- Causes of leukoplakia
- Diagnosing leukoplakia
- Diagnosis
- Introduction
- Preventing leukoplakia
- Prevention
- Symptoms of leukoplakia
- Treating leukoplakia
Leukoplakia
Causes of leukoplakia
The exact cause of leukoplakia is unknown, but may be the result of substances irritating the tissue inside the mouth.
Scientific evidence, though weak, has identified a number of things that can increase your risk of developing the condition. These are described below.
Tobacco
Tobacco significantly increases your risk of developing leukoplakia. Smokers are much more likely to get leukoplakia than non-smokers.
There is an even higher risk for people who use smokeless tobacco products, such as chewing tobacco, or betel nut preparations, such as paan.
Studies have shown regular users of betel nuts are 25 times more likely to develop leukoplakia than non-users.
Alcohol
After tobacco, heavy alcohol use is the second most important reason for increased risk of leukoplakia. Heavy drinkers are eight times more likely to develop leukoplakia than non-drinkers.
Heavy drinking is defined as drinking more than the recommended weekly limit for alcohol consumption, which is 21 units for men and 14 units for women.
A unit of alcohol is approximately half a pint of normal-strength lager, a small glass of wine or a single measure (25ml) of spirits.
Read more about alcohol units.
Binge drinking may also increase your risk of developing leukoplakia or mouth cancer.
Other possible risk factors
There are no other consistent risk factors for leukoplakia.
However, infection with the human papilloma virus (HPV) has been suggested as a possible risk factor for leukoplakia. Any link between these two conditions is currently being investigated.
A long-lasting (chronic) infection of the mouth with a type of fungus called Candida can also increase the risk of leukoplakia. Cases where the condition is associated with this infection are often called Candidal leukoplakia.
White patches may sometimes occur if people have a habit of biting their cheeks or dragging their lips across the teeth. Similarly, poorly fitting dentures that rub the lining of the mouth can cause thickened areas that appear as white patches.
However, these white patches are not considered to be leukoplakia as, unlike leukoplakia, they have a clear cause and do not have a risk of developing into mouth cancer.
Useful Links
- Published Date
- 2013-05-15 09:07:39Z
- Last Review Date
- 2012-10-21 00:00:00Z
- Next Review Date
- 2014-10-21 00:00:00Z
- Classification
- Diabetes,Leukoplakia,Stopping smoking
Leukoplakia
Diagnosing leukoplakia
Your dentist should be able to diagnose leukoplakia by examining the white or grey patch on the inside of your mouth.
Biopsy
Your dentist may take a small sample of cells from the patch using a procedure called a biopsy. The cells will then be sent to a specialised laboratory for closer examination. Alternatively, your dentist may refer you to a specialist who will do the biopsy.
See the Health A-Z pages about Biopsy for more information about the procedure.
Following the biopsy, laboratory tests will be able to determine whether there are any abnormal cells present in the patch. If abnormal cells are detected, it can suggest that you have an increased chance of developing oral cancer and will require regular check-ups.
Exactly what that risk is will depend on how abnormally the cells inside the patch are behaving (the medical term for this level of abnormality is dysplasia).
See the Health A-Z topic about Mouth cancer for more information about the condition.
- Biopsy
- A biopsy is a test that involves taking a small sample of tissue from the body so it can be examined.
Useful Links
- Published Date
- 2011-09-11 17:30:28Z
- Last Review Date
- 2011-01-17 00:00:00Z
- Next Review Date
- 2013-01-17 00:00:00Z
- Classification
- Biopsies, swabs or scrapings,Leukoplakia
Leukoplakia
Introduction
Leukoplakia is a white patch that develops in the mouth.
The condition is usually painless, but is closely linked to an increased risk of mouth cancer.
Places where the patch can develop include the:
- lips
- floor or roof of the mouth
- inside of the cheek
- gums
- tongue
Read more about the symptoms of leukoplakia.
You should see a dentist if you notice a white patch or lump in your mouth that hasn’t healed after about 14 days.
As there is no specific test for leukoplakia, your dentist will need to rule out other conditions before they can diagnose it. They may refer you to a specialist for a biopsy, which involves removing a small sample of tissue from the patch. The tissue will be sent to a specialised laboratory to see if it is abnormal and potentially cancerous.
Why does leukoplakia happen?
The exact cause of leukoplakia is unknown, but the use of tobacco, both smoking and chewing tobacco products, is thought to increase the risk of developing it.
Heavy alcohol consumption is also believed to increase the risk of leukoplakia.
Read more about the causes of leukoplakia.
How is leukoplakia treated?
Leukoplakia usually causes no symptoms, and the condition should not affect your quality of life, however, it should be investigated to assess your risk of developing mouth cancer.
Evidence suggests the most effective way of controlling leukoplakia is to stop using tobacco and to drink alcohol in moderation.
Although estimates for people with leukoplakia from different population groups who will develop mouth cancer vary considerably – from around 0.5% to almost 20% – the risk of mouth cancer is thought to be much higher in people who continue to smoke heavily or chew tobacco.
If you are thought to be at high-risk, leukoplakia can be surgically removed to ensure any abnormal cells don’t later become cancerous.
Regardless of the treatment you receive, it is important to have your mouth regularly examined by a dentist or suitable specialist to ensure the condition is not progressing.
Read more about treating leukoplakia.
Preventing leukoplakia
The most effective way of preventing leukoplakia is to avoid using any form of tobacco and to reduce alcohol consumption. However, it is not always possible to prevent the condition developing, as it sometimes has no identifiable cause (known as idiopathic leukoplakia).
