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The White Patches Inside the Mouth And Why You Should Get Them Checked

A white or gray patch on the tongue or the floor of the mouth is called Leukoplakia. This patch forms due to chronic irritation of the mouth’s mucous membranes. It is the mouth’s reaction to the irritation. Leukoplakia can develop on the inside of a person’s cheek. Immediate medical attention is important, as Leukoplakia might become cancerous.

What is leukoplakia?

Leukoplakia is a whitish-grey patch that develops on the tongue surface or the floor of the mouth. It might be hairy in the mouth. In such cases, the Epstein-Barr virus is the causative agent. This type of unusual Leukoplakia is seen in patients with HIV/AIDS. These patches can occur at any age and are mostly non-cancerous.

Most of these white patches are non-cancerous and benign in nature. However, some of these might show early signs of cancer. Oral cancer can occur near these patches in the mouth. Speckled Leukoplakia (mixed white and red patches) might indicate the possibility of cancer. It is imperative to consult your dentist/PCP (Primary Care Professional) if you notice the signs of Leukoplakia or any abnormal changes in your mouth.

Causes of Leukoplakia

The common causes of Leukoplakia are-

  • The lips’ exposure to the sun
  • Smoking
  • Tobacco use in any form
  • The rubbing of fillings or crowns  against the cheek and gums
  • Ill-fitting dentures
  • HIV-AIDS
  • Oral Cancer (very rare)

Symptoms of Leukoplakia

It is essential to know when to see a doctor. Leukoplakia does not lead to any painful sensations and may go unnoticed. Common symptoms are –

  • Whitish-grey patches on the tongue, the floor of the mouth, or cheeks.
  • The patches have an irregular or flat nature.
  • It is thick and hard in a few areas
  • Erythroplakia lesions that appear as a red patch alongside
  • Usually, it is painless but can be sensitive to touch, spicy foods, heat, or other irritation

When to see a doctor?

Consult your primary care doctor or dentist or if you experience any of the following:

  • White sores or plaques in the mouth that do not heal on their own within two weeks
  • Persistent changes in the tissues of the mouth
  • Lumps or red, white, or dark patches in the mouth
  • Pain in the ear when swallowing
  • Progressive decrease in the ability to open the jaw

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Diagnosis of Leukoplakia

Diagnosing Leukoplakia involves an examination of the mouth. Your doctor might take a biopsy to check for oral cancer or other such causes. In a biopsy, a numbing agent is used to eliminate any sensation of pain. The doctor then removes a piece of tissue on the patch and then examine it.

Complications of leukoplakia

Leukoplakia does not cause any discomfort in the form of pain but can cause long-term damage. In the case of erythroplakia, the is a possibility of it turning into cancer.

Treatment of leukoplakia

Your doctor is likely to diagnose your Leukoplakia by examining the patches and attempting to wipe them off. A biopsy might be done to check for cancer. In case the lesions show any signs of cancer, then the treatment plan might involve the entire removal of the patches. 

If the biopsy result is positive for oral cancer, then your doctor will perform an excisional biopsy. The entire patch is removed, leaving no trace behind.

Treatment of hairy leukoplakia

Hairy Leukoplakia does not require an intensive treatment plan as it does not usually lead to cancer. Your doctor might prescribe some oral medications like antiviral medication. These help to suppress the activity of the Epstein-Barr virus that causes it. Topical treatment may be prescribed too.

Follow up visits to keep a check on them are needed. The white patches may return once you stop the treatment.

Precautions to avoid leukoplakia

You can prevent Leukoplakia if you eliminate the risk factors.

Restricting alcohol and tobacco usage can decrease the risk of developing white patches. Your doctor can help you quit these habits.

Frequently Asked Questions (FAQs)

1. What causes Leukoplakia?

The underlying cause of Leukoplakia is still not known. The doctors assume that frequent consumption of alcohol and excessive tobacco usage in the form of smoking and chewing can result in chronic irritation in the mucous membrane of the mouth  and causes these patches. Secondary causes like a misfit of denture, broken ends of teeth rubbing over the surface of the tongue can also lead to Leukoplakia.

2. Does Leukoplakia go away?

Leukoplakia is a condition of white patches on the surface of the tongue, cheeks, and floor of the mouth. Mild Leukoplakia having no severe signs and symptoms might go away on its own. It does not cause any discomfort in the form of pain but can cause long-term damage. It can increase the risk of oral cancer. Consult your doctor immediately if you are experiencing abnormal changes in the mouth.

3. How often does Leukoplakia turn to cancer?

The difference between Leukoplakia and erythroplakia is a significant risk of developing oral cancer. Leukoplakia is usually non-cancerous; very rarely does it turn into cancer of the mouth. Erythroplakia lesions that appear as a red patch alongside Leukoplakia are associated with a higher risk of oral cancer.

4. What happens if Leukoplakia goes untreated?

Leukoplakia in some instances may develop into oral cancer if left untreated. You should consult your doctor as soon as you witness any change inside your mouth. Mild Leukoplakia shows minimal signs and often goes away on its own.

5. What is the best medicine for Leukoplakia?

In cases of hairy Leukoplakia, your doctor might prescribe some oral medications like antiviral medication. These help to suppress the activity of the Epstein-Barr virus. The doctor might prescribe topical treatment too. Vitamin A treatments help to reduce the red lesions.

In case of severe Leukoplakia where the biopsy tests positive for cancer, your doctor is likely to perform an excisional biopsy. This removes the entire white patch.

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