White skin on inside of mouth

Leukoplakia - Symptoms and causes

Overview

Leukoplakia

Leukoplakia appears as thick, white patches on the inside surfaces of your mouth. It has a number of possible causes, including repeated injury or irritation. It can also be a sign of precancerous changes in the mouth or mouth cancer.

With leukoplakia (loo-koh-PLAY-key-uh), thickened, white patches form on your gums, the insides of your cheeks, the bottom of your mouth and, sometimes, your tongue. These patches can't be scraped off.

Doctors don't know what causes leukoplakia but consider chronic irritation from tobacco — whether smoked, dipped or chewed — to be the main culprit in its development.

Most leukoplakia patches are noncancerous (benign), though some show early signs of cancer. Cancers on the bottom of the mouth can occur next to areas of leukoplakia. And white areas mixed in with red areas (speckled leukoplakia) may indicate the potential for cancer. So it's best to see your dentist or primary care professional if you have unusual, persistent changes in your mouth.

A type of leukoplakia called hairy leukoplakia, sometimes called oral hairy leukoplakia, primarily affects people whose immune systems have been weakened by disease, especially HIV/AIDS.

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Symptoms

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

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

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Causes

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

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.

Risk factors

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.

Hairy leukoplakia

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.

Complications

Leukoplakia usually doesn't cause permanent damage to tissues in your mouth. However, leukoplakia increases your risk of oral cancer. Oral cancers often form near leukoplakia patches, and the patches themselves may show cancerous changes. Even after leukoplakia patches are removed, the risk of oral cancer remains.

Hairy leukoplakia

Hairy leukoplakia isn't likely to lead to cancer. But it may indicate HIV/AIDS.

Prevention

You may be able to prevent leukoplakia if you avoid all tobacco products or alcohol use. Talk to your doctor about methods to help you quit. If you continue to smoke or chew tobacco or drink alcohol, have frequent dental checkups. Oral cancers are usually painless until fairly advanced, so quitting tobacco and alcohol is a better prevention strategy.

Hairy leukoplakia

If you have a weakened immune system, you may not be able to prevent hairy leukoplakia, but identifying it early can help you receive appropriate treatment.

By Mayo Clinic Staff

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Leukoplakia - NHS

Leukoplakia is a white patch in the mouth. If you have a white patch in the mouth that does not go away, get it checked by a dentist or GP.

Check if you have leukoplakia

Leukoplakia patches often appear on the tongue.

Credit:

Medican / Alamy Stock Photo https://www.alamy.com/stock-photo-hairy-leukoplakia-31088074.html?pv=1&stamp=2&imageid=50B53D74-85FC-4C29-8279-1752D2D567FB&p=17774&n=0&orientation=0&pn=1&searchtype=0&IsFromSearch=1&srch=foo%3dbar%26st%3d0%26pn%3d1%26ps%3d100%26sortby%3d3%26resultview%3dsortbyRelevant%26npgs%3d0%26qt%3dleukoplakia%26qt_raw%3dleukoplakia%26lic%3d3%26mr%3d0%26pr%3d0%26ot%3d0%26creative%3d%26ag%3d0%26hc%3d0%26pc%3d%26blackwhite%3d%26cutout%3d%26tbar%3d1%26et%3d0x000000000000000000000%26vp%3d0%26loc%3d0%26imgt%3d0%26dtfr%3d%26dtto%3d%26size%3d0xFF%26archive%3d1%26groupid%3d%26pseudoid%3d62486%26a%3d%26cdid%3d%26cdsrt%3d%26name%3d%26qn%3d%26apalib%3d%26apalic%3d%26lightbox%3d%26gname%3d%26gtype%3d%26xstx%3d0%26simid%3d%26saveQry%3d%26editorial%3d%26nu%3d%26t%3d%26edoptin%3d%26bespoke%3d4%26customgeoip%3dGB%26apaid%3d%7b18B189B6-6A83-41BD-8442-2448A6B7E281%7d%26custspecid%3d14369B5F-24B7-4344-B743-D5DE569A1F46%26cap%3d1%26cbstore%3d1%26vd%3d0%26lb%3d%26fi%3d2%26edrf%3d0%26ispremium%3d1%26flip%3d0%26pl%3d

You can also get them on the inside of your cheeks.

