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What is Leukoplakia?

If you have leukoplakia, you will notice you have white and thickened patches on your:

• Gums
• Inside your cheeks
• On the floor of your mouth
• Tongue or on your lips

Usually, the patches take several weeks to develop. It isn’t possible to remove the patches by scraping.

What Causes Leukoplakia?

It’s not quite clear what causes leukoplakia, but it’s thought to be due to chronic irritation often caused by tobacco use.

It doesn’t matter what kind of tobacco you use as you can smoke, dip, or chew it, but it seems to be the main culprit in the development of leukoplakia.

There are other causes of leukoplakia, such as:

• Injury inside your cheek, for example, if you tend to bite the inside of your cheek
• Uneven or rough teeth, as can wearing dentures, especially those that are ill-fitting
• Long-term alcohol use increases your risk of developing leukoplakia, and inflammatory conditions of the body can cause it

What Are the Symptoms?

Leukoplakia can develop in parts of the body that has mucosal tissue, which is why it develops in the mouth.

The condition causes unusual-looking patches that can vary in appearance. Sometimes they can look:

• White
• Gray
• Occasionally they can have red spots

The surface of these patches can be:

• Hard
• Raised
• Thickened

There is also another condition called hairy leukoplakia that causes hairy or fuzzy patches to develop in the mouth. The main cause of hairy leukoplakia is the Epstein-Barr virus, and once you have this virus, it remains in the body permanently but is usually dormant, and is more likely to affect people with immune problems or who have HIV. It’s rare for leukoplakia to be painful.

Is It Harmful?

Most often, leukoplakia is not harmful and the patches are non-cancerous or benign.

However, you cannot take this for granted as some can show early signs of cancer. Cancers affecting the floor of the mouth can sometimes develop next to patches of leukoplakia. If patches of leukoplakia look red, it could be a sign of cancer and it’s important to see your dentist immediately.

You must see a dentist immediately if you notice:

• White patches or sores in your mouth that fail to heal within two weeks
• Lumps or red or white or dark-colored patches in your mouth
• Persistent changes to the tissues in your mouth do need investigation.

You must also seek medical help if:

• It’s difficult to open your jaw
• You have pain when swallowing

Although leukoplakia doesn’t usually cause any pain, it can indicate a more serious problem so please don’t ignore these signs.

Sometimes leukoplakia is mistaken for oral thrush, which is a yeast infection in the mouth. Oral thrush creates soft white patches that bleed more easily than leukoplakia patches, which is why it’s important to get a proper diagnosis from your dentist.

How Is It Diagnosed?

When you see your dentist Dr. Shalman, he can usually diagnose leukoplakia by examining your oral tissues.

If necessary, they may wish to carry out other tests to confirm this condition. If a patch looks at all suspicious, your dentist might want to do a biopsy, removing a small section of tissue for examination by a pathologist. This is to check for signs of precancerous cells.

There are two ways dentists can perform a biopsy:

• Least invasive. Using a small oral brush that is wiped over the lesion to pick up some cells. However, although this is non-invasive, the result may not always be definitive.
• Excision biopsy. An excision biopsy surgically removes some tissue and although it is more invasive, it does provide a more definitive diagnosis.

Also, if the diagnosis is positive for cancer, your dentist may have removed the entire patch of leukoplakia during the biopsy and there could be no need for further treatment.

How Is Leukoplakia Treated?

Most often, leukoplakia patches improve without any treatment, but it can be useful to avoid triggers that may have caused them in the first place such as using tobacco.

If your dentist thinks leukoplakia is related to irritation, they may suggest other treatments, including:

• Denture. If you have an old denture that doesn’t fit well, it might be time to replace it or to at least think about having it relined.
• Tooth Crowns or Porcelain Veneers. Teeth that are rough or crooked can also be corrected with restorative dental treatments.
• Nightguards. If you bite the inside of your cheek or have other signs of bruxism, your dentist may suggest using a nightguard to prevent this habit. The night guard is custom-made to fit over your teeth, preventing you from biting your cheeks and preventing damage to your teeth.

If your dentist took a biopsy, and it comes back as being positive for oral cancer, it is necessary to have immediate treatment to remove the patch of leukoplakia to prevent the cells from spreading. There are several ways this can be achieved as sometimes leukoplakia patches are removed by freezing them, or laser therapy is another non-invasive and very gentle way to get rid of leukoplakia.

Alternatively, it may be necessary for the patch to be excised using a scalpel. Hairy leukoplakia doesn’t usually cause mouth cancer and doesn’t normally need removing. However, your dentist may suggest using anti-viral medication to prevent the patches from growing.

There are also topical ointments that contain retinoic acid that can help reduce the size of the patch.

Is It Possible to Prevent Leukoplakia?

Often leukoplakia can be prevented by making some lifestyle changes, such as:

• Tobacco. For example, if you use tobacco products seriously consider stopping. Tobacco use is awful for oral and overall health and greatly increases the risk of oral cancer and other cancers.
• Alcohol. If you drink alcohol, think about reducing your intake and make sure it remains within safe limits.
• Diet. You might also want to think about overhauling your diet. Eating foods that are rich in antioxidants such as fresh fruits and vegetables helps to protect your overall health, giving your body the nutrients it needs to fight disease and infection.

For more information about Leukoplakia treatment at Shalman Dentistry, visit our dentistry center in New York or call us: (212) 658-1093