Introduction

Leukoplakia is a white patch that develops in the mouth.

The condition is usually painless, butis closely linked to an increased risk of Oral cancer .

What are the symptoms?

The main feature of leukoplakia is a white patch in the mouth that can't be removed by rubbing.

A white patch most commonly occurs on the tongue but can also develop on the:

• floor of the mouth
• soft palate (back of the roof of the mouth)
• inside of the cheek
• lower lip
• gums

There's usually only one clearly defined patch, but there can sometimes be more than one spread over a larger area.

The patch is almost always painless and may be slightly raised, with a thickened or irregular feel to it. The patch is often persistent and can't be removed by brushing or scraping. Sometimes, there's also redness around the affected area.

When should I seek medical advice?

Visit your dentist if you notice a white patch in your mouth that doesn't heal within 14 days.

Leukoplakia doesn't usually cause pain or discomfort, but your dentist will be able to rule out other causes of the white patch, such as a fungal infection.

Your dentist may also be able to assess your risk of developing oral cancer in later life. As part of this risk assessment, you may have to attend regular follow-up appointments or see a specialist so that your leukoplakia can be carefully monitored.

You may be referred to a specialist for a biopsy , which involves removing a small piece of tissue from the patch. The tissue sample will be sent to a laboratory so it can be examined to see if it's potentially cancerous.

What causes leukoplakia?

In a few cases, the cause of leukoplakia is unknown (idiopathic) and certain factors are thought to increase your chances of developing it.

Tobacco (smoking and chewing it) and heavy alcohol consumption are the two main risk factors for leukoplakia. This is because these substances irritate the mucous membranes (soft tissues) in your mouth.

Persistent infections caused by candida ( thrush ) can also lead to leukoplakia. This is known as candidal leukoplakia.

Other causes of white patches include:

• frictional keratoses this can be caused by misaligned teeth, ill-fitting dentures or long-term cheek biting
• oral lichen planus a non-infectious rash that can sometimes occur in the mouth
• oral thrush (candidiasis) a short-term fungal infection of the mouth
• a vitamin A or B deficiency

Readmore about the causes of leukoplakia .

Treating leukoplakia

Leukoplakia doesn't usually cause symptoms and it shouldn't affect your quality of life. However, it should be investigated.

Stopping smoking or chewing tobacco and reducing your alcohol consumption may help clear up the white patches in your mouth, as well as reducing your chances of developing mouth cancer.

If you're thought to have an increased risk of developing mouth cancer, leukoplakia can be surgically removed to ensure any abnormal cells don't later become cancerous.

Regardless of the treatment you receive, it's important to have your mouth regularly examined by a dentist or suitable specialist to ensure the condition isn't progressing.

This is known as idiopathic leukoplakia.

The best thing you can do is to avoid using any form of tobacco and to reduce your alcohol consumption.

A diet containing plenty of fresh fruit and vegetables may also help prevent leukoplakia and mouth cancer.

It's estimated that about one in 100 people will develop leukoplakia at some point in their life.

However, leukoplakia rates are higher in parts of the world such as India and Taiwan, where the use of chewing tobacco and related products , such as the areca nut (also known as the betel nut), is widespread.

Men are twice as likely as women to develop leukoplakia, and most cases affect older adults who are 50-70 years of age.

Hairy leukoplakia

Hairy leukoplakia is a type of leukoplakia that affects people with a weakened immune system (the bodys natural defence against infection and illness), particularly those who have HIV .

It almost always occurs on the side (or both sides) of the tongue and doesn't cause pain or any change in your sensation of taste. It usually resolves when the immune system improves.

Hairy leukoplakia is usually caused by the Epstein-Barr virus, although antiviral medicines rarely help. Unlike other types of leukoplakia, hairy leukoplakia doesn't carry a risk of mouth cancer.

However, it should be taken as an important warning sign that your immune system may be weakened. Visit your GP or specialist as soon as possible if you develop hairy leukoplakia.

Please note that hairy leukoplakia doesn't always mean you have HIV/AIDS.