Credit:

SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/476749/view

Some people get patches on their gums.

Credit:

CNRI/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/643692/view

It's also possible to get patches on the floor or roof of your mouth.

The patches:

are not painful
are an irregular shape
are slightly raised
may be slightly red within the patch
cannot be rubbed or scraped away (patches that can be removed could be oral thrush)

There are also a number of other causes of a white tongue.

Non-urgent advice: See a dentist or GP if:

you have a white patch in your mouth that has not gone away after 2 weeks
you have a white patch on your tongue and a weakened immune system – for example, you have HIV or have had an organ transplant

What happens at your appointment

Your dentist or GP will examine the patch and be able to rule out other possible causes, like a fungal infection of the mouth (oral thrush) or cheek biting.

You may be referred to a specialist for a biopsy. A small piece of tissue from the patch will be removed and checked for abnormal cells.

Mouth cancer risk

If you have leukoplakia, there's a small risk it could progress to mouth cancer over time.

This is why it's important to see your dentist or GP if you have a white patch in your mouth.

Treatments for leukoplakia

Treatment for leukoplakia is not always needed, but you'll have regular check-ups to make sure the patch is not getting bigger.

The patch may get smaller or go away if you:

stop smoking
reduce the amount of alcohol you drink

An operation is sometimes needed to remove the patch if there's a risk it could become cancerous.

This may be done while the area is numbed (local anaesthetic) or while you're asleep (general anaesthetic).

The patch can be removed in a number of ways, including using a laser or a surgical scalpel. Your mouth should heal quickly afterwards.

Preventing leukoplakia and mouth cancer

In the UK, leukoplakia is mostly caused by smoking. But sometimes the exact cause is not known.

There are things you can do to reduce your risk of getting leukoplakia. These may also reduce your chances of getting mouth cancer.

Do

keep your mouth and teeth healthy by taking care of your teeth and gums
have regular dental check-ups
if you wear dentures, make sure they fit properly
eat a balanced diet, including plenty of fresh fruit and vegetables

Don’t

do not smoke
do not chew tobacco, paan or betel nuts
do not drink more than the recommended amount of alcohol

Hairy leukoplakia

Hairy leukoplakia is a type of leukoplakia caused by the Epstein-Barr virus.

You may have this type if you have a weakened immune system – for example, you have HIV or have had an organ transplant.

It causes fuzzy white patches, often on the sides of the tongue, that look folded or ridged. They're not painful and cannot be brushed or scraped away.

Antiviral medicines, or treatments applied directly to the patch, may be prescribed to treat hairy leukoplakia.

Unlike other types of leukoplakia, hairy leukoplakia does not carry a risk of mouth cancer.

Page last reviewed: 02 March 2021
Next review due: 02 March 2024

Oral candidiasis, what is it and why is it dangerous, how to treat candidiasis – Comfort Dentistry

How is it manifested and what is dangerous infection

The most striking symptom of oral candidiasis is a white loose coating on the mucosa. It mainly covers the tongue, cheeks, and can affect the gums and palate. The plaque is easily scraped off, the tissues beneath it are prone to reddening and may bleed. Among other signs of the disease:

unpleasant aftertaste;
dry mouth; nine0008
burning;
the appearance of cracks in the corners of the lips;
difficult or painful swallowing;
discomfort with habitual movements of the tongue.

Candidiasis is acute and chronic. In most cases, it is the acute form that manifests itself, the chronic one is typical for carriers of HIV infections and smokers. Depending on the degree and form of the disease, other symptoms may also be observed, so even if one or two appear, you should immediately consult a dentist. nine0005

Causes of oral candidiasis

How does the disease occur? A fungus of the Candida species lives in the body from birth and, under certain circumstances, provokes a disease. What becomes the trigger for infection:

weakening of the immune system;
taking antibiotics;
prolonged use of removable dentures, especially in the case of their loose fit;
inadequate oral hygiene; nine0008
smoking;
oncology;
use of inhalers for asthma;
an excess of simple carbohydrates in the diet;
period of pregnancy;
infancy or old age.