Read more about stopping smoking and alcohol misuse.
A diet high in fresh fruit and vegetables may also help prevent leukoplakia and mouth cancer.
Read more about food and diet and healthy eating.
How common is leukoplakia?
Leukoplakia is a common condition. It is estimated that slightly fewer than one in 100 people will develop the condition at some point in their life. However, occurrence of leukoplakia is higher in parts of the world where the use of chewing of tobacco and related products is widespread, such as India and Taiwan.
Men are more likely than women to develop leukoplakia and most cases affect adults who are over 50 years old.
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- Published Date
- 2013-05-15 09:07:11Z
- Last Review Date
- 2012-10-21 00:00:00Z
- Next Review Date
- 2014-10-21 00:00:00Z
- Classification
- Leukoplakia,Mouth cancer
Leukoplakia
Preventing leukoplakia
Tobacco and alcohol
The most effective way of preventing leukoplakia is to avoid using any form of tobacco and to stop drinking alcohol, or at least ensure that you stick to the recommended daily allowance for alcohol consumption.
See the Health A-Z pages on Quitting smoking and Alcohol misuse for information and advice about how to achieve this.
Mediterranean-style diet
Eating a Mediterranean-style diet may also reduce your risk of developing leukoplakia and oral cancer.
A Mediterranean-style diet is high in fresh vegetables, particularly tomatoes, citrus fruits (such as oranges, grapefruit and lemon), olive oil and fish oil.
Eating five portions of fruit and vegetables a day will also help to prevent leukoplakia, oral cancer and other types of cancers. Fruit and vegetables contain chemicals known as antioxidants, which are thought to help protect human cells from damage.
Leafy vegetables, such as lettuce, spinach and cabbage are thought to provide the most protection against cancer. Your diet should also be low in fat and high in starchy foods, such as wholemeal bread, wholegrains and potatoes.
See the Health A-Z pages about Diet and the Live Well section about Healthy eating for more information and advice about eating healthily.
Useful Links
- Published Date
- 2011-09-11 17:30:30Z
- Last Review Date
- 2011-01-17 00:00:00Z
- Next Review Date
- 2013-01-17 00:00:00Z
- Classification
- Leukoplakia,Stopping smoking
Leukoplakia
Symptoms of leukoplakia
The main feature of leukoplakia is the appearance of a white patch in the mouth that cannot be scrubbed off.
The patch can occur on the:
- floor of the mouth
- soft palate (the back of the roof of the mouth)
- inside of the cheek
- lower lip
- gums
- tongue (usually the sides)
There is 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 often slightly raised, with a thickened or irregular feel to it. The patch is often persistent and cannot be removed by brushing or scraping. There may be some redness associated with the patch.
When to seek medical advice
Visit your dentist if you notice a white patch or lump in your mouth that does not heal within 14 days.
Leukoplakia does not 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 your leukoplakia can be carefully monitored.
Useful Links
- Published Date
- 2013-05-15 09:07:26Z
- Last Review Date
- 2012-10-21 00:00:00Z
- Next Review Date
- 2014-10-21 00:00:00Z
- Classification
- Leukoplakia
Leukoplakia
Treating leukoplakia
Treating leukoplakia is important as it should reduce your risk of developing mouth cancer.
Everyone with leukoplakia should consider the advice below, even if their biopsy finds no abnormal cells.
Stopping smoking
If you smoke or use other tobacco products, the most effective form of treatment for leukoplakia is to stop. Avoiding tobacco can cause a leukoplakia patch to slowly disappear and may also significantly reduce any risk of developing mouth cancer.
If you smoke, it is strongly recommended you stop as soon as possible. Your GP can advise you about stopping, and prescribe medication to help you quit. The NHS Smokefree website also provides information, support and advice about giving up smoking.
Read more about stopping smoking and treatments for stopping smoking.
Reducing alcohol
Giving up alcohol or reducing your alcohol consumption may reduce the size of a leukoplakia patch or cause it to disappear entirely. As with stopping smoking, avoiding alcohol or limiting your intake will reduce your risk of developing oral cancer.
If you do not want to stop drinking alcohol altogether, you should ensure you don’t drink any more than the recommended daily limits, which are:
- three to four units a day for men
- two to three units a day for women
A unit of alcohol is equal to about half a pint of normal-strength lager, a small glass of wine or a pub measure (25ml) of spirits.
Visit your GP if you are finding it difficult to moderate your drinking. Counselling services and medication are available to help you reduce your alcohol intake.
Read more about drinking and alcohol and treatment for alcohol misuse.
Surgical treatment
Surgically removing the leukoplakia patch may reduce the risk of mouth cancer developing by removing any abnormal cells.
The leukoplakia is usually removed using a scalpel or laser. The procedure is typically done using a local anaesthetic, though a general anaesthetic may be required if the area is large.
Medical treatment
There is currently limited evidence that medical treatment will cause leukoplakia to disappear. Medications such as retinoids or substances made from vitamin A have been proposed, but these treatments can have adverse side effects, and there is no consistent evidence that they are effective.
Treatments such as radiotherapy or chemotherapy are of no benefit.
Medical treatment may be used in cases where leukoplakia is associated with an infection by a fungus called Candida. In these cases, treatment with antifungal medicines may be used to get rid of the infection within the white patches. However, this is not a specific treatment for leukoplakia.
Useful Links
- Published Date
- 2013-05-15 09:07:57Z
- Last Review Date
- 2012-10-21 00:00:00Z
- Next Review Date
- 2014-10-21 00:00:00Z
- Classification
- Leukoplakia,Mouth cancer,Retinoids,Safe drinking,Stopping smoking