Have you ever looked inside your mouth and noticed a white spot on your tongue or inside your cheek? Maybe you tried to rub it off, but it wouldn't go away. It's normal to feel a little scared and curious when you see something like this. "What is this?" You might think. So, today we're going to talk about a condition that you might see inside your mouth, but that you might not pay much attention to, but that's something that you should pay attention to. That's leukoplakia.
What exactly is Leukoplakia?
Simply put, leukoplakia is a condition where white, thickened patches appear inside your mouth, including your tongue, gums, inside your cheeks, and sometimes inside your lips. These patches are usually painless, but they can't be removed by rubbing them off or brushing them off. They're often caused by constant irritation from something inside your mouth. For example, a misaligned set of teeth, a sharp edge from a broken tooth, or habitual cheek chewing.
The important thing is that some leukoplakia spots have a chance of developing into oral cancer , so if your dentist sees one, don't ignore it and perhaps refer you to a specialist. Only then can you find out exactly what the condition is and start treatment if necessary.
What are the main types of Leukoplakia?
There are two main types of leukoplakia. Let's talk about that a little bit.
Homogeneous leukoplakia
This is the most common type. "Homogeneous" means "of the same type." So, in this type, the spot that appears inside the mouth is usually flat, white, and uniform in appearance. The surface of this spot can be smooth, or it can be slightly wavy or look like small bumps. The good news is that this homogeneous type is usually very unlikely to become cancerous. That means it is often harmless.
Non-homogeneous leukoplakia
"Non-homogeneous" is the opposite of the previous one, which means "not the same." In this type, the spots that appear inside the mouth can be somewhat irregular, of different shapes, sometimes white, sometimes reddish (this is sometimes called `erythroleukoplakia`). These can be flat, or they can be raised and lumpy. Studies have shown that this non-homogeneous type is about seven times more likely to turn into cancer than the previously mentioned homogeneous type. Therefore, you need to be a little more careful about this type.
Should we also learn about the subtypes of Leukoplakia?
In addition to the two main types, there are several subtypes that require special attention.
Proliferative verrucous leukoplakia (PVL)
This is a rare but potentially serious subtype that needs attention. Some studies suggest that over 60% of people with PVL will eventually develop oral cancer . These start as small white spots inside the mouth. They can appear on the tongue, gums, soft tissue between the lips and gums, and the inside of the cheeks. PVL spots can grow and spread very quickly, appearing as small, cauliflower-like bumps or blisters. If you have this condition, you will need regular medical checkups.
Oral hairy leukoplakia
As the name suggests, these are white, hairy patches. Sometimes they are raised, so the hairs may appear to be growing out of the folds. These patches are most common on the sides of the tongue, but they can also occur in other parts of the mouth. Most importantly, this type of oral hairy leukoplakia does not become cancerous. It usually occurs in people with weakened immune systems. This type is especially common in people with conditions like HIV/AIDS or those infected with the Epstein-Barr virus. It is actually the result of a virus.
Does Leukoplakia always become cancer?
This is a question that many people ask, and it's a scary one. No, it doesn't. Not everyone with leukoplakia will develop oral cancer. Studies show that less than 15% of people with leukoplakia will develop oral cancer. That means the majority of spots will not become cancerous.
Medical researchers are still figuring out how and when leukoplakia becomes cancerous. For example, leukoplakia on your gums is less likely to become cancerous than one on the underside of your tongue or the floor of your mouth. Also, the non-homogeneous type of spots mentioned earlier are more likely to become cancerous.
Remember: Not all white spots in your mouth are cancerous. If you have leukoplakia, your doctor will tell you what to expect and how to monitor it. Don't panic, but don't ignore it either.
Is this condition called Leukoplakia common?
Leukoplakia is actually not a very common condition. It affects less than 5% of the world's population. So, if you have it, it's relatively rare.
What are the symptoms of Leukoplakia?
The main symptom of leukoplakia is white patches that form inside the mouth and cannot be removed. These patches:
- It can occur on your tongue, gums, and inside your cheeks .
- It may appear flat or slightly raised and thickened on the surface .
- It can also appear as white, gray, or white with small red dots (speckled leukoplakia).
- There is usually no pain , but sometimes you may feel a little discomfort and sensitivity when eating or drinking something hot.
What are the causes of Leukoplakia?
There are several main causes of leukoplakia.
- Chronic irritation of the tissues inside the mouth: This is the main cause.
- Tobacco use: Smoking, chewing tobacco (such as chewing betel leaves, lime, and tobacco), and using smokeless tobacco. The chemicals released by these can damage the delicate lining of the mouth.
- Excessive alcohol consumption: Drinking alcohol regularly and in excess is also a major risk factor. The risk is even higher for someone who both smokes and drinks alcohol.
- Mechanical abuse: Things like ill-fitting dentures, the sharp edge of a broken tooth constantly rubbing against the cheek or tongue, and habitual cheek biting.
- Genetic factors: Sometimes, random changes (mutations) in some genes in our body can cause the tissue cells in the mouth to divide faster than normal, causing these spots to form.
- Some viral infections: The previously mentioned oral hairy leukoplakia seems to be caused by the Epstein-Barr virus.
What things increase the risk of developing leukoplakia?
In addition to the reasons mentioned above, these things may increase your risk of developing leukoplakia:
- Smoking or chewing tobacco and smokeless tobacco use: This is the biggest risk factor.
- Frequent heavy drinking.
- Having certain medical conditions that affect your immune system , such as Epstein-Barr virus or HIV.
- Age: This condition is more common in people over 40 years of age, especially men.
Think about it, aren't there some of our friends who use tobacco like that with betel nuts? Or people who smoke cigarettes every day? People with such habits are at higher risk. Therefore, it is very important to stay away from these habits.
How do doctors diagnose leukoplakia?
When you see a dentist or general practitioner because you have a white spot in your mouth, the first thing they will do is examine your mouth carefully. They will look at the unusual white spot and note its size, shape, location, and texture. They will try to find out what is causing your symptoms. For example, if you use a denture, they will check to see if it is stuck in your mouth and rubbing against your gums or cheek.
Then, a biopsy is often recommended. This means that a small piece of tissue (tissue sample) is removed from the mole and sent to specialists called pathologists to be examined under a microscope. Only then can we determine exactly what the condition is, what changes (`dysplasia`) are in the cells, and how likely it is to develop into cancer.
Should every spot suspected of being leukoplakia be biopsied?
Yes, that's usually what's recommended. A biopsy is the only way to know for sure whether you have leukoplakia, which can develop into oral cancer, or whether it's just a harmless condition. So if your doctor suggests a biopsy, it's important to be supportive and not afraid.
What are the treatments for Leukoplakia?
Leukoplakia is treated by removing the spots in the mouth. However, the treatment method is determined by considering many factors, such as the nature of the spot, the results of the biopsy report, and the risk of the spot turning into cancer.
- Treating the cause: The first step is to eliminate the cause of the leukoplakia, if it can be identified. For example, if you smoke, stop smoking, or if you have a dental problem, correct it. Sometimes, once the cause is eliminated, the spot may disappear on its own.
- Surgical removal of the scar:
- Doctors may use a scalpel , a sharp knife like the one used in surgery, to cut out and remove the spots.
- Laser removal is also often used to remove spots . This reduces bleeding and heals faster.
- Using a method called cryotherapy . This involves using extreme cold (like liquid nitrogen) to freeze and destroy the abnormal cells, thereby removing the spots.
- Removing spots using an electrically heated needle or other device (electrocauterization).
- Other treatments: Sometimes, topical or oral medications such as vitamin A (retinoids) can be used, but these are not suitable for everyone due to side effects. Photodynamic therapy, which uses light to treat cancer, is also used in some cases.
Even after treatment, leukoplakia can recur, so it is very important to have regular follow-up appointments as directed by your doctor.
Can Leukoplakia be prevented?
Leukoplakia is not always completely preventable because the exact cause is not always known. However, we do know that the condition is strongly linked to tobacco use and alcohol consumption. So, you can do these things to reduce your risk:
- Avoiding tobacco use completely. This includes smoking, chewing tobacco, and smokeless tobacco. This is the best thing you can do.
- Limiting the amount of alcohol you drink, or quitting altogether. According to the American Cancer Society's guidelines, if you do drink alcohol, men should have no more than two drinks per day and women should have no more than one drink per day.
- Eating a balanced diet. Eating more fruits and vegetables is good for your oral health as well as your entire body.
- Taking care of your oral health is important. Brushing your teeth daily and getting regular checkups with a dentist are important.
Can Leukoplakia recur?
Yes, it can happen. Studies show that after leukoplakia is removed, there is a 10% to 20% chance that it will come back. Sometimes it can grow back in the same place it was before, or in a different part of the mouth. That's why it's important to continue to see your doctor after treatment.
Will Leukoplakia get better on its own?
Usually, no, it doesn't. Leukoplakia spots can be removed surgically, especially if they are large or if a biopsy shows changes in the cells (dysplasia). However, sometimes, small spots can gradually fade once the cause of the irritation (e.g. smoking, a broken tooth) is removed. However, this should be done under the supervision of a doctor.
When should I see a doctor?
If you notice a new white spot, a red spot, or a mixed white and red spot inside your mouth, especially if it has been there for more than two weeks, be sure to see a dentist or general practitioner.
If you have had surgery to remove leukoplakia, your doctor will likely recommend that you come in for regular follow-up appointments for several years. Usually every 3-6 months or once a year. Also, don't forget to see your dentist every six months for regular dental checkups.
What questions should I ask the doctor?
If you have leukoplakia, you can ask your doctor these questions to get a better understanding of the condition:
- What type of leukoplakia do I have?
- What could be the reason for this?
- What kind of treatment do you recommend? Why?
- Will these spots go away completely with treatment?
- Are there any side effects of the treatment? What are they?
- What is the chance that this leukoplakia will turn into oral cancer?
- What are the chances of it happening again? What should I do if it happens?
- What can I do to reduce my risk of developing oral cancer?
- How often do I need to come for tests?
Finally, a few things to remember
Leukoplakia is a condition that causes white patches to form on your tongue, gums, or inside your cheeks. These patches are painless, but they don't go away on their own. Although leukoplakia may seem harmless at first glance, there is a chance that this condition could develop into oral cancer.
So, if you see white spots, red spots, or a sore that doesn't heal inside your mouth, and it's been there for more than two weeks, be sure to tell your dentist or general practitioner.
He or she will examine your mouth and, if necessary, refer you to a specialist for further testing and treatment. Recognizing these things early, getting proper treatment, and following your doctor's instructions are the best ways to protect your health. Don't panic, but it's important to be aware.
` leukoplakia, white spots in the mouth, oral cancer, oral cancer, smoking, alcohol, dentist
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