It can be seen that there are many reasons, often they act together, less often - alone. In general, oral candidiasis in adults is rare. It mainly affects babies in the first years of life and the elderly. Among these categories, the prevalence of the disease reaches 10%. nine0005

How is oral candidiasis treated

To begin with, let's say that treatment is necessary, otherwise the infection spreads to the pharynx, tonsils, and gums. Further, the disease descends into the lungs, gastrointestinal tract, liver and causes them irreparable harm.

When the first signs of candidiasis of the oral mucosa appear, you should contact your dentist or therapist to confirm the diagnosis. At the doctor's appointment, describe all the symptoms you have, even those that are not on the list. For example, you have noticed increased anxiety or a tendency to stress lately. Information about the medications you take, recent illnesses and the presence in the community of sick people is also important. To confirm the diagnosis, it is often enough to take a swab from the oral cavity and conduct an appropriate analysis. If the disease has already spread to other organs, a more thorough examination may be required, for example, endoscopy - diagnosis of the condition of the esophagus and stomach using a flexible tube with a camera at the end. nine0005

How to treat oral candidiasis? Treatment can be local or systemic, depending on the form and stage of the disease. At local prescribe antifungal agents and antiseptics. It can be sprays, rinses, gels, lozenges and more. Treatment on average takes up to 3 weeks, as a general rule - until the symptoms disappear and another week. Systemic treatment is used for chronic forms or when the infection spreads to other organs. It usually involves the use of more drugs designed to treat the directly affected areas. nine0005

Never self-medicate! A fungal infection has nothing to do with inflammation, so by your actions you are more likely to harm your body. In doing so, you can reduce the harmful effects of the infection and make you feel better. To do this, eat natural sugar-free yogurt and take probiotics as recommended by your doctor. But these actions are not a complete treatment for candidiasis in the mouth!

How to avoid candidiasis?

To prevent the disease, you must follow a few simple rules:

maintain oral hygiene;
contact the dentist at least twice a year, even in the absence of complaints;
control nutrition, avoid excess carbohydrates in food;
refrain from smoking, which can cause a chronic form of the disease.

Treatment of candidiasis of the oral mucosa can take a long time, as well as cause irreparable harm to health, so we recommend that you take care of yourself in advance, observing preventive measures. If symptoms have already begun to appear, see a doctor as soon as possible so that the infection does not have time to spread to other organs. You can undergo oral cavity diagnostics in Comfort Dentistry. Our experts will tell you in detail about the prevention of common diseases of the teeth and gums, and, if necessary, will provide high-quality treatment. nine0005

Oral leukoplakia

Leukoplakia is a disease of the oral mucosa, accompanied by increased keratinization of the epithelium, in which its thickening and desquamation also occur. Most often, leukoplakia of the mouth is localized on the surface of the tongue, at the corners of the mouth and on the buccal mucosa. At risk are men aged 30 to 40 years, however, in not rare cases, the disease affects young people, children and women. nine0005

Symptoms and causes of leukoplakia

Most cases of oral leukoplakia present with white or gray plaques. They form on the tongue, cheeks, gums and palate. Depending on the characteristics of the human body, plaques form in a period of several weeks to several months. Over time, they harden and take their final form in the form of thickened areas that slightly rise above the surface of the mucosa. Usually leukoplakia, the treatment of which must be started immediately after the discovery of plaques, is absolutely painless. However, thickenings can react to too spicy or hot food and other external stimuli. nine0005

Consider the causes of this disease. Leukoplakia occurs as a result of the adverse effects of an aggressive external environment and factors caused by impaired functioning of the whole organism as a whole.

