Leukoplakia are white patches that develop on the soft tissue of the mouth. This can include gums, tongue, or inner cheeks. The patches form over the course of weeks or months.
There are different types of leukoplakia that may appear in different areas of the body, such as the vulva in females, esophagus, or bladder. The information in this fact sheet will focus on oral leukoplakia.
Leukoplakia usually results from irritants, such as:
- Smoking, including cigars and pipes
- Smokeless tobacco, including chewing tobacco or snuff
- Rough teeth
- Rough places on dentures, fillings, or crowns
Leukoplakia is more common in men after age 65. Other factors that may increase your chance of leukoplakia include:
- Tobacco use, especially smokeless tobacco
- Long-time alcohol use
- Suppressed immune system, which can occur with chronic health conditions or medications
Leukoplakia causes patches on the tongue, gums, or inside of the cheeks. These patches may appear as:
- White, gray, or red in color
- Thick, slightly raised, or hardened on the surface
There may be pain or signs of infection. The patches may also be sensitive to touch, heat, or spicy foods.
In some cases, leukoplakia looks like oral thrush, which is an infection also associated with HIV infection and suppressed immune function.
Oral Thrush—Resembles Leukoplakia
Untreated leukoplakia can turn into cancer. Some types of leukoplakia carry a higher risk of turning into cancer than others. If you have leukoplakia, talk to your doctor about your cancer risk and how often you should be evaluated or tested.
Your doctor will ask about your symptoms and medical history. A physical exam will be done, including the area where the patches are. In most cases, oral leukoplakia can be diagnosed during an oral exam. Your doctor may do a brush biopsy to check for cancer. The biopsy sample is evaluated under a microscope.
Talk with your doctor about the best treatment plan for you. Treatment options include:
- Removing the irritant—Quitting smoking or correcting dental problems often takes care of the problem.
- Removing patches—If the problem persists, or if signs of cancer are present, your dentist or doctor may need to remove patches of leukoplakia. This may be done with surgery, laser treatment, electrocauterization, or freezing.
If the patches do not fade as expected, your doctor may advise:
- Topical medications or solutions that are applied to the patches
- Medicated mouthwashes
- Oral medications, such as retinoids, vitamin A, beta carotene, or lycopene
- Antiviral medications—if the leukoplakia is due to viral infection (more common in people with suppressed immune function)
To help reduce your chance of leukoplakia:
- If you smoke, talk to your doctor about how you can successfully quit.
- Avoid or limit your use of alcohol.
- See a dentist regularly, especially if you have rough places in your mouth.
Mouth Healthy—American Dental Association
National Institute of Dental and Craniofacial Research
Canadian Dental Association
Canadian Dental Hygienists Association
Epstein-Barr virus (EBV) infection. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 24, 2014. Accessed June 11, 2015.
Hairy leukoplakia. DermNet NZ website. Available at: http://dermnetnz.org/site-age-specific/hairy-leukoplakia.html. Updated December 29, 2013. Accessed June 11, 2015.
Oral hairy leukoplakia. AETC National Resource Center website. Available at: http://aidsetc.org/guide/oral-hairy-leukoplakia. Accessed June 11, 2015.
Parlatescu I, Gheorghe C, Parlatescu E, Tovaru S. Oral leukoplakia—An update. Maedica (Buchar). 2014;9(1):88-93.
Last reviewed June 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.