Leukoplakia

There are four types of leukoplakia:

• Homogenous leukoplakia: The patch appears uniformly white, muddy and is slightly raised from the surface. It is either present as a single patch or multiple patches. The lesion can appear as ulcerated, smooth or fissured (cracked).
• Non-homogenous leukoplakia: The patch appears white and red in colour and is medically called erythroplakia. The lesion appears as a white nodule with a red base and shows proper markings.
• Granular or nodular leukoplakia: The patch is completely white in colour but does not have a smooth base. The base is granular and nodes (speckles) may be present.
• Verruciform leukoplakia: The patch is white in colour but has a deep cleft in it. The lesion grows outward beyond the base. It is the most aggressive form of leukoplakia. 

There is one other kind of leukoplakia called hairy leukoplakia, which is not associated with the use of tobacco. Hairy leukoplakia is caused due to the Epstein-Barr virus. It has been reported in people with a poor immune system. It looks like white towel-like patches on the sides of the tongue. The lesion appears folded and ridged.

Leukoplakia is usually seen in the third or fifth decade of life and is more prevalent in men. The symptoms of leukoplakia are:

• A white patch that can be present on the mucosa (inner side) of the cheeks, tongue, commissure (corner) of the lips or roof of the mouth.
• The patch is slightly raised from the surface
• The patch does not scrape off on rubbing
• The lesion is painless
• The patch can be a little red sometimes 

A person should immediately consult a doctor if any of the following happen:

• The patch starts growing outwards
• The patch gets hard and firm
• Nodules start appearing on the patch
• There is ulceration on or around the patch
• There is bleeding from the patch

Leukoplakia usually occurs due to the consumption of tobacco. It is usually seen in people who chew and smoke various forms of tobacco. The other causes that can lead to leukoplakia are:

• Oral fungal infection (oral candidiasis or thrush)
• Alcohol consumption
• Ill-fitted dentures
• Radiation therapy
• Deficiency of vitamin A
• Primary syphilis (a sexually transmitted disease)

You can prevent leukoplakia in the following ways:

• Completely quit the use of both chewable and smoked tobacco, as it is the major cause of leukoplakia in people.
• Reduce your alcohol consumption to prevent leukoplakia.
• Brush your teeth regularly to keep the bad bacteria away from your mouth. (Read more: Oral hygiene tips)
• Gently massage your gums with your fingers to keep them clean and also to help the blood circulation get better.
• If you wear dentures, make sure that they are properly fitted. If not, then contact your dentist and get them fixed.
• Eat a balanced diet rich in vitamin C, vitamin A and minerals to maintain the health of the oral cavity.
• Visit your dentist every six months to make sure that your oral cavity is healthy.

Leukoplakia can be diagnosed in the following ways:

• Oral examination: Your dentist will be able to diagnose the lesion just by doing a regular oral examination. The doctor would take your detailed medical history and would ask about the duration and frequency of consuming tobacco.
• Biopsy: If your doctor suspects that the patch may have cancerous cells, then they may recommend a biopsy of the patch.

The first step in treating leukoplakia would be to stop using tobacco. Recovery can only be seen if the person quits the habit.

Read more: How smoking affects your teeth, gums and mouth

The treatment of leukoplakia can be done in one of these ways:

1. Drug treatment for leukoplakia
2. Surgical treatment for leukoplakia