External influences include: coarse food, improperly installed fillings and dentures, as well as bad habits and poor living conditions. There are other external factors as well. Leukoplakia of the tongue often manifests itself under the influence of production factors. This is especially true for those people whose work is related to oil refining or the production of tar, alkalis, acids and mineral fertilizers. nine0005

Among the functional disorders of the body, first of all, it is necessary to note the pathology of the gastrointestinal tract and vitamin A deficiency.

In some cases, leukoplakia occurs under the influence of a genetic predisposition to such diseases.

Oral leukoplakia:

types and signs of the disease

In modern medicine, different forms of the disease are distinguished:

flat leukoplakia - patients report a feeling of tightness, but there are practically no other complaints. Grayish-white plaques appear on the mucous membrane of the oral cavity, having a clear localization; nine0008
warty leukoplakia of the oral cavity - plaques have sharply defined borders, are keratinized elevations with a bumpy surface;
erosive form - along with plaques, the patient has the appearance of erosions, cracks and other mechanical damage to the mucosa;

Leukoplakia of the oral cavity

o leukoplakia of the tongue - whitish-gray filamentous formations appear on the surface of the tongue, which sometimes pass to the buccal mucosa. Most often, cases of this form of disease are observed in patients with AIDS. nine0005

Leukoplakia of the tongue

Leukoplakia - treatment and prevention of the disease

If leukoplakia is suspected, it is necessary to consult a doctor! The reason is simple - the probability of degeneration into a malignant formation in the advanced stage of the disease is very high.

Leukoplakia is classified as a precancerous disease: 30% of patients with squamous cell carcinoma of the tongue and oral mucosa are preceded by leukoplakia, in addition, the same etiological factors are involved in the pathogenesis of both diseases. The appearance of leukoplakia is deceptive: histological examination of white plaques may reveal squamous cell carcinoma. nine0005

Leukoplakia degenerating into squamous cell carcinoma

Treatment of any form of leukoplakia should be complex. First of all, dentists must sanitize the oral cavity and eliminate irritating factors that have a traumatic effect on the oral cavity. Such activities include: quitting smoking, alcohol, taking non-hot and non-spicy food, removing dentures and metal fillings from the oral cavity, proper nutrition. Since oral leukoplakia can be caused by endogenous factors, patients are carefully examined for somatic diseases, in particular, pathologies of the gastrointestinal tract. Also, leukoplakia of the oral cavity, the treatment of which is carried out in a complex, requires examination by a dermatologist, endocrinologist, oncologist and therapist. When ulcers and erosions appear in the oral cavity, a mandatory consultation with an oncologist and no self-treatment! nine0005

The material was prepared by
dentist-therapist
of the highest qualification category Lebedeva N.M.

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Oral leukoplakia

Symptoms and causes of leukoplakia

Among the functional disorders of the body, first of all, it is necessary to note the pathology of the gastrointestinal tract and vitamin A deficiency.

In some cases, leukoplakia occurs under the influence of a genetic predisposition to such diseases.

Oral leukoplakia:

types and signs of the disease

In modern medicine, different forms of the disease are distinguished:

flat leukoplakia - patients report a feeling of tightness, but there are practically no other complaints. Grayish-white plaques appear on the mucous membrane of the oral cavity, having a clear localization; nine0008
warty leukoplakia of the oral cavity - plaques have sharply defined borders, are keratinized elevations with a bumpy surface;
erosive form - along with plaques, the patient has the appearance of erosions, cracks and other mechanical damage to the mucosa;

Leukoplakia of the oral cavity

Leukoplakia of the tongue

Leukoplakia - treatment and prevention of the disease

If leukoplakia is suspected, it is necessary to consult a doctor! The reason is simple - the probability of degeneration into a malignant formation in the advanced stage of the disease is very high.

Leukoplakia degenerating into squamous cell carcinoma

Treatment of any form of leukoplakia should be complex. First of all, dentists must sanitize the oral cavity and eliminate irritating factors that have a traumatic effect on the oral cavity.

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