Leukoplakia: definition, symptoms, causes, treatment

Definition

What is leukoplakia?

Leukoplakia is a type of oral problem in the form of whitish or gray patches that appear on the inside of the mouth walls, gums, or tongue.

Sometimes, leukoplakia not only causes white patches, but also makes the surface of the tongue rough or hairy. This condition is called oral hairy leukoplakia (OHL).

These whitish spots can form due to several factors. However, the most common cause of this condition is long-term consumption of tobacco such as cigarettes.

Apart from cigarettes, improper installation of dentures and the habit of biting the inside of the cheeks also has the potential to cause these blotches.

Leukoplakia occurs as a result of the mouth's reaction to chronic irritation of the mucous membranes of the mouth. This condition is different from other oral problems that have similar symptoms, such as canker sores or lichen planus, because it has the potential to develop into oral cancer.

However, not all cases of leukoplakia turn into oral cancer. Instead of being a medical condition, leukoplakia is the name for various kinds of white sores on the mouth.

The chances of cancer appearing depend on the size, shape, and presence of abnormal cells in the mouth. Your dentist can order a biopsy if the area looks dangerous.

How common is leukoplakia?

Leukoplakia is a fairly rare mouth problem. This condition is considered risky and can develop into cancer. Within 15 years, squamous cells were found in 3 to 17.5 percent of leukoplakia sufferers.

This mouth problem is more common in elderly patients who are in the age range of 40 to 70 years. The incidence of this disease in patients in their 20s is relatively low.

In addition, this disease is more common in male patients than female patients, with a male to female ratio of about 2: 1.

Leukoplakia is a condition that can be treated by controlling the existing risk factors. To find out more information regarding this condition, you can consult a dentist.

Type

What are the different types of leukoplakia?

Leukoplakia can be divided into several types. The following is an explanation of each type of leukoplakia, including:

1. Homogenic

The spots in this type have an even white color, soft, wrinkled, and rough texture. The shape of the ibi homogeneous spots resembles the spots found in common canker sores.

2. Nonhomogenic

The non-homogenic patches are white and red in color, patchy, textured like small lumps (nodular) and arise. This type of leukoplakia is 7 times more likely to develop into cancer cells.

3.

PVL or what is called fluorid papillomatosis, is one of the rarest subtypes of nonhomogenic and develops rapidly compared to other types.

The spots found in PVL are believed to be an infection of the Epstein-Barr virus, a type of herpes virus. Sometimes, the spots that appear are accompanied by fine, hair-like fibers. This condition is called oral hairy leukoplakia (OHL).

Signs & symptoms

What are the signs and symptoms of leukoplakia?

The signs and symptoms of this disease can be seen clearly, namely the appearance of changes in the appearance of your gums, the inside of your cheeks, under your mouth, or your tongue. These changes can take the form of:

• White or gray areas that cannot be removed by scrubbing.
• Irregular or flat texture.
• Thickening in certain areas.
• Red sores (erythroplakia), which may indicate a change towards an early phase of cancer.

In some cases, especially the hairy type of leukoplakia, this condition affects people with weakened immune systems due to medication or a disease, especially HIV / AIDS.

Leukoplakia causes white patches and fine hairs to appear. The patches resemble folds or bumps and are found on the side of the tongue.

There may be signs and symptoms not listed above. If you have concerns about certain symptoms, consult your doctor.

When should I see a dentist?

Sometimes the mouth sores can be annoying or painful, even though they are not dangerous. However, in certain cases, problems with the mouth can indicate a more serious condition.

Visit a dentist if you have:

• White plaque or sores in the mouth that don't heal on their own in 2 weeks.
• Lumps or white, red, or dark areas in the mouth.
• Changes in oral tissue.

Each sufferer's body can show signs and symptoms that vary. To get the most appropriate medical treatment and in accordance with your health condition, check with your doctor for any symptoms as soon as possible.

What are the complications that can occur?

Generally, leukoplakia can be treated easily and will not cause permanent damage to the oral tissues.

However, if leukoplakia is not treated immediately, the white patches in the mouth have the potential to increase the risk of developing oral cancer.

Cancer cells can develop from these white patches. Even though the white patches have been cleaned surgically, it is still possible for cancer cells to remain in the mouth.

Cause

What causes leukoplakia?

Until now, experts are still investigating what the exact cause of leukoplakia is. However, it is believed that the cause of leukoplakia is chronic irritation of the mouth.

Long-term irritation of the mouth can cause the tissues inside to become swollen, thickened, and sometimes produce a substance known as keratin.

Keratin is an important protein for maintaining the health of the outer layer of the skin. In addition, keratin plays a role in the formation of the structure of skin cells and protects the skin from injury or injury. This protein also helps heal open wounds on the skin.

White patches in the mouth are generally a symptom of minor injury or injury, and are not always associated with leukoplakia. Here are some factors that can cause mouth sores or injuries.

1. Tobacco

Substances produced by burning tobacco tar and resin can irritate the mouths of active smokers. Therefore, long-term smoking has the potential to trigger the formation of white patches in the mouth.

2. Alcohol

There are side effects from alcoholic drinks that can occur on the body. This is because the ingredients contain the risk of damaging the mucous membrane, which is the inner layer of the skin.

3. Problems with the anatomy of the teeth and mouth

If the shape of the mouth and teeth has birth defects, such as malocclusion or teeth that are too sharp, then the inside of the mouth wall is at risk of being bitten. This also has the potential to cause sores and white patches to appear.

4. Viral infection

Meanwhile for oral hairy leukoplakia , the main cause is Epstein-Barr virus (EBV) infection. Right after infection, the EBV virus will stay in your body for life. However, this virus is usually inactive.

When your immune system is weakened, the EBV virus will reactivate so that it can develop white patches of hairy leukoplakia at any time.

Other conditions that may affect the appearance of leukoplakia include:

• Undergo chemotherapy
• Suffering from HIV / AIDS
• Food or drink that is too hot
• There are mushrooms Candida albicans in the mouth
• Improper installation of dentures or braces
• Lack of maintaining oral and dental health
• The habit of biting the tongue or the inside of the cheek
• Lack of vitamins A and B

Risk factors

What factors can increase your risk of developing leukoplakia?

Leukoplakia is a mouth condition that can occur in almost anyone, regardless of age and racial group. However, there are several factors that can increase a person's risk for developing this condition.

You need to know that having one or more risk factors does not mean that you will definitely suffer from a certain health condition or disease.

In some cases, it is possible for a person to have certain diseases or health conditions without any risk factors.

The following are risk factors that can trigger the appearance of leukoplakia.

1. Age

This health condition is more commonly found in patients aged 50-70 years. About 80% of people with this condition are over 40 years old.

2. Gender

Most cases of the appearance of white patches in the mouth occur in male patients. However, the exact cause of this factor is still not known with certainty.

3. Actively smoking

Tobacco in cigarettes is believed to be the main cause of the appearance of white patches on the mouth.

4. Improper installation of dentures

If you have undergone a denture insertion procedure, but the procedure was done incorrectly, it has the potential to cause irritation of the mouth.

5. Suffering from HIV / AIDS

Diseases that affect the body's immune system, such as HIV / AIDS, can increase a sufferer's risk of developing patches in the mouth. In addition, people with HIV / AIDS also have a higher risk of being exposed to the Epstein-Barr virus infection which can increase the chances of developing leukoplakia.

Diagnosis & treatment

How to diagnose this condition?

In diagnosing this condition, the doctor will perform examinations that focus on the mouth, such as:

• Check for white spots
• Trying to wipe the white patches off
• Discuss medical history and existing risk factors
• Determine what the causes are

When your doctor or medical team believes that the white patches you have are not regular canker sores, you may undergo additional tests in the form of a biopsy.

1. Biopsy

This procedure is done by removing cells from the spots with a small brush. However, the results from this type of biopsy are sometimes not accurate enough to determine if there are cancer cells in the spots.

2. Existential biopsy

In this procedure, the doctor will cut a portion of the tissue from the white patches in your mouth. Then, the tissue will be examined in the laboratory.

What are the treatments for leukoplakia?

The main focus of leukoplakia treatment is to remove the white patches and prevent the condition from recurring at a later time. In addition, eliminating the source or addressing the cause of the irritation also helps the treatment process.

The success rate of treatment will be higher if the spot or wound is found in the early phase, that is, when the size is still small.

So, always try to pay attention to any visible and unusual changes in the mouth area. Then, immediately consult a doctor to get the right treatment.

Treatment usually also focuses on reducing or eliminating the source of the irritation, for example by stopping tobacco or alcohol consumption.

If this method is considered ineffective, the doctor will recommend other treatments.

1. Medicines

You may be prescribed systemic drugs, such as antiviral drugs. These drugs aim to fight the Epstein-Barr virus, especially those found in cases of hairy leukoplakia.

In addition to oral medication, the doctor will also prescribe a topical retinoat or topical medication that is applied directly to the affected skin area.

2. Operation

In some cases, your doctor will recommend that you perform a surgical procedure or surgery to remove the spots. Surgical procedures are performed using scalpels, lasers, or instruments that can freeze and destroy cancer cells (cryoprobe).

3. Further examination

After stopping any medications or surgical procedures, you will need to return to the doctor for further tests. This is important because it is possible that the white patches will reappear at a later time.

Prevention

What lifestyle changes can be made to prevent this condition?

The following are lifestyle change tips that you can follow to treat this condition:

1. Stop smoking

As previously explained, smoking is one of the main triggers for this condition. Therefore, it is a good idea to immediately stop smoking or using other tobacco products.

2. Routinely carry out oral and dental examinations

Make sure you have a regular schedule to visit the dentist, at least every 6 months. This is important so that oral health and hygiene are always maintained, so that you avoid the risk of experiencing this condition.

3. Live a healthy diet

This condition is also associated with a deficiency or deficiency of vitamins A and B. Therefore, add a diet that is healthy, nutritious, and of course rich in both types of vitamins.