Have you ever looked in the mirror and noticed a white spot or patch inside your mouth, perhaps on your tongue, inside your cheeks, or on your gums? We usually don't pay much attention to such things. However, if you have a white spot that doesn't go away even after wiping it or looking at it, we should be a little concerned. Because these can sometimes be the first signs of a serious condition. Today we are talking about this condition, which is called Leukoplakia in medical science.
Simply put, what is Leukoplakia?
Leukoplakia refers to white patches or spots that appear inside your mouth. These usually don't hurt. But the biggest thing is that you can't wipe them off no matter how hard you try . This condition usually occurs when something continuously damages, or what we call 'irritation', the delicate tissues inside the mouth. The most important thing is that some types of leukoplakia can develop into oral cancer over time. Therefore, if you see a spot like this, it is very important to inform a doctor about it.
What are the main types of leukoplakia?
Leukoplakia can be divided into two main types. There is a clear difference between the appearance and the risk of cancer between the two. Let's look at this to make it easier to understand.
| Type of leukoplakia | Appearance and characteristics | Cancer risk |
|---|---|---|
| Homogeneous leukoplakia | This is the most common type. This spot is usually flat and white. The surface can be smooth or slightly wavy. | This type usually rarely becomes cancerous, which means the risk is low. |
| Non-homogeneous leukoplakia | The shape of these spots is varied and irregular. There may be red spots mixed in with the white color. The surface may be flat or rounded with bumps. | The risk of developing cancer is about seven times higher than other types, so special care should be taken with this. |
Are there other subtypes of these?
Yes, there are two more subtypes that need to be discussed in detail.
Proliferative verrucous leukoplakia (PVL) - the highest risk type
This is a slightly more serious, higher-risk subtype. According to some studies, more than 60% of people with this condition (PVL) will eventually develop oral cancer. These may start as small white spots inside the mouth and spread to other areas, such as the tongue, gums, and inside the cheeks. These spots can grow very quickly and may develop into small bumps on the surface.
Oral hairy leukoplakia - the type that looks like "hair"
As the name suggests, these spots look like white hairs or hairy folds. They are most commonly found on the sides of the tongue. But the best thing about this type is that it does not turn into cancer . This condition usually occurs in people with weakened immune systems. This condition can especially occur in people with `(HIV/AIDS)` and those infected with the Epstein-Barr virus.
Do all white spots turn into oral cancer?
No, that's not the case at all. So don't panic unnecessarily when you see a white spot in your mouth.
In fact, less than 15% of people with leukoplakia develop oral cancer. There are several factors that affect this risk. For example, a spot on the tongue or floor of your mouth is more likely to become cancerous than a spot on the gums. If you have one of these spots, your doctor will explain exactly what your risk is.
What are the causes and risk factors for leukoplakia?
The main reason for this is the continuous damage to the tissues inside the mouth. Imagine, when you wear a set of dentures that are not properly adjusted, they constantly rub against the gums or cheek. Or some people have the habit of chewing on the inside of their cheeks. Things like this can cause leukoplakia.
In addition, certain changes in the genes that instruct the cells in our body can cause cells in the mouth to divide faster than normal, creating spots like these.
There are several main factors that increase the risk of this condition:
- Smoking, eating betel nuts, and chewing tobacco are the main causes.
- Frequent and excessive drinking of alcohol.
- Diseases that weaken the immune system, such as HIV.
How does a doctor diagnose this?
When you go to see a doctor, the first thing he or she will do is examine your mouth carefully to see if you have any unusual white spots. Then they will try to find out what is causing them. For example, if you are using a denture, they will check to see if it fits properly and if it is causing any damage.
However, the only way to know for sure whether or not this is cancerous is to have a biopsy. This involves taking a very small piece of tissue from the spot and examining it under a microscope to determine the nature of the cells.
The only way to know for sure whether every suspicious white spot in your mouth is cancerous or not is to have a biopsy. So if your doctor suggests one, don't be afraid to do it.
What are the treatments for this?
The main treatment for leukoplakia is to completely remove the spot. There are several methods for this.
- The mole is removed with a simple scalpel.
- Removing the spot using a laser .
- Removing the mole using light-activated drugs (photodynamic therapy) .
- Cryotherapy is a method of destroying abnormal cells by applying extreme cold .
- Removing the mole by burning it with an electrically heated device (electrocauterization) .
Your doctor will decide which treatment method is best for you.
Can these come back after treatment? How can I prevent them?
Yes, sometimes even after treatment and removal, there is a small chance of leukoplakia recurring, about 15%. That is why it is important to continue to go for checkups as prescribed by your doctor even after treatment. These spots do not heal on their own, so treatment is essential.
To prevent this, we need to stay away from risk factors.
- Completely avoid all forms of tobacco, including smoking, chewing tobacco, and chewing betel nut.
- Limit your alcohol intake. According to the American Cancer Society, it is recommended that men have no more than two units of alcohol per day and women have no more than one unit per day.
Take-Home Message
- Leukoplakia is a condition that causes white patches inside the mouth that cannot be removed with a swab. These are usually painless.
- This condition is strongly linked to tobacco and alcohol use.
- Never ignore these, as they can sometimes turn into oral cancer.
- The only way to know for sure whether a mole is cancerous or not is to have a biopsy.
- If you see a white spot like this that doesn't change inside your mouth, see a doctor immediately for advice.
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