Leukoplakia is a condition when thick and white patches that cannot be scraped of, form on the inside of the cheeks, bottom of the mouth or the tongue. The cause of leukoplakia is not known, but doctors consider tobacco one of the key malefactors. Leukoplakia although not dangerous, sometimes can be serious. Most of the patches are noncancerous. However , some can show early signs of cancer. A lot of cancers appear around places with leukoplakia such as cancers beneath the tongue, on the floor of the mouth, so it is important to visit a dentist regularly to inspect any possible, unusual and persistent changes in the mouth.



The patches of leukoplakia can differ in appearance. They usually appear on the gums (the inside of the cheeks), the bottom of the mouth or the tongue and cannot be wiped away. They can be:

  • White or grayish
  • Flat of with irregular texture
  • Thick and hard in some parts
  • Along with red and raised lesions (which may show precancerous changes)

There is a type called hairy leukoplakia. It usually affects people with weak immune systems due to use of medications or having another disease, especially HIV/AIDS. This kind of leukoplakia is manifested with white ridges on the side of the tongue.

A person should visit the dentist if something of the following is noticeable:

  • White sores in the mouth that do not heal up to 15 days
  • white, red or dark lumps
  • Consistent change of the mouth tissue



The use of tobacco seems to be the most responsible factor for causing leukoplakia. Regular users of tobacco products have leukoplakia patches developed on the places on the cheeks where the tobacco is held. Constant use of alcohol or other chronic irritants can be also associated to leukoplakia.

The hairy leukoplakia results from infection with the Epstein-Bar virus (EBV). The EBV virus stays in the body for life. The virus is dormant, unless the immune system is weak because of some disease or medications when the virus can be reactivated. If the virus is reactivated it can result with hairy leukoplakia.

People with HIV/AIDS are more prone to hairy leukoplakia. Although the number of cases is reducing over the years, a lot of HIV-positive people still have leukoplakia. Leukoplakia can show as one of the primary symptoms of HIV infection.


Risk factors

Tobacco use as well as smoking combined with it increases the risk of leukoplakia.



Leukoplakia isn’t always serious. It doesn’t damage the mouth tissues permanently. However, it can refer to potential oral cancer as cancers in the mouth often form near the leukoplakia patches. Even if the leukoplakia patches are removed, the chances for cancer remain still. On the other hand, the hairy leukoplakia isn’t painful and doesn’t indicate cancer, but it may be a sign of HIV/AIDS.



If stopping tobacco and alcohol use doesn’t resolve the condition, and there are early signs of cancer, the dentist can recommend treatments including: removing the leukoplakia patches using a scalpel, laser or cryoprobe treatment that freezes and destroys cancer cells; as well as regular visits as recurrence of the condition is possible. The treatments are most effective when the injury is treated early.

Normally, there is no need for treatment of hairy leukoplakia as it is symptom free and doesn’t refer to mouth cancer.  The doctor may recommend systemic or topical medication. However, when the treatment ends, the leukoplakia may reappear. That’s why it is advisable to visit the dentist regularly in order to monitor the condition for any possible tissue changes or reoccurrence of leukoplakia.



Leukoplakia may be prevented from occurring if tobacco products and alcohol use are avoided.