Leukoplakia is a white or gray patch that is seen on the tongue or on the inside of your cheeks, which does not go away by rubbing. These patches occur mainly due to a chronic irritation of the mucous membranes of the mouth. Leukoplakia is also seen in the female genital area, however the reason is unknown. Leukoplakia can develop at any stage of your life but it’s more common in elderly people. It’s also a precancerous lesion.
Hairy leukoplakia is an unusual form of leukoplakia that is seen in people with HIV virus or have the condition AIDS or any other disease that cause AIDS. This is caused by the virus Epstein-Barr virus (EBV). This virus lives dormant in the body, when the immune system is down it recurs and cause hairy leukoplakia.
Is Leukoplakia Curable?
Leukoplakia is curable, most of the time it cures without any treatment when the cause of the chronic irritation is removed.
Causes of Leukoplakia
- Tobacco chewing
- Rough or uneven teeth
- Dentures that are not fitting
- Irritation from fillings and crowns
- Injury to your inside cheek by biting
- Alcohol usage long term
- Poor oral hygiene
Diagnosis of Leukoplakia
Leukoplakia can be suspected by your doctor upon examination and with the relevant history, to confirm it a biopsy should be done. Leukoplakia can sometimes contain cancer cells, therefore biopsy is done to confirm that this patch is leukoplakia and not oral cancer.
Oral Brush Biopsy: This procedure involves in removing cells from the surface of the patch with a small brush. This is a non-invasive procedure, but it does not give a definitive diagnosis as cancer cells might not have been taken included in the sample taken.
Excisional Biopsy: This procedure involves removing part of the patch or the whole leukoplakia lesion. This gives more accurate diagnosis and can rule out cancer if the biopsy is negative. To reduce the pain an anesthetic (numbing agent) will be given before the procedure.
Treatment for Leukoplakia
- Treatment mainly involves removing the cause of irritation.
- If the irritation is because by a rough or uneven teeth it should be removed.
- If it’s an unfitting denture it should be removed and a smoother fitting denture should be inserted.
- You need to stop smoking.
- Stop tobacco chewing.
- If it’s due to alcohol you need to stop or reduce the intake.
- Leukoplakia usually clears off in a few weeks or months after the irritation is removed.
- If the tobacco chewing, smoking is continued oral leukoplakia can turn into a cancer.
- Even after the irritation is removed, if the leukoplakia is present then you need to undergo a very minimally invasive surgery in order to remove the leukoplakia.
- This can be removed either by a dentist or by an oral surgeon in the clinic under local anesthesia.
- It can be done either by using a scalpel, laser therapy or by cryotherapy (freezing the patch).
- Follow-up should be done after the treatment.
- Hairy leukoplakia
- Antivirals for the EBV virus.
- If HIV/AIDS is present it should be treated as well.
- If its oral cancer
- If the biopsy is positive for cancer excisional biopsy (if not done during the diagnosis) should be performed. This can be done in the clinic under local anesthesia. The specimen should be sent for biopsy
- If the lesion is very large you may be referred to an oral surgeon or Ears, Nose, Throat (ENT) specialist for the further treatment.
- After treatment, you need to follow up in the clinic.
Leukoplakia is curable. Leukoplakia is white, gray spots that are seen on the tongue or inner side of the cheeks. These are harmless patches. Causes for leukoplakia are chronic irritation by rough or uneven teeth, unfitted dentures, injury to the mucous membranes by biting, smoking and long term alcohol usage. Sometimes these patches can be an oral cancer or precancerous lesion so it’s important that a biopsy is taken to rule out cancer. When these chronic irritation causes are removed leukoplakia patches disappear after several months. If it does not disappear then it has to be surgically removed.