Leukoplakia causes thick white or gray patches inside the mouth that can’t be scraped off. Most patches are not cancer, but Mayo Clinic notes some show early signs of cancer, and mouth cancers can form next to them. That’s why any patch that doesn’t go away deserves a professional look.
What it looks like
Mayo Clinic says leukoplakia usually appears on the gums, the insides of the cheeks, under the tongue and sometimes on the tongue. It’s usually painless and may go unnoticed. Patches can be:
- white or gray and impossible to wipe away
- rough, ridged, wrinkled or smooth
- irregular in shape and edges
- thick or hard, sometimes slightly raised (MedlinePlus)
MedlinePlus says patches can hurt when they touch acidic or spicy food.
Speckled leukoplakia
White patches mixed with raised red areas (erythroplakia) are called speckled leukoplakia. Mayo Clinic says these are more likely to show changes that may lead to cancer.
Hairy leukoplakia
Fuzzy white patches, usually on the sides of the tongue, caused by the Epstein-Barr virus. Mayo Clinic says it mainly affects people with weakened immune systems, especially HIV/AIDS, and may be an early sign of HIV. It’s often mistaken for oral thrush, whose creamy patches can be wiped away. Hairy leukoplakia is not likely to lead to cancer.
Causes and risk factors
The exact cause isn’t known. Both sources point to ongoing irritation:
- Tobacco, smoked or smokeless. Mayo Clinic says it appears strongly related to many cases, often where tobacco is held between gum and cheek. MedlinePlus notes pipes especially.
- Betel (areca) nut held in the cheek (Mayo Clinic).
- Long-term, heavy alcohol use. Combined with tobacco, the risk rises further.
- Rough or broken teeth, and rough or poorly fitting dentures, fillings or crowns.
MedlinePlus says it is more common in older adults. See smoking, vaping and oral health and alcohol and oral health.
When to see a dentist or doctor
Mayo Clinic advises an appointment for:
- white patches or sores that don’t heal on their own within two weeks
- lumps, or white, red or dark patches in the mouth
- mouth changes that don’t go away
- ear pain, trouble swallowing or trouble opening the jaw
Diagnosis and treatment
MedlinePlus says a biopsy confirms the diagnosis and may find changes that indicate oral cancer. Treatment aims to get rid of the patch:
- Remove the irritation: have rough teeth, dentures and fillings fixed promptly, stop tobacco and avoid alcohol.
- If that doesn’t work, a provider may apply medicine to the patch or remove it surgically.
- Hairy leukoplakia usually clears with antiviral medicine.
MedlinePlus says patches often clear within weeks or months after the irritation is removed. Mayo Clinic cautions that the risk of mouth cancer remains even after patches are removed, so keep up follow-up visits. See our oral cancer screening guide.
Prevention
Mayo Clinic says avoiding all tobacco products and alcohol may prevent leukoplakia. If you continue to use them, have frequent dental checkups. Mouth cancers are usually painless until advanced. MedlinePlus adds having rough teeth treated and dental appliances repaired. See how often to see the dentist.
Frequently asked questions
Is leukoplakia cancer?
Usually not. But Mayo Clinic says some patches show early signs of cancer, so get any persistent patch checked.
Can I scrape it off?
No. Leukoplakia can’t be scraped or wiped away. Thrush often can.
Sources
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Basic dental screening 150218-N-QK202-017” by U.S. Navy, via Wikimedia Commons, in the public domain. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.