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Leukoplakia

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  3. Leukoplakia

Overview of Leukoplakia

Leukoplakia is a condition in which the person suffers from the formation of white patches on the gums, inside the cheeks, the bottom of the mouth, and in some cases the tongue. It is impossible to get rid of these patches as they can be scraped off. 

People need to pay attention to these white formations because they can eventually transform into cancerous mutations. It is estimated that within 15 years about 3 to 17.5% of people who have leukoplakia can develop squamous cell carcinoma which is a common type of skin cancer. 

Signs and Symptoms of Leukoplakia

Leukoplakia is a disease that is not very painful and may go unnoticed after a while. Leukoplakia may appear in the following forms:

  1. White gray patches that do not get scrapped 
  2. Irregular or flat-textured white formations 
  3. Thick and hard white formations 
  4. Alongside raised or red lesions that are likely to show precancerous changes 

Types of Leukoplakia

Given below are the main types of leukoplakia:

  1. Homogenous 

In this type of leukoplakia, there is an even and mostly white-colored thin patch formation. This white formation has a smooth or in some cases wrinkled appearance that remains the same throughout its formation. 

  1. Non-homogenous 

 In this type of leukoplakia, there is a formation of white or white-red irregularly formed patches. Sometimes they can be flat formations and sometimes they can be in the form of nodules.  Non-homogenous leukoplakia is seven times more likely to cause cancer than homogenous leukoplakia.

  1. Proliferative Verrucous Leukoplakia 

It is a rare and aggressive type of leukoplakia. The presence of Epstein-Barr is responsible for this type of leukoplakia. All the cases of this type of leukoplakia become cancerous at potentially different sites.  The rate of recurrence of PVL is also quite high. 

Causes of Leukoplakia

Given below are some of the known causes of leukoplakia:

  1. Heavy smoking 
  2. Continuously chewing tobacco 
  3. Chewing areca nut 
  4. Heavy alcohol consumption 

Idiopathic leukoplakia is a type of leukoplakia that has no known cause. Men are most susceptible to this disease, especially those who are around the age of 50 and 70. Less than 1% of the patients belong to the age group of 30.

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Risk Factors of Leukoplakia

Given below are some risk factors that lead to the onset of leukoplakia:

  1. HPV increases the risk of leukoplakia transformation into oral cancer.
  2. Poor or low dental hygiene maintenance
  3. Excessive dependency on alcohol 
  4. Chewing tobacco 

Leukoplakia Complications

Although leukoplakia does not cause any permanent damage to the tissues in your mouth. But untreated leukoplakia can increase the chances of oral cancer. The formation of oral cancers mostly occurs near the white patches of leukoplakia. These patches may also show some cancerous mutations if they are left untreated for a long period of time. Even after the proper treatment of leukoplakia, the risk of oral cancer is still there.

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Prevention

The preventive measures for leukoplakia are not concrete. Some of the best strategies to prevent the onset of leukoplakia are given below:

  1. Quit smoking
  2. Do not chew tobacco in any shape or form 
  3. Try to eat a nutrient-rich diet 
  4. Remember to make healthy lifestyle choices 
  5. Take care of your oral hygiene 
  6. Do not shy from regular checkups with your doctor
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Diagnosis

The patches of leukoplakia do not cause any symptoms. Most of the time they are noticed during a physical checkup by your healthcare provider. The doctor does not always conclude the onset of leukoplakia. They start with inspecting the friction inside the mouth which is followed by repeated cheek biting as well as fungal infection. 

If the doctor is unable to find the root cause and the white patches are still there after a week or two, then a biopsy is suggested.

In case the biopsy also fails to show a clear diagnosis then the white patches are confirmed as leukoplakia. It is important to note here that leukoplakia has the potential to lead to oral cancer. But if the cancer cells are found then it is a diagnosis of cancer and not leukoplakia. 

Treatment of Leukoplakia | When to Consult a Doctor

Prevention of leukoplakia from becoming cancer is the main goal of treatment. But the treatment of leukoplakia is a challenge in itself. The remedies may succeed in removing the lesions but they can return with the passage of time. 

Surgical Treatments

Some given surgical methodologies are used to treat leukoplakia:

  • Surgical removal of lesions. But this comes with a  10% to 20% chance that they might make a return. 
  • Laser lesions removal.
  • Photodynamic therapy; involves the use of light-activated cancer drugs 
  • Use of freezing therapy to remove the lesions; cryotherapy 
  • Electrocauterization; is the use of an electrically heated needle to remove the lesions  

Medications 

The doctor may suggest you take some antiviral drugs so that the Epstein-Barr virus can be suppressed.  Vitamin A and beta-carotene supplements are also suggested. Isotretinoin supplements are also considered to be effective in preventing the transformation of leukoplakia into oral cancer. 

Follow Up Visits 

 

Once the patient has stopped the treatment, these white matches can make a return. Thus your doctor may also suggest a regular follow-up session so that they can monitor your oral hygiene status. 

 

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