Oral leukoplakia is a precancerous lesion that can develop on the inner cheek tissue or tongue due to chronic irritation from sources such as ill-fitting dentures, smoking, or chewing tobacco. Hairy leukoplakia can be a sign of an HIV infection, while thrush is a yeast-like infection associated with immunodeficiency conditions. Symptoms include gray or white lesions on the tongue and cheeks, which may become rough and sensitive. Treatment may involve removing the irritating source or surgery. Most leukoplakia is benign and resolves within months.
Oral leukoplakia generally refers to oral precancerous lesions. Typically, oral leukoplakia is seen on the inner cheek tissue or can develop anywhere on the tongue. Commonly, leukoplakia develops due to chronic irritation. Some sources of irritants that may contribute to the incidence of oral leukoplakia include irritation from ill-fitting dentures, smoking or chewing tobacco. Individuals who chew tobacco usually hold the substance in their mouths for long periods, contributing to oral irritation.
A condition called hairy leukoplakia is a form of the condition that can be seen in the immunocompromised patient. Hairy leukoplakia can be the initial sign of an HIV infection. While this condition can indicate a sign or symptom of HIV, it can also be caused by post-transplant bone marrow transplantation or Epstein Barr viruses.
Oral leukoplakia can also resemble a condition called thrush. Thrush refers to a yeast-like infection caused by a substance called candida. Thrush is commonly associated with immunodeficiency conditions such as HIV.
Typical symptoms of oral leukoplakia can include skin lesions on the tongue and cheeks. Although the lesions are usually gray or white, they can also be red. Red oral lesions are referred to as erythroplakia. These mouth lesions may be slightly raised, hard, and slightly thickened. Alternatively, the mouth spots of hairy leukoplakia may appear white and fuzzy. These lesions are typically painless and usually found on the tongue.
Generally, a diagnosis of oral leukoplakia can be made after your doctor looks at the lesion. The white patches usually develop over months and can become rough and sensitive to heat, touch, or the spiciness of the food. Occasionally, your doctor may recommend a biopsy for oral leukoplakia. A biopsy can show changes or mutations that can be diagnostic of oral cancer.
Treatment for oral leukoplakia may include complete elimination of the mouth lesion. Removing irritating sources, such as painful dentures or crowns, can contribute to the healing process. Patients should also stop smoking and chewing tobacco, as these contribute greatly to irritation of the mouth and mucous membranes. Patients are often advised to seek help from their physician if they are unable to stop using tobacco products on their own.
Occasionally, surgery may be used to excise the lesion. Oral leukoplakia is often removed in the doctor’s office or in an outpatient setting. Local anesthesia is used to numb the oral cavity, so the lesion can be removed effectively without pain. Most of the time, leukoplakia is benign and harmless. These oral lesions commonly resolve within months if the irritating sources are effectively removed. Patients are advised to inform their doctor if they notice any oral abnormalities.
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