|  | |  | | | | Leukoplakia
Leukoplakia is a white or gray-white patch in the mouth that has not been connected to any disease or other cause. Leukoplakia patches usually develop slowly over weeks or months. Leukoplakia is often seen on the lip or inside the cheeks or gums. Leukoplakia found on the tongue, lip or under the tongue on the "floor" of the mouth is more often pre-cancerous or cancerous. Patches vary in size.
The cause of leukoplakia is unknown. White patches caused by chronic (long-term) irritation or a fungal (yeast) infection are not classified as leukoplakia.
Sources of chronic irritation include:
- Rough edges on dentures, fillings, crowns or teeth
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Habits such as chewing pens or biting your lip
True leukoplakia has no known cause, but there are many suspected causes associated with it, including:
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Chewing tobacco
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Cigarette, cigar or pipe smoke
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Sun exposure on the lips
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Using a mouthwash or toothpaste that contains sanguinarine
Leukoplakia is considered to be mostly benign (non-cancerous). In rare cases, leukoplakia develops into oral cancer.
A specific type of leukoplakia, called oral hairy leukoplakia, occurs in people infected with HIV. It consists of hairy, painless white patches, usually on the sides of the tongue. Oral hairy leukoplakia can be one of the first signs of HIV infection.
Leukoplakia frequently does not cause symptoms. The white patches usually are found during an oral exam. The patches are slow to develop and can be either flat or raised. A leukoplakia patch can become rough or pebblelike in texture. Leukoplakia usually is painless, but the patches eventually can become sensitive to spicy foods, temperature or touch.
Leukoplakia often is diagnosed by excluding other diseases. Your dentist will inspect the patch and may do a biopsy if the white patch does not heal after possible sources of irritation are removed. A biopsy involves removing a small piece of tissue from the patch and having it examined under a microscope by a pathologist. The biopsy results will show if the tissue contains pre-cancerous cells, cancerous cells or signs of other diseases.
If the white patch is caused by irritation, as most are, it will disappear within weeks after the source of the irritation is removed. If it does not, you can have the leukoplakia surgically removed, or your physician or dentist may monitor it periodically. Surgically removed leukoplakia can return. Repeat biopsies may be necessary in some cases where there is a significant risk of cancer or changes in the size, color or texture of the leukoplakia.
If the patch is caused by a fungal infection, you will receive antifungal medication, which should cause the patch to disappear.
Leukoplakias containing cancerous cells should be removed by surgery.
Regular dental exams can catch leukoplakia early, which is important if the lesion contains cancerous cells. Even people without teeth should have annual oral cancer exams (with their dentures removed).
People who use tobacco in any form are at much higher risk of both leukoplakia and oral cancer. Stopping the use of tobacco is a major way to prevent leukoplakia. Also, drinking alcohol is a risk factor for oral cancer, especially if it is combined with tobacco use.
Avoiding exposure of the lips to ultraviolet light (sunlight) is another way to prevent leukoplakia.
When a source of irritation is suspected as the cause of a white patch in the mouth, the potential source should be removed quickly. Stop or avoid any oral habits that could cause irritation. Have your dentist smooth any rough edges on fillings, crowns or dentures to prevent irritation and allow for healing of the white patch. Your dentist may make a soft splint or appliance to cover sharp, prominent or irregularly aligned teeth.
Leukoplakia does not always need to be treated. If a white patch results from irritation, the source of irritation should be removed. Often the patch disappears as a result. This is not true leukoplakia. However, the dentist should re-examine the white patch within two weeks for proper healing. If the white patch persists after removal of the suspected irritant, a biopsy should be performed.
Once true leukoplakia is confirmed, the treatment may include frequent examination, surgical removal and/or medication gel applications to any affected areas.
White patches that result from fungal infection should disappear after treatment with antifungal medication. Any white patch that remains after antifungal therapy is considered to be leukoplakia and should be removed surgically for further diagnosis. White patches that contain cancer cells usually are removed surgically.
A dentist or doctor should look at any lesion (spot or patch) in your mouth that is present for more than two weeks.
The vast majority of oral white patches are harmless, and treatment usually first involves removing potential sources of irritation. If a white patch persists and is thought to be a true leukoplakia, treatment options should be discussed with your dentist or dental specialist. Leukoplakia that contains pre-cancerous or cancerous cells on a biopsy is usually called dysplasia or carcinoma. The prognosis will depend on the type and extent of the cancer.
American Academy of Oral Medicine
P.O. Box 2016
Edmonds, WA 98020-9516
Phone: (425) 778-6162
Fax: (425) 771-9588
http://www.aaom.com/
American Academy Of General Dentistry
211 East Chicago
Suite 900
Chicago, IL 60610-1999
Toll-Free: (888) 243-3368
Fax: (312) 440-0559
http://www.agd.org/
American Dental Association
211 East Chicago Ave.
Chicago, IL 60611
Phone: (312) 440-2500
Fax: (312) 440-2800
http://www.ada.org/
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