When thick white or gray patches form in the mouth, many individuals believe it to be a form of plaque or thrush. But unlike plaque, these patches can't be washed or brushed away. They're a sign of leukoplakia, a potentially cancerous condition that can occur in anybody. It's a complicated disease with several potential causes, including substandard dental care. 

What Causes Leukoplakia?

The condition is tied to long-term alcohol or tobacco use. Individuals who routinely bite the inside of their cheeks injure the tissue, making the disease more likely to form. 

Jagged teeth, or ill-fitting fillings, crowns, and dentures, will irritate the inside of the cheeks or an individual's gums, increasing the disease’s chances of developing. 

Hairy leukoplakia may develop in those with the Epstein-Barr virus (EBV). It forms similar white-gray patches that have a fuzzy texture. Outbreaks are common in immunocompromised patients, especially those with HIV. 

Often, the patches don't cause permanent tissue damage and usually are found to be benign. However, they can lead to oral cancers forming. Even after the patches are removed, the increased oral cancer risk remains. 

What Are the Symptoms? 

Leukoplakia affects the mucosal tissue in the mouth. The irritation allows for the patches to form inside the cheeks, the gums, on or under the tongue, or on the lips. If there are red spots inside the patches, it may be a sign of oral cancer. While they vary in appearance, their colors remain the same, and are thick, hard, and raised. Even a tongue scraper won't remove them. 

Individuals may experience ear pain when swallowing. Over time, the mouth's tissue will begin to change, and it will become more difficult for the jaw to open. 

How Is Leukoplakia Treated & Prevented? 

Dentists will use a numbing agent on the mouth to prevent discomfort. They'll then remove the patches using a fine scalpel, laser treatments, or a cryoprobe to freeze and destroy the cells. 

They will likely test for HIV and run an oral brush biopsy or an excisional biopsy to confirm the patches are noncancerous. 

Those who have been treated for leukoplakia should prioritize their dental care, as they will be prone to recurrences. 

Hairy leukoplakia is treated through antiviral medications that suppress EBV, causing the patches to fade.

However, the best treatment is prevention. By maintaining twice-yearly dental check-ups, quitting tobacco products, and limiting alcohol intake, the chances of developing leukoplakia will remain remote. 

For nearly 20 years, the families of Olive Branch, MS, have relied on Bradley M. Stewart, DMD, for their dental care needs. From routine cleanings to restorative and cosmetic work, he takes pride in maintaining and improving his patients' health and smiles. Dr. Stewart continually takes classes to further his education and learn new techniques to provide the best possible care. For his quality work and dedication, Dr. Stewart was honored to become a member of the Mississippi Dental Association. For more information on his practice, visit his website. To schedule an appointment, call (662) 893-5800.