Approximately 0.5% of the world population may be affected by oral leukoplakia. Leukoplakia is a painless lesion which appears in the mouth usually in adult life and increases with age. Also, leukoplakia is six more times common in smokers than non-smokers. A large proportion of oral cancers are associated with longstanding oral leukoplakia.
Leukoplakia develops as a response to chronic irritation. The typical white patch of leukoplakia develops slowly, over weeks to months. An early lesion is a grey-white and elevated. The most common site affected is the inside cheeks and then gums, lower lip, floor of mouth (under tongue), sides or undersurface of tongue. The lesions may be leathery, smooth, wrinkled, corrugated or have shallow cracks. The lesions may eventually become rough in texture, and may become sensitive to touch, heat, spicy foods, or other irritation.
"Hairy" leukoplakia of the mouth is an unusual form of leukoplakia that is seen mostly in HIV-positive people. It may be one of the first signs of HIV infection. It can also appear in others when their immune systems are not working well, such as after a bone marrow transplant. It may be caused by the Epstein-Barr virus or lupus.
The goal of treatment is to eliminate the lesion. Removal of the source of irritation is important and may lead to disappearance of the lesion. For example, rough teeth, irregular denture surface or fillings should be treated as soon as possible. And smoking or other tobacco use should be stopped immediately.
Leukoplakia is usually harmless and lesions usually clear in a few weeks or months after the source of irritation is removed.
Approximately 3% of leukoplakia lesions develop cancerous changes. Classic changes of cancer are ulceration, hardness, bleeding and/or tumor outgrowth. A biopsy of the lesion confirms the diagnosis. An examination of the biopsy specimen may find changes that indicate oral cancer. There may be no change in appearance or symptoms in the early stages of cancer development.
Surgical removal of the lesion may be necessary.