What is leukoplakia?
Leukoplakia is a white or gray patch that develops on the tongue or the inside of the cheek. It is the mouth's reaction to chronic irritation of the mucous membranes of the mouth. Leukoplakia patches can also develop on the female genital area; however, the cause of this is unknown.
The growth can occur at any time in your life, but it is most common in the elderly.
"Hairy" leukoplakia of the mouth is an unusual form of leukoplakia that is seen only in people who are infected with HIV, have AIDS, or AIDS-related complex. It consists of fuzzy, hence the name "hairy," white patches on the tongue and less frequently elsewhere in the mouth. It may resemble thrush, an infection caused by the fungus Candida which, in adults, usually occurs if your immune system is not working properly, and may be one of the first signs of infection with the HIV virus.
What are the symptoms for leukoplakia?
Leukoplakia usually occurs on your gums, the insides of your cheeks, the bottom of your mouth — beneath the tongue — and, sometimes, your tongue. It isn't usually painful and may go unnoticed for a while.
Leukoplakia may appear:
- White or grayish in patches that can't be wiped away
- Irregular or flat-textured
- Thickened or hardened in areas
- Along with raised, red lesions (speckled leukoplakia or erythroplakia), which are more likely to show precancerous changes
Hairy leukoplakia causes fuzzy, white patches that resemble folds or ridges, usually on the sides of your tongue. It's often mistaken for oral thrush, an infection marked by creamy white patches that can be wiped away, which is also common in people with a weakened immune system.
When to see a doctor
Even though leukoplakia doesn't usually cause discomfort, sometimes it can indicate a more serious condition.
See your dentist or primary care professional if you have any of the following:
- White plaques or sores in your mouth that don't heal on their own within two weeks
- Lumps or white, red or dark patches in your mouth
- Persistent changes in the tissues of your mouth
- Ear Pain when swallowing
- Progressive reduction in the ability to open your jaw
What are the causes for leukoplakia?
Although the cause of leukoplakia is unknown, chronic irritation, such as from tobacco use, including smoking and chewing, appears to be responsible for most cases. Often, regular users of smokeless tobacco products eventually develop leukoplakia where they hold the tobacco against their cheeks.
Other causes may include chronic irritation from:
- Jagged, broken or sharp teeth rubbing on tongue surfaces
- Broken or ill-fitting dentures
- Long-term alcohol use
Your dentist can talk with you about what may be causing leukoplakia in your case.
Hairy leukoplakia results from infection with the Epstein-Barr virus (EBV). Once you've been infected with EBV, the virus remains in your body for life. Normally, the virus is dormant, but if your immune system is weakened, especially from HIV/AIDS, the virus can become reactivated, leading to conditions such as hairy leukoplakia.
What are the treatments for leukoplakia?
Treatment, if needed, involves removing the source of irritation. For example, if leukoplakia is caused by a rough tooth or an irregular surface on a denture or filling the tooth will be smoothed and dental appliances repaired. If leukoplakia is caused by smoking, you will be asked to minimize or stop smoking or using other tobacco products.
Leukoplakia is usually harmless, and lesions usually clear in a few weeks or months after the source of irritation is removed. If eliminating the source of irritation is ineffective in reducing leukoplakia, the lesion may need to be surgically removed. The lesion can be removed either by your general dentist or by an oral surgeon in their office under local anesthesia.
Hairy leukoplakia requires treatment with an antiviral medication.
What are the risk factors for leukoplakia?
Tobacco use, particularly smokeless tobacco, puts you at high risk of leukoplakia and oral cancer. Long-term alcohol use increases your risk, and drinking alcohol combined with smoking increases your risk even more.
People with HIV/AIDS are especially likely to develop hairy leukoplakia. Although the use of antiretroviral drugs has reduced the number of cases, hairy leukoplakia still affects a number of HIV-positive people, and it may be one of the first signs of HIV infection.