What are the other Names for this Condition? (Also known as/Synonyms)

• Leukoplakia of Mouth
• Leukoplakia of Oral Mucosa

What is Oral Leukoplakia? (Definition/Background Information)

• Oral Leukoplakia may be described as benign or pre-malignant condition that manifests as a white patch on the mucosal surfaces of the mouth. It may arise from a variety of factors, chiefly smoking. Other causes include fungal infection, repeat oral trauma, or vitamin deficiency
• A treatment of Oral Leukoplakia is dependent on treating the underlying causative factor. Individuals with benign white patches may have better prognosis than those with premalignant lesions

Who gets Oral Leukoplakia? (Age and Sex Distribution)

• The presentation of symptoms of Oral Leukoplakia may be noted in both children and adults
• Both males and females may be affected
• Worldwide, individuals of all racial and ethnic groups may be affected

What are the Risk Factors for Oral Leukoplakia? (Predisposing Factors)

The risk factors for Oral Leukoplakia may include a wide variety of factors such as:

• Alcohol use
• Betel nut chewing; chewing tobacco
• Carcinoma in situ of the mouth (oral cavity)
• Chronic smoking resulting in nicotine stomatitis
• Cutaneous lupus erythematosus
• Frequent lip or cheek biting (habitual biting)
• Frictional keratosis
• Human papillomavirus (HPV) infection of the mouth
• Oral candidiasis
• Oral cavity lichen planus
• Sanguinaria - oral toothpaste (herbal) extract
• Trauma such as from a broken tooth or misaligned teeth
• Vitamin and iron deficiencies
• Weakened immune system

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Oral Leukoplakia? (Etiology)

In a majority of cases, Oral Leukoplakia develops from an underlying cause.

• Oral Leukoplakia is not termed as a disease or disorder, but rather as a reactive development to an underlying causative factor that includes oral trauma, infections, alcoholism, and oral mucosal malignancies
• However, smoking or chewing tobacco is the biggest predisposing factor for the condition. Chronic smokers have a 6-times higher risk than non-smokers for Oral Leukoplakia

What are the Signs and Symptoms of Oral Leukoplakia?

The size, location in the mouth, and appearance of Oral Leukoplakia may depend on the underlying condition. The signs and symptoms may include:

• A white plaque/patch that cannot be scraped off in any part of the mouth
• This may affect the tongue, gums, and inner cheeks (mucosal surfaces)
  • When the inner cheeks are affected, it is known as leukoplakia buccalis
  • When the tongue is involved, it is known as leukoplakia lingualis
• The patches may turn into fluid-filled blisters, which may rupture on trauma and ooze pus or serum
• Mouth dryness
• Rough-surfaced tongue
• Sensation of metallic or bitter taste in the mouth; partial or total loss of taste
• Numbness and tingling sensation may be felt
• Mouth pain, pain in the tongue
• Eating, chewing, and swallowing difficulties

Additionally, the signs and symptoms of the underlying causative condition, if any, may be noted.

How is Oral Leukoplakia Diagnosed?

Oral Leukoplakia is diagnosed on the basis of the following information:

• A thorough physical examination and a complete personal and family medical history
• Oral examination
• Laboratory tests and imaging studies, as necessary, to detect the underlying cause
• Tissue biopsy: A tissue biopsy of the lesion is performed and sent to a laboratory for a pathological examination, who examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. A tissue biopsy is often necessary to establish a diagnosis

A differential diagnosis may be necessary to eliminate other conditions that present similar signs and symptoms. These may include:

• Dyskeratosis congenita (in children)
• Hidrotic ectodermal dysplasia (in children)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Oral Leukoplakia?

The complications of Oral Leukoplakia may include:

• Emotional stress
• Increased risk for development of oral cancer
• Complications of the underlying causative condition, if any present

Complications may occur with or without treatment, and in some cases, due to treatment also.

How is Oral Leukoplakia Treated?

The treatment for Oral Leukoplakia is strongly dependent on managing or treating the underlying cause.

However, based on cause and the biopsy results, the healthcare provider may recommend the following:

• Surgical excision of the lesion
• Laser therapy to destroy the lesion
• Use of freezing temperatures to destroy cells in the plaque (cryotherapy)

Regular medical screening at periodic intervals with tests and physical examinations are recommended.

How can Oral Leukoplakia be Prevented?

The exact cause of Oral Leukoplakia is not known, and therefore, no methods or guidelines are available for its prevention at the present time

• However, addressing risk factors, such as smoking and alcohol consumption, may decrease the likelihood of developing the condition
• Active research is currently being performed to explore the possibilities for treatment and prevention of conditions such as Oral Leukoplakia

What is the Prognosis of Oral Leukoplakia? (Outcomes/Resolutions)

The prognosis of Oral Leukoplakia is dependent upon the nature of the underlying cause and its severity. Typically, the prognosis may be assessed on a case-by-case basis.

• Approximately, the lesion is pre-cancerous or cancerous in 25% of cases, at the time of biopsy. Of these, about 8-15% are known to become cancerous over time
• In cases where the condition is benign, discontinuing tobacco habit leads to clearing of the plaques

Additional and Relevant Useful Information for Oral Leukoplakia:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/