia.
Inflammation: Any other chronic inflammatory conditions within the body may aggravate the chances of developing leukoplakia in the mouth as well.
Alcohol: Long term alcohol abuse may make one prone to leukoplakia.
Leukoplakia usually happens in the oral cavities having mucosal lining, i.e., in the insides of the cheeks, beneath the tongue, the bottom of your mouth and sometimes the tongue. Since these patches are painless, it often gets unnoticed for a long time. But the common signs and symptoms that do appear includes:
- White or greyish patches that can't be scraped off
- Thickened or hardened areas within the mouth
- Irregular or flat-textured surface
- Raised, red lesions (speckled leukoplakia or erythroplakia that is a sign of precancerous stage)
Symptoms of Hairy Leukoplakia
- Fuzzy, white patches in the form or folds or ridges (on the sides of the tongue)
Diagnosis And Treatment
On noticing the above-mentioned signs and symptoms while brushing, do consult a doctor right away. The dentist usually does a thorough oral check-up, examines the patches in the mouth, attempts to scrape off the patchy area to rule out oral thrush, and acknowledges the patients past medical history to rule out other causes. Lastly, the doctor may conduct some diagnostics including:
- Oral brush biopsy
- Excisional biopsy
In case of hairy leukoplakia, the doctor may conduct other diagnostic procedures to evaluate certain conditions that may contribute to a weakened immune system.
In case the leukoplakia lesion is small, it is usually treated when diagnosed in the earlier stages. This usually involves certain medications to stop oral irritation and total ban on the use of tobacco and alcohol.
If the lesions show early stages of oral cancer, the treatment plan may involve:
Removal of leukoplakia patches by using a scalpel, a laser or an extremely cold probe that freezes and destroys cancer cells (cryoprobe) and further follow-up doctor visits to prevent recurrences.
In case of hairy leukemia, the doctor may prescribe anti-viral medications to suppress the Epstein-Barr